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matrixcare and restorative nursing

guereb07 guereb07 (New) New

What is a good way to Implement toileting programs? Realistically, we know the aides are not going to refer to resident profile and think O.K I am going to toilet john smith and etc at 7-8pm and so on....Any ideas?

TheCommuter, BSN, RN

Has 14 years experience. Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

At my workplace, patients on toileting programs are automatically toileted every two to four hours while awake until it becomes a routine. We also limit excessive nighttime fluids to minimize the chance of overnight incontinent episodes.

Patients with indwelling Foley catheters who have orders for bladder training will have their catheter tubing clamped every four hours to promote the feeling of a full bladder.

Straight No Chaser, ASN, LPN

Has 4 years experience. Specializes in Sub-Acute & Long-Term Care Nursing.

hourly rounding, and honestly, just putting the patient on the commode whenever the opportunity presents itself. There is no reason between a nurse and an aide that a patient cant be offered the toilet q2h. I swear, I just want to have a job where I travel and let cnas follow me to see how its done. I never had an issue and I almost always could get through a shift with INCONTINENT patients who were dry the whole time, because I toileted them. I wish they would do away with that word...

It drives me insane ! Like that is basically what needs to be done. I see CNAs just lingering at the nurses station and what even drives me crazier is when I see pairs of them. It does not take 2 people to toilet this person and so forth....Its so sad everyone is an adult and incontinence is not a normal part of aging....But thank you!

When I was an aide we used to go q2 and toilet everyone. Morning ADL's-on the toilet after breakfast-toilet before and after lunch-toilet. Basically all the breaks between personal care and feeding were spent toileting, and those times do wind up falling about 2 hours apart from each other.

Straight No Chaser, ASN, LPN

Has 4 years experience. Specializes in Sub-Acute & Long-Term Care Nursing.

It's awful, I know. I don't understand why so many people are happy to accept their patient is incontinent. To me, all that means is no one toilets them often enough. It seems like a lot of CNAs don't get it, or they don't care. :( It's maddening, because I don't function that way, but I know many who do.

WittySarcasm, BSN

Has 10 years experience. Specializes in rehab.

I agree with everyone q2 he toileting is the best for days. At night you can try to expand it out a little. And try to not push fluids at night. So many are worried that a patient drinks only a glass of water at night. But how much do most people drink? Not a lot.

One facility had bladder training for all foleys and I loved it. I rarely had an incontinent patient after a Foley was pulled. The place I'm at now doesn't do this and all Foley patients are incontinent because their bladders aren't used to it.

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