Diapers, good or bad?
- 0Dec 9, '08 by overwurkdMy med surg floor is pretty strict about a no diaper policy but no one has ever explained the rationale. Before I ask them why, I'm wondering if anyone can tell me... why not? We use pads or chucks under all our pt's but I'm not really sure if they are there to protect the sheet? draw moisture away? or help boost the pt up in bed? Does anyone have any intelligent input on the pros and cons?
- 1Jan 3, '09 by KimT08The reason I do not recommend diapers are that most hold moisture and stool against the skin causing a multitude of problems from yeast, to excoriation, and ultimately ulcers. Most staff members do not take the time to find the appropriate size diaper either which results in one of two things, either the diaper is too tight causing the diaper to cut into the skin and cause a wound or the diaper is too big and will bunch up creating a pressure point which will result in a wound. Chucks and pads can be bad also because a lot of staff members will use more than one and they will bunch up and create a pressure point. Bottom line is that no matter what method is used the patient must be cleaned up promptly, have the proper fitting diaper if used, and ensure that there are not wrinkles or wads underneath the patient. If these things are not ensured then the patient will most likely end up with wounds. I hope this helps!
- 0Feb 13, '09 by michelle126seems like we go back and forth on this one with each new DON in our LTC.
A good diaper will wick the wetnss away from the skin. Changing frequently is a must no matter what type of diaper you use. We have the cloth chux too. The reason we use diapers more often is that is was deemed a dignity issue.
If we have a person with a specific problem or catheter, someimes we will leave the diaper open to air.
Try layin on a wet chux....it gets very cold.
Of course....a good skin barrier and cleaning and drying with each inct episode should never be over looked.
- 0Feb 13, '09 by heronI'm on a bit of a mission on my unit re diapers, especially when there's a foley in place.
On my night shift, I take briefs off my patients to allow for a little exposure to air and good foley care. After all, what are we taking care of ... a person or bed linen? I find that with non-stop diaper use, pts' skin can become macerated and too warm from the plastic. If there's a foley in place and any loose stool, you're asking for a UTI ... not to mention the discomfort of having to clean around a foley on a female pt, over and over. Because of the wicking action, I will often leave a diaper opened under the patient, especially if they are not particularly mobile.
I make less of an issue during the day ... it is a dignity issue since there are many more people around and no adult wants to be obviously incontinent in front of strangers.
- 0Mar 21, '09 by AtheosQuote from Stanley-RN2BDiapers, like the Tena ones, are far superior to chux and pads in that they turn into gel when wet with urine. They also aren't made with plastic anymore so they aren't holding in heat.Most nurses and aids are uninformed about diapers.
There are diapers out there FAR SUPERIOR to chucks.
Of course... they cost money.
Lying on a pad means that wetness is directly against the skin the entire time they are lying in it.
We recently had to have an in-service teaching the aides to visually check briefs because people would urinate and say they were dry. Thing is, they ARE dry.
Oops, Though I hit the edit button...
- 0Mar 22, '09 by mama_dI think the issue comes down to $$$$, of course.
It's amazing that my toddler can wake up in the morning with his diaper almost floating away, but his skin is still fairly dry and in good shape. However, it's b/c we're willing to spend the money on a particular brand; if it's not Pampers, it destroys his skin (even Huggies do, which we used religiously for our other three kids).
I think if the grown up diapers that facilities were willing to spend $$$$ on were anywhere near as good as the Pampers I put on my toddler, we'd see a lot less wounds.
But they're not willing, so we use bed pads instead. Our core staff of techs on my shift happen to be awesome, and checked even diaper wearers frequently, but many of the techs who get pulled to our floor (and a few of the new ones we haven't broken in properly yet) tended to use them as an excuse to not check or clean up the patients. Hence the strict no diaper policy we have in place now.