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Restorative Nursing Bladder Training program: recommending a strategy
1Post Acute Rehabilitation Unit Kennedy Health System, Health Care Center at Washington, Sewell, NJ, USA. j.glenn@kennedyhealth.org
Abstract:
This article describes a Restorative Nursing Bladder Training program, a performance improvement initiative aimed at helping patients regain bladder control by postponing voiding, and then urinating according to a specific, individualized timetable. Data were collected on 14 patients who participated in the program from April 1999 through January 2001. Eight patients achieved a 100% reduction in incontinent episodes; 1 patient documented a 90% reduction; another patient attained an 85% reduction; 3 patients showed a 50% reduction; and 1 patient showed a 30% reduction.
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The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...