Adult diaper with additional pad for night use??

[ambil]

Hello all,

We've got a few patients who seem to be having problems with staying dry until we show up for morning care.. The beds are so often soaking from neck to bottom with urin. We had always used extra thick pads in evening care to help absorb the excess. We even used extra absorbent diapers for adults(nightcare) and 2 pads. The product names are irrelevant because I work in germany, all names are different of course! A co-worker of mine says we shouldn't use extra pads because it stops the diapers from absorbing properly. Well, I've always found they help, expecially when one removes the pads as soon as they are wet. Hmmm, any suggestions out there how you deal with this common problem? Are there really disadvantages to using extra pads at night with a diaper?

[Faby]

Hi: I was wondering about how many hours are we talking about, because, there's a high risk of pressure sulcers. Do these patients turn by themselves? maybe what they need is to be institutionalized.

Faby

[Faby]

Hi again: It's not recomended for pressure ulcer prevention to use double pads, or diappers because that implies the patient isn't going to be turned and cared of he or she as requires

Faby

[ambil]

Faby said:

Hi again: It's not recomended for pressure ulcer prevention to use double pads, or diappers because that implies the patient isn't going to be turned and cared of he or she as requires

Faby

These patients are being taken care of at home by their families. Our last visit is around 1900-2000, then we are there again in the morning as early as possible. So yes, unfortunatly these patients are lying in a very wet diaper for the last few hours in any case. For the most part the family members are not able to do much themselves, thats why they are in our care. The patients can turn themselves a little bit, but not always. All of our patients, when called for, have a antidecubitus mattress. (forgive my lack of wording, I've been living in germany a long time, my english is fading...) So turning is not the problem. What I simply don't get is that if you don't use pads or a diaper what do you use then? I mean, I can't let them just make a huge mess in their beds, they will also smear everything with their hands, get the picture?

These patients cannot simply be institutionized, their families want them to stay home and it is of course a financial problem for many.

I've been working with this team for almost 10 years and I've never seen a patient develop severe problems due to diapers with a pad. I think sometimes we as nurses have a tendency to over react. We're so afraid of getting the blame when a problem occurs, know what I mean?

[Faby]

Hi: I definitelly get the picture. What I would do is use the double pad and extra absobent diaper. But still I would make sure of covering the area with abundant skin protectant lotion, and avoid wrinkles to the linnen; at least if they need to lye wet for some time the skin would protected as much as it could be. This, and of course educate the family member if they provide some care; it should be adjusted to each case. Hope this helps.

Faby

[NotReady4PrimeTime, RN]

If you're using a liner pad inside the diaper you have to check the packaging to ensure that they don't have a waterproof backing which will reduce the ability of the diaper to absorb to its capacity by deflecting the urine to an area that may already be saturated. There are a few brands that are suitable, and they do really cut down on the overflow. As for the van Gogh effect, it may be a solution to use extra-long t-shirts that can be snapped or Velcroed at the crotch so that they can't get their hands inside their pants. Large hooks and eyes like those used to close bras would be useful in this application... easy enough for the caregiver to close but difficult for the client to undo them. We also use a hospital-grade moisture-proof soaker pad under them to protect the mattress.

[liveyourlife747]

Is there anyway that an aide could be assigned from 1900 until 2300 or all night to help with changing and repositioning these patients?

[txspadequeenRN, BSN, RN]

If I were you I would have those families changing the patient through the night or put them in a 24 hour care facility...that skin will break down if you don't and then your really going to have a mess....

[morte, LPN, LVN]

Remember, this nurse is NOT posting from the USA....

Things you might address to prevent the excess voiding...Med Regemin: Are they getting diuretics too late in the day? Diet: Are they getting too much liquid late in the day? or tea/coffee too late in the day?

Do they have dependent edema, that is pulled back into circulation when they are made horizontal?

[HmarieD]

"...As for the van Gogh effect, it may be a solution to use extra-long t-shirts that can be snapped or Velcroed at the crotch so that they can't get their hands inside their pants..."

LOL, I never heard it called that, but I'm stealing it now!!!

[NotReady4PrimeTime, RN]

You liked that one did you? There are times when one just has to laugh, or we 'd all go mad!

[RDR.Mallie]

The problem you are having is that The adult diaper Companies do not make the diapers with absorbent padding all around the diaper ( Expanding to the ends of the wings front to back ) ,,,,,and not enough padding in the diaper it self

The solution is to either modify the diaper so it has super thick all around padding ,,,,Or you can put Patient in a cloth diaper that dose not have a water proof backing ,,,,Then put a disposable Night time diaper on then a pair of Vinyl pants

If the patient takes the his or her diapers off or or tampers with them then you can put them in a Suprima jumpsuit style Pajamas ,,,, there are many styles of these Jumpsuits and they are designed to Patients from tampering with their diapers or taking them off ,,,,but are easy for the care givers to put patiens in and change thier diapers with out needing to take the Jumpsuit off

Another thing that should be done is ,,,all health care providers should ban together and get the adult diaper Companies to make an ultra think plastic backed diaper the padding that expands to the ends of the wings (full matted diaper)

One of the reasons the companies do not make a full matted plastic backed diaper is because they make to much money on selling booster pads and they sell more diapers because they need changing more often

I hope this helps