Development and testing of an incontinence monitoring record.

Bladder records can play an important role in the assessment and treatment of incontinence. Many records currently used in long-term care settings are difficult to read and interpret, and they do not provide for the recording of information that can be of value in the assessment and treatment process. Two versions of an incontinence monitoring record (IMR), one using black and white symbols and the other using colored circles, were developed and tested in a quasiexperimental design in three proprietary nonacademically affiliated nursing homes. The IMRs were well accepted by the nursing staff in these homes. Recordings were made more frequently and interrater reliability was highest with the color version of the IMR. Results of this initial study are promising and suggest that the IMR, or a similarly designed record, will be helpful in nursing homes to assess the bladder and bowel status of new admissions, determine patterns of and factors associated with incontinence, design individualized bladder training programs, and monitor the results of these programs and other treatment modalities. In addition, the IMR can provide an opportunity for nurses' aides to meaningfully participate in the assessment and treatment of a condition they manage on a daily basis.