Any reasons not to put Barrier Cream (20% zinc oxide in petrolatum base) on a skin tear?
What I'm hearing is band-aids and diaper creme are within policy for CNA's to apply. So they are using it on everything. (When all you have is a hammer everthing looks like a nail...)
I recently had to clean a pretty thick layer of it off a 25mm x 35mm skin tear where the CNA had trimmed away the flap of skin herself because "it wouldn't stretch back over wound."
That issue aside, what and when are the negatives of zinc-oxide and petrolatum on wounds?
We cleanse with saline and use Allevyn Gentle Border change Q 5 days and prn. Technically with a skin tear with no drainage we can put on only a tegaderm but I have never liked tegaderm on skin tears, they tend to pull on the open areas when removed.
Our facility does not generally use steri strips either, although I've used my judgement and applied them when it really seemed appropriate.
I would be livid to find a CNA covering something with a band-aid. You, as the nurse with the license, who ultimately is held responsible for said CNA's actions, should ALWAYS be notified of any skin integrity issue. I can definitely see why you are frustrated. Check out your state reg's. And barrier cream is a bust. Its only helpful when skin is intact. Even then it can creat an issue when people apply to much of it. If you can roll your pt over and write your intials in it, its too much Lol.... LTC/SNF can be one of the hardest nursing job's, when you actually care. Chin up. :)
Our protocol is to cleanse with wound cleanser, apprximate the edges, apply steri stips, calcium alginate and tegaderm. Change every 3-5 days. It works beautifully!!
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SuesquatchRN, BSN, RN
10,263 Posts
Steri-strips, left alone until they fall off!