Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Communication Techniques with Prompted Voiding Protocol

Approach person at prescribed time.

  • Establishes trusting relationship.
  • Reinforces desired toileting behaviour.

Greet individual by name, introduce self, and state purpose of interaction.

  • "Hello, Mr. Roberts. I am Jane, your nurse. I am here to help you get to the bathroom".

Provide information.

  • "It’s 2:00 – the time we agreed to meet so I could help you. I am here to help you get to the toilet".

Determine how the person informs others of the need to toilet.

  • "Your call light is on – do you need to use the toilet?"

Provide visual cues in the environment to promote desired toileting behaviour.

  • Use a picture of toilet on bathroom door rather than abstract symbols.
  • Leave bathroom door ajar when not in use.
  • Use clocks with large numbers near restrooms to remind staff of toileting schedules.
  • Post toileting schedules where staff will see it to remind them of the need to maintain assigned prompted voiding schedule

Provide for privacy.

  • "Let’s go into the bathroom to check your clothing. I will wait outside the restroom while you empty your bladder."

Ask for permission prior to performing continence check.

  • "Can I help you find out if your clothing is still dry?"
  • "Can I help you find out if your clothing is still dry?"
  • "I want to check your underclothes to see if they are wet - is that okay with you?"
  • "Sometimes it’s hard to remember or realize that you have passed urine. Do you mind if I check to see if you’re still dry?"

Determine person’s awareness of continence status.

  • "Can you tell me if you feel wet or dry right now?"

Ask if person feels the need to void.

  • Encourages the individual to re-learn bladder sensations.
  • "Does your bladder feel full?"
  • "Do you feel pressure in your lower abdomen?"

Prompt person to use toilet. Repeat prompt up to 3 times.

  • "It’s time for you to use the bathroom."
  • "Please use the toilet to empty your bladder."

Use familiar language for toileting behaviour. Be consistent with language.

  • Do you need to empty your bladder/urinate/pee/ make water/use the toilet/etc?

Offer toileting assistance.

  • "Can I help you on to the toilet/bedpan?"
  • "I will leave the urinal with you so you can empty your bladder."
  • "Can I help you clean up/adjust your clothing?"

Give positive feedback at an adult level.

  • "Yes, you are dry. You’re doing a good job with this new plan."
  • "Thanks for reminding me when to help you in the bathroom."
  • "You stayed dry all day. It must feel great to be accomplishing your goals".

Refrain from using negative feedback or treating the individual like a child..

  • Promotes self-esteem. Builds trusting relationship.

Provide frequent reminders about desired behaviours.

  • "If you feel the urge to go to the toilet, let me know and I will help you."
  • "Try to hold your urine until our appointment at 4:00."
  • "I will help you to the toilet at 4:00."
  • "If you need to use the toilet, please do so. I will help if you need it."

Inform individual of next scheduled prompted voiding session.

  • "I would like you to hold your urine until 4:00."
  • "That is 2 hours from now. I will help you use the toilet at 4:00."

Reprinted with permission:
Lyons, S. S. & Specht, J. K. P. (1999). Prompted voiding for persons with urinary incontinence evidence-based protocol. In M. G. Titler (Series Ed.), Series on Evidence-Based Practice for Older Adults, Iowa City, IA: The University of Iowa College of Nursing Gerontological Nursing Interventions Research Center, Research Translation and Dissemination Core.