Help! OB Supplies Expensive!

[layna]

I have been asked to cut 5% of OB supply expense. I am looking for input from all of you out there.

1) What do you use for perineal ice packs?

2) What is in your patient admission/comfort kits?

3) What is in your delivery packs?

4) Do all breastfeeding mothers receive a manual breast pump to take home?

Your input would be a big help.

Thank-you,

Layna

[cindyln]

1. diaper cut down middle and ice packed in it

2. pitcher,peri pads, mesh underwear,peri bottle,diapers, wipes and formula if desired

3. the bare minimum

4. absolutely not!!

[mother/babyRN, RN]

Hi there...We don 't give moms free breast pumps, however, that said, we do offer the use of our breast pumps and give them a medela kit ( which costs about 30 dollars each), that they can take home and use with their own hospital grade breast pumps, if they have or rent one, the apparatus is interchangeable and reusable...The kit also converts to a manual breast pump. If a mom is pumping for a preemie, boarder or just has a lot of breast milk, we empty glucose or sterile water bottles, have her attach that to the (we use medela) pump, label the milk and then store it in our fridge. Those bottles and formula bottles as well, are interchangeable and fit on the pump apparatus supplied to the mom.

As for perineal pads, I have used both the ice pack pads and now, at my newest facility, they prefill gloves with crushed ice, put them in the freezer so they harden to a maleable consistancy...We then precut stockinette, which is placed on a shelf in the kitchen area, so that when nurses or patients desire ice packs, they can retrieve the ice glove and slip it into the cast sleeve ( I am talking about the solid tubular material we use to make infant hats)...The peri pad ice pads are nice, but as they have a thin layer of gauzy material and are primarily made out of their chemical component, I personally think they don't hold a lot and patients end up using scores of them. At first I was hesitant when I saw the ice gloves ( which we always used prior to the ice peri pads), but when the soft cut cast stockinette was used to slip over them, it made perfect sense. Patients love them, they are disposable and fashioned from relatively inexpensive materials....They also melt fairly evenly and mold to the individual patient.

If you are buying infant caps, think about making your own out of the same material (cast stockinette or actually, the sold tubular cotton like material that goes under some models of venodyne boots.) We cut it into various lengths, put an elastic in the middle, then turn it over itself and make a neat infant newborn cap....

Also current facility does not use peri pads for new deliveries. They use what resembles diapers...Whatever you elect to use, my current facility takes cotton carry sacks, fills them with a peri bottle, these pads ( or whatever you elect to use), some cotton stretchy (reusable if one chooses to soak them) panties, no name tucks pads, and puts this ensemble in the bathroom of each lrdp...We make those ahead of time also and store them in the supply room so that whenever a patient is admitted, a pack can be introduced to the room. If a patient uses up their supplies, which doesn't often happen, they merely ask for more..This has worked out better than giving patients entire packs of pads and several panties that they either discard or take home...That way we can better monitor our supplies.

We also recyle our non patient info discarded paperwork, into scrap paper that we then use for transcribing info such as a patient planning to arrive, lab values, etc...Hope this helps!

Oh, we used to provide alpha keri lotion for each patient who received a sitz bath, and every vag delivery used to receive a sitz bath set up. That became expensive, especially if people either didn't use them or threw them away. I didn't like the original idea of my then management to stop adding alpha keri to the warm water of sitz baths, but after awhile, discovered that the sitz bath worked just as well without it, and losing the alphakeri cut down majorly on the delivery budget. I will also give a patient who needs one, a sitz bath when I get them up to the bathroom for the first time before they get to pp to make sure they get the sitz bath and teaching involved, in case the next nurse is either too busy or the patient not willing to do one later on. That way we don't use as many setups, and save in that way too....Let us know how you do!

[L&D.RN]

1. The good ol' glove with ice in it!

2. It isn't much...tiny box of kleenex, IV set-up, granny panties, 1 pkg of pads, 10 blue chux, water pitcher and a small package of baby supplies (20 diapers, baby shampoo, thermometer)

3. Instruments, laps, cord clamp, sterile towels, Dr gown and gloves, placenta container,

4. NO breast pump

We don't give out tucks, we use witch hazel poured onto these little "cloths". We don't give out Dermoplast either, but it is a chargeable item and is on the docs standing orders, so we can use it if needed. We do charge for the "OB Tub" and we also charge for the "Delivery Pack".

Oh, and we don't use baby wipes...we give them as many wash clothes as they need...they go back into laundry service and are reused!

[ADN 2002]

We use:

#1: Glove /c ice in it (but we also have a chargeable ice pack that has a cloth cover that you re-use -- I find this gross after a PP mom has been bleeding all over it, and just cover the glove with a washcloth).

#2: When we set up a PP room, we give them:

1 water pitcher (non-charge)

1 pkg of 12 kotex pads (now non-charge)

1 pkg blue chux pads (chargeable)

1 peri bottle (now non-charge)

1 sitz bath (chargeable; in a semi-private room for sure, and we give them to our private room patients if they don't want to sit in the tub)

#3: Our (chargeable) delivery packs contain:

1 set sterile instruments (to be re-sterilized)

1 bulb syringe

1 set sterile vag delivery drapes

1 syringe

1 needle

1 sterile cup for cord blood (to be re-sterilized)

1 placenta basin

1 cord clamp (but we throw this out, as we have security clamps in a separate pack)

5 laps

1 kotex pad

1 (or 2?) white cloth things that we throw out when setting up the table

Other stuff we routinely throw on the table:

1 sterile doctor's gown

2 sets sterile gloves according to doctor preference

1 set of 5 sterile blue OR towels

1 suture for epis/repair (again, doc preference)

1 vial lidocaine for epis/repair

1 extra syringe and needle

#4: We have no manual breast pumps. We have chargeable kits that work with our one electric pump, but somebody has run off with the electric pump station as our unit (in their infinite wisdom) loans it out to patients after they go home - I do not promote this practice, because the unit does not come back and our inpatients don't have one to use.

Hope this helps! It's kinda interesting to hear what other units do...