Challenge of Diaper Change Timeliness

[George Acenas]

If CNA ratio to total care resident is 1:8, Is responding to SAR/LTC resident’s call to be changed within 30 minutes realistic? On weekends the ratio increases to 1:12 and more due to call outs? Should visiting families be asked to help toilet their family because of an overwhelmed team? Should the General public be educated that this eventual incontinence is our natural destiny? The advance directive exists here in America.

[Hoosier_RN, MSN]

9 hours ago, vintagegal said:

Am I the only one cringing at the phrase “diaper change”? How about incontinence care, brief change, or perineal care ? 

Amen. Peri care is my go to. Diaper change is so degrading

[Nurse Pompom]

On 7/10/2022 at 6:39 PM, George Acenas said:

if CNA ratio to total care resident is 1:8, Is responding to SAR/LTC resident’s call to be changed within 30 minutes realistic? On weekends the ratio increases to 1:12 and more due to call outs? Should visiting families be asked to help toilet their family because of an overwhelmed team? Should the General public be educated that this eventual incontinence is our natural destiny? The advance directive exists here in America.

I think getting the families involved is realistic. Why not? Participating in the care of a loved one can have positive outcomes, the sense that you were involved in their lives and their care even though they couldn't be at home. Now, would families be willing to do it, that's another story.

A ratio of 1 to 8 and someone ringing the call light every 30 min is too much, I agree. 

[hppygr8ful, ASN, RN, EMT-I]

13 hours ago, vintagegal said:

Am I the only one cringing at the phrase “diaper change”? How about incontinence care, brief change, or perineal care ? 

See my previous answer.

 

[Googlenurse, ASN, BSN, RN]

In my previous facility, the ratio wasn’t the problem. It was Cnas that would rather gossip than help a resident. 
There were many times that I was changing a resident in the middle of 0600 med pass,and while I walking down the hall to place the brief  in the soiled utility room, there was the CNA assigned to the patient sitting at the nurses station. She claimed she was documenting. 

This is one the reasons I so love ❤️ homecare. I don’t have to deal with supervision of other staff. 

[MunoRN, RN]

On 7/14/2022 at 4:44 PM, vintagegal said:

Am I the only one cringing at the phrase “diaper change”? How about incontinence care, brief change, or perineal care ? 

The term "diaper" is weird because we make it weird.  

I've never had a patient who found the term cringeworthy but have had many who didn't know what I was talking about when I said "Incontinence brief".  I explained that people find it embarrassing when we call it a diaper, and it was only at that point that they realized they should be embarrassed because they were wearing an incontinence brief, or diaper, or whatever you call it, and at that point I realized I was the asshole in this scenario.

[Hoosier_RN, MSN]

5 hours ago, MunoRN said:

The term "diaper" is weird because we make it weird.  

I've never had a patient who found the term cringeworthy but have had many who didn't know what I was talking about when I said "Incontinence brief".  I explained that people find it embarrassing when we call it a diaper, and it was only at that point that they realized they should be embarrassed because they were wearing an incontinence brief, or diaper, or whatever you call it, and at that point I realized I was the asshole in this scenario.

In LTC, especially memory care units, the patients generally don't care. But the family members do. I heard more than one complaint on that issue when I was a DON

[No Stars In My Eyes]

As an aside: I used to refer to the diaper/brief as "just-in-case pants."

[BethCNA]

Also please remember residents' comfort levels. I have years of experience as a CNA, but there's no way my elderly family members would accept toileting or brief change help from me. Their generation was raised to maintain dignity and privacy, which for some means not allowing family to help this way.