Bowel & Bladder Retraining/Maintenance

  1. I work as a RNAC at a 300 bed long term care facility. Recently we had a visit from UMR. They found our facility did not have adequate documentation to support the MDS items-- B&B retraining/maintenance. Can anyone give any further information or e-mail forms that support these items.

    Thank You!!
    Liz
    Last edit by LizGaff on Sep 8, '01
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  2. 20 Comments

  3. by   aimeee
    I'm no longer in LTC, but in the facility I worked at we had a sheet of paper for each day of B/B training. It had all the hours of the day listed down one side and across the page boxes to check showing whether the resident was continent or incontinent of stool and urine and then the CENA initialed and marked the times when the resident was toileted or changed.
  4. by   Talino
    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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  5. by   OneThunder

    Excellent explaination!
  6. by   jkw
    Hi,
    Just finished developing a Bowel and Bladder Program in my facility. I am also an RAI coordinator as well as infection control, wound nurse, and Quality Improvement Coordinator (and anything else that the facility wants me to be!)
    Anyway, I don't have the p&p on my home computer with the forms .
    I also have other programs that I have developed -let me know.
    In Missouri.
    Last edit by Silverdragon102 on Sep 10, '07 : Reason: remove fax number request
  7. by   PROFETA548
    HELP I COULD USE SOME FORMS HERE!!! PLEASE HELP!!! THANKS!! I NEED A NEW TOILET PROGRAM FLOW SHEET!!1 AND OTHERS TOO!!! SKIN MONITORS!!!!! AND ANY OTHERS!!! THANKS:kiss :kiss
  8. by   jnjrn
    Hi from Chicago.
    I would love to get some copies of your forms. We are trying to put together a new programs as our is not meeting the requirements.
    Last edit by Silverdragon102 on Sep 9, '07 : Reason: please do not post your personal contact information
  9. by   benjo113
    Quote from jkw
    hi,
    just finished developing a bowel and bladder program in my facility. i am also an rai coordinator as well as infection control, wound nurse, and quality improvement coordinator (and anything else that the facility wants me to be!)
    anyway, i don't have the p&p on my home computer with the forms but if you have a fax # i will fax them to you.
    i also have other programs that i have developed -let me know.
    in missouri.

    will appreciate if you can contact via pm
    Last edit by Silverdragon102 on Sep 9, '07 : Reason: please do not post your personal contact information
  10. by   jetscreamer101
    Just wanted to let you know the OP last posted in 2003.
  11. by   BoopetteRN
    I am working on a bladder program here, in fact I just finished the powerpoint to train staff regarding incontinence. The forms we are using come from Briggs
  12. by   cschuess
    Quote from jkw
    Hi,
    Just finished developing a Bowel and Bladder Program in my facility. I am also an RAI coordinator as well as infection control, wound nurse, and Quality Improvement Coordinator (and anything else that the facility wants me to be!)
    Anyway, I don't have the p&p on my home computer with the forms but if you have a fax # I will fax them to you.
    I also have other programs that I have developed -let me know.
    In Missouri.

    Could you please send me copies of any forms you may have as well...attn: Cyndy

    Thanks!!
    Last edit by Silverdragon102 on Sep 9, '07 : Reason: please do not post your personal contact information
  13. by   princessB
    Quote from jkw
    Hi,
    Just finished developing a Bowel and Bladder Program in my facility. I am also an RAI coordinator as well as infection control, wound nurse, and Quality Improvement Coordinator (and anything else that the facility wants me to be!)
    Anyway, I don't have the p&p on my home computer with the forms but if you have a fax # I will fax them to you.
    I also have other programs that I have developed -let me know.
    In Missouri.
    could you please fax me any info on the b &b program. I'm also in need of a p & p for this program.
    thank you
    Last edit by Silverdragon102 on Sep 9, '07 : Reason: please do not post your personal contact information
  14. by   stephyscopeRN
    Quote from BoopetteRN
    I am working on a bladder program here, in fact I just finished the powerpoint to train staff regarding incontinence. The forms we are using come from Briggs
    could I get more info from you on your b&b program?

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