Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Background - Prompted Voiding Interventions

Prompted voiding is a behavioural intervention used in the treatment of urinary incontinence. Behavioural interventions for urinary incontinence seek to change the way a person reacts to urine loss (Lyons & Pringle Specht, 1999).  Other examples of behavioural responses to urinary incontinence include:

  • The application of an incontinence product to collect and store urine until a time at which the urine can conveniently be disposed.
  • Emptying of the bladder prior to urine loss.

Prompted voiding differs from the examples above, in that it is the care provider’s, rather than the incontinent individual’s, response to urinary incontinence that is changed. Rather than relying on an incontinence aid or clothing, the caregiver will intervene prior to the undesired bladder voiding. An individualized prompted voiding schedule is determined using a 3-day voiding record that is based on the person’s normal pattern of voiding and/or incontinence. Prompted voiding is used for the treatment of urinary incontinence in persons with physical and/or cognitive deficits, requiring timely reminders to toilet from caregivers. This intervention has been used successfully to treat urinary incontinence in acute and long-term care, as well as in home care settings (Lyons & Pringle Specht, 1999).

Each time prompted voiding is initiated, the care provider uses three primary behaviours:

  • Monitoring: This involves asking the incontinent individual, at regular intervals, if he or she needs to use the toilet. The care provider may look for behaviours that the client needs to be toileted (e.g., restlessness, agitation, disrobing), and take the client to the toilet at regular intervals specific to their schedule, rather than routinely every two hours.
  • Prompting: This process includes prompting the person to use the toilet at regular intervals, and encourages the maintenance of bladder control between prompted voiding sessions.
  • Praising: This important step is the positive reinforcement of dryness and appropriate toileting, and is the response from the care provider to the individual’s success with maintaining bladder control.