Scheduled toileting program

according to the rai p 3-125, yes ...

"facility staff may list a resident's toileting schedule by specific hours of the day or by timing of specific routines, as long as those routines occur around the same time each day. if the timing of such routines is not fairly standardized, specific times should then be noted."

if resident rises in am at different times, e.g. 8 on mon, 6:30 tues, 8:30 wed, etc., "upon rising in am" becomes non-specific because the routine is not standardized. the actual time should be specified, "toilet @ 6:30 am daily" meaning whether resident is up or not.

also, the 3 key ideas must be captured be in item h3a:

1) scheduled - performing the activity according to a specific, routine time that has been clearly communicated to the resident (as appropriate) and caregivers,

2) toileting - voiding in a bathroom or commode, or voiding into another appropriate receptacle, and

3) program - refers to a specific approach that is organized, planned, documented, monitored and evaluated

often, #3 (documented, monitored and evaluated) is overlooked and picked on. when a resident is continually incontinent at a scheduled time, e.g. 2 pm, there must be documentation of an attempt to change the schedule or modify the resident's activity in an effort to achieve a continent episode.

Why both before and after meals?

We just give hours- 7am,10am,12:30, 4pm, 6:30 pm and PRN work for most patients, others are catered to their unique schedules. We have the CNA sign on the toileting schedule each day.

however, a resident always has a right to refuse- especially if they are sleeping. In my facility, many residents request not to be woken up during the night or in the morning. The CNA's have to wait for the resident to call them to wake up with the exception of resident's who can not communicate their needs

Does someone have a scheduled toileting forms that you use to monitor the toileting program? Just wondering if I could get a copy of it. Our building hasn't done this yet, but Administrator has recently showed interest in giving it a trial on a few patients. Thank you in advance. Tara