Supervised Toileting
Supervision during toileting allows staff to verbally and/or physically assist a patient to help keep them safe during this task. Patients may need help for a variety of reasons (pain, injury, deconditioning, cognitive impairment, medication side effects, etc.) and with a variety of components of the task (ambulating to the bathroom, performing a transfer on/off a toilet or commode, clothing management, etc.). While there are competing tensions between patient privacy and safety when it comes to toileting, the bathroom is an important place for staff to provide supervision and assistance due risk of falls and fall-related injury in this environment.
Supervised Toileting Education
Audio/Visual Resources
- Safe Transfers and Mobility Webinar: The webinar Best Practices in Safe Transfers and Mobility to Decrease Fall Risk created by the UNMC CAPTURE Falls team describes principles of balance, strategies to reduce patient fall risk during transfers and ambulation, and strategies to improve a patient’s balance in sitting. While toileting is not addressed specifically, the information can be generalized to this task. This webinar could be used as an educational tool for staff training on this topic.
Supervised Toileting Tools
Safe Transfers and Mobility Training Videos
Sixteen stand-alone training videos created by the CAPTURE Falls Team demonstrate safe strategies for assisting patients with a variety of movement tasks ranging from rolling in bed to an assisting a fall. While toileting is not addressed specifically, the information can be generalized to this task. These videos can be used as tools for staff education on this topic.
Safe Patient Handling
Tool 3E Clinical Pathway for Safe Patient Handling in the Agency for Healthcare Research and Quality Fall Prevention Toolkit can be used to support nurse clinical-decision making regarding how to safely assist patients with mobility, including potential ambulation to the bathroom or transfers to a commode.
Algorithm for Patient Mobilization
Tool 3K: Algorithm for Mobilizing Patients in the Agency for Healthcare Research and Quality Fall Prevention Fall Prevention Toolkit can be used to support nurse clinical-decision making regarding when to initiate patient mobilization and when to refer to physical and/or occupational therapy. It could also be helpful in deciding if ambulation to the bathroom or transferring to a commode is safe.
Mobilization Test
The ICU Mobilization Test, originally intended to assess the potential for safe mobility of patients on mechanical ventilation, could be used to assess any patient’s potential for safe mobility. It could also be helpful in deciding if ambulation to the bathroom or transferring to a commode is safe.
Banner Mobility Assessment Tool
The Banner Mobility Assessment can be used by nurses to guide decision-making for patient mobility, including the need for safe patient handling equipment and physical therapy referral. It could also be helpful in deciding if ambulation to the bathroom or transferring to a commode is safe.
Safe Mobilization Tools
A variety of tools from the Clinical Excellence Commission of the New South Wales (Australia) Ministry of Health provide guidance on terminology used to describe assistance levels, an algorithm and tip sheet for how to mobilize patients, and videos of various assistive devices.