Implementation of a Scheduled Toileting Program in a Long Term Care Facility: Evaluating the Impact on Injury Risk to Caregiving Staff

Abstract

This study evaluated the impact of a scheduled toileting program on the risk of injury to caregivers and on resident agitation or aggressive behaviors. Injury data, ergonomic assessments, staff questionnaires, and resident agitation checklists were used to evaluate the program in a 75 bed unit, with a similar unit acting as a comparison. The program resulted in an increased percentage of residents toileted regularly in the intervention unit, while aggressive incidents declined in both groups. Staff in the intervention unit reported a significantly lower perceived risk of injury to the head and neck than the comparison group. Although the program resulted in increased workload to manage multitasking, monitor an additional aspect of scheduled care, and perform more toileting transfers, overall risk of physical injury was reduced. The toileting program, a shift toward resident focused care, and enhanced agitation awareness combined to reduce resident handling injuries and resident agitation expressed as verbal behaviors or emotional upset, but not as physical behaviors. Clear communication, mentoring, and monitoring were important for successfully changing care practices.