Assuming you’re not referring to a regular “toileting schedule” as a “bladder retraining program” (see definitions of toileting and bladder retraining in MDS Manual Section H#3 Appliances and Programs), certain criteria have to be met.
The objective of the re-training program is to restore the normal pattern of voiding and continence. Candidates must be mentally and physically capable of toileting themselves, with or without assistance, and motivated to do so. It requires adequate cognitive function, mobility, dexterity, and cooperation.
PROCEDURE: Do Not Use pads/briefs during retraining program.
1. Increase fluid intake between 6:30 am and 8 pm. Encourage toileting every two hours for first 7 days and document results then establish a voiding pattern. Record I&O.
2. Set up a preliminary toileting schedule. When the resident has the urge to void, and it is prior to the scheduled time, instruct the resident to practice deep, slow breathing until the urge diminishes and disappears. Encourage resident to urinate by the clock rather than a response to the urge, not before or after (remember, this is training the bladder to empty when the resident wants it to, not when the bladder wants to).
3. Gradually lengthen the intervals of urination by no more than 15 mins. every 7 days until the resident urinates not more often than every 3 hours.
4. Review and document progress at least monthly. Update CP. Provide rational for extending or discontinuing the program.
The re-training program must be regimented and must be followed closely and may take several weeks to several months. The program shall show a schedule of progressive lengthening or shortening of toileting intervals. At least monthly documentation of progress is required and revisions to care plan indicated. Otherwise, it is simply called a “toileting program.”
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Bowel & Bladder Retraining/Maintenance
