"Peenie-wraps"?

Specialties Geriatric

Published

Has anyone else heard of these? At my facility (90% male residents) we put them on most of our incontinent residents. Basically it's where you take a brief, poke a hole through it, pull the member through the hole and wrap it around the member in a ball. So the member is all "wrapped" up. Then you just dress the resident in another brief and pants like normal. This is done so the guys don't soak their pants, sheets, wheel chair, etc. They've been doing it this way for at least 20 years. A new nurse just started, and she says this is "illegal" anywhere else. I have to admit, I was shocked and appalled at this practice when I started, but it really doesn't seem to cause any skin issues. I DO think we have more UTIs because of them. When i started, the staff educator told me they were harmless. I had never seen them before this place, does anyone else use them? Does it seem like a health issue?

Specializes in LTC.

We had a guy who was a heavy wetter, completely incontinent, a mechanical lift, and more often that not would start punching you if you tried to wash his peri-area. And eventually his scrotum ended up badly excoriated from sitting in urine all the time. We tried a condom catheter but it would not stay on, and none of the creams the treatment nurse put on would work because they were difficult to wash off and the CNAs couldn't sit there and wipe over and over without getting punched in the nose, even with 3 of them in there. I'm a CNA and I started wrapping a pad around his balls so they wouldn't be bathed in urine anymore, and everything cleared up. Then the DON found out about it and had a knee-jerk reaction thinking that we must just be doing it because we are lazy and don't want to change anyone. So I had to stop doing that and his scrotum got all bloody again... and so did our noses.

Specializes in Transitional Nursing.

Seems to me it's just an excuse to not have to change someone as often. If the pt is incontinent they need to be changed more than once a shift. Using this method just makes it easier on the staff

Specializes in ICU, OR, LTC, Utilization Management.

I would definitely call this double-briefing, and it would be a major issue with me, and with the State surveyors. It's a dignity issue, IMHO.

Specializes in Geriatrics, WCC.

We have actually called them weenie wraps. I've heard of them since the 70's. But, the way it was done then was wrap an inc. product around the member then tuck it inside the brief or other product. I always outlawed it from my staff as a dignity issue. The main reason for their use is... med like to hold on to their member even while sleeping and it tends to get urine all over. Just protect them by place their arms and hands abovethe covers.

Specializes in Psych, LTC/SNF, Rehab, Corrections.

I've never heard of it and our DON and nurses would have a pooh-fit if any of the aides tried it.

Of course, I cut corners when I was an aide. I have double-padded a bed or two for my heavy pee-ers, because you had to be on top of these folks every hour. Literally.

I refused to risk a wet bed.

But...I don't know about this one. Even though I worked understaffed with a heavy load half the time. I still don't know about it.

I won't rush to call anyone 'lazy'.

On a combative/delirious resident? Seems like a good idea. One way or another, you have to keep them dry and clean. I've had a psychotic little lady refuse to wear the large brief and so I had to put two smalls on her b/c she wouldn't allow the large. Said that it had glass in it. I told the nurse and she understood.

I can understand doing this in the night, too. The guys want their rest. These residents can't sleep in peace for being bothered q2h. Doesn't mean that you dont' check them. But...with a 'burrito'?

You could take a flashligh and check for wetness. A heck of a lot easier than flipping them all over the bed and rousing them out of their sleep.

But -

On an avg incontinent resident? No. It just seems 'improper'....

Also, it's being done for the convenience of the staff. Largely.

I mean, what happens when your females pee a river? Is it acceptable for the aides to double-diaper them, too?

I'd also think about hygiene. Infection. The odds that every aide is checking on their guy to do peri is slim. It's not a stretch to think that they're sitting in pee for hours...b/c they're not visibly wet.

If a resident is soaking through like that per hour, shouldn't they be evaluated or something?

Is it the meds...? Is it an underlying issue? Seems like - and let's say that this person is 'new' - it would be somewhat more difficult to notice a voiding issue or something more until it gets out of hand. I dunno.

Either way, I understand that the guys prefer it. That's fair.

Residents prefer a lot of things. Some of our residents prefer to not bathe. Still bathed them. Some of our residents used to prefer to not eat. Still fed them. Some preferred to only eat PB&J and sherbert. The nurse still made them eat real food.

One with social phobia+depression would've laid up in bed in his excrement 24/7 if we allowed it.

We still had him get up for 2/3 meals.

So, I understand that the guys prefer it.

Just not sure what that has to do with anything.

Specializes in LTC.

I agree with those who say this a dignity issue. I understand that time is in the negative when you are on 11-7 and have 20-30 even more residents to care for but.. if it was your grandpa or father.. and he had a "peenie-wrap" on at night.. how would that fly with you. I would be that PITA family member that would have a cow about it.

Specializes in Geriatrics, WCC.

Just a comment to one of the posters who referred to the periarea as being "excoriated" from the urine. Excoriation looks like linear scratches and not what you see from the skin sloughing away due to urine/incontinence. The skin that is loss due to unrine is called denuded.

Specializes in LTC.
Just a comment to one of the posters who referred to the periarea as being "excoriated" from the urine. Excoriation looks like linear scratches and not what you see from the skin sloughing away due to urine/incontinence. The skin that is loss due to unrine is called denuded.

***The more you know****

Thanks!

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