The Bridge Project

Linking Research & Practice in Nursing Homes

Forms for Conducting a Prompted Voiding Trial

> Resident Motivation and Preference Assessment Form Use this form to assess residents' motivation and preferences for using the toilet.

> Prompted Voiding Trial Assessment Form
Use this form to record how residents respond to a brief (3 day) trial of prompted voiding.

> Toileting Trial Results Form
Use this form to analyze results of the toileting trial.

> Wet Check Form
Use this form to monitor the prompted voiding program.

> Resident Data Form
Use this form to report assessment results to us.

Optional Forms

> Prompted Voiding Policy & Procedure Statement
Feel free to use this as is or modify it to suit your nursing home.

> Assessment of Incontinence Type
Use this handy pocket card to help identify a resident's type of incontinence.


Scripps Gerontology Center : Miami University : Upham Hall Room 396 : Oxford, Ohio : 513.529.2914