Hi-R-Ed Online

Prompted Voiding Techniques

Either a physician or a well-trained pump trainer can calculate initial settings for basal and bolus insulin rates. The pump does not make these calculations. There are several ways to calculate the basal and bolus rate. The simplest method is to get the current total daily dose (or TDD) and split it in half (50% for basal, 50% for bolus). This may be too much insulin though, since pumping insulin is more effective than injecting insulin. Another approach is to use only 75% (for under- or normal-weight individuals) to 90% (for overweight or obese individuals). This can then be split 50/50 or 70% basal/30%.

•Developing a voiding schedule

•Overnight use?

•Used mainly in clients with
cognitive or functional impairments

Communities who use prompted voiding programs have demonstrated positive outcomes such as increased recognition or urge to void, and an increase in the daily average of dry and non-wet checks.

Habit training is toileting on a rigid schedule. Using a bladder diary for three days helps identify the times that an individual is most likely to void, and the opportunities to use the toilet are scheduled at that time. Usually the schedule is intervals of 3-4 hours, after meals and before bedtime. It may or may not be continued during the overnight hours. This program is used most frequently with people with cognitive and functional impairments.

(Wyman, J. Behavioral Interventions for the Patient with Overactive Bladder, JWOCN. Supplement 1.2005;32:511-515)

Absorbent Product Options for OAB

•Pads and panty liners

•Briefs and protective underwear

•Drip collectors for men

•Underpads

There are several absorbent product options available for the client with OAB, and many variations within those individual categories.

However, not all people who have overactive bladder have urge urinary incontinence and so may not need an absorbent product. Some may want a low profile product just in case the sense of urgency is overwhelming and they are unable to suppress the urge--or just in case a toilet is not readily available. Find out what your client needs and match the product options from this slide to what they can use. Consider the amount of urine lost/episode, if any, the client’s weight and gender, their activity level, their mobility and manual dexterity, as well as any cognitive abilities or other self-care abilities that foster the ability to toilet.

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