Do you use powder on your patients?

MLK RN · Sep 14, 2004

Personally I discourage powder useage because most of the people needing powder in the hospital are "Fluffy" as I like to call them or a little on the large side. They either need talcum for the bedpan or Nystatin in the valleys....Yeah its all gross to me..Just bathe 'em or get some turning help so you can align the pan properly. Powder is just a odor cover up to many and It is absolutly disgusting if it dosnt get washed off properly, it just makes more work for us all. :wink2:

julie978 · Sep 14, 2004

Good Question!

Our hospital just went :powder free: Not even stocked any more, due to the possible link to cancer.

Talcum Powder and Cancer

Talcum powder is produced from talc, a magnesium trisilicate mineral, which in its natural form may contain asbestos, a known human carcinogen. Because of this association with asbestos, all home-use talcum products marketed after about 1973 - baby powders, body powders, facial powders - have been required by law to be asbestos-free. Asbestos can cause lung cancer and mesotheliomas (cancers affecting the lining surfaces of the pleural and peritoneal cavities).

It has been suggested that talcum powder may be carcinogenic to the covering layer of the ovaries through the migration of talcum powder particles (applied to the genital area, sanitary napkins, diaphragms, or condoms) through the lady parts, uterus, and fallopian tubes to the ovary. Several epidemiologic studies have examined the relationship between talcum powder and cancer of the ovary. Findings are mixed, with some studies reporting a slightly increased risk and some reporting no association. A case-control study published in 1997 of 313 women with ovarian cancer and 422 without this disease found that the women with cancer were more likely to have applied talcum powder to their external genital area or to have used genital deodorant sprays. Women using these products had a 50% to 90% higher risk of developing ovarian cancer. Storing diaphragms with powder did not significantly increase cancer risk. Since many of these women might have used products with more asbestos contamination than that in current products, the ovarian cancer risk for current users is difficult to evaluate. Until additional information is available, women may wish to consider avoiding these products or substituting cornstarch-based powders that contain no talc. One study has suggested that an increased risk, if it exists, might be confined to borderline and endometrioid (uterine-like) tumors and therefore might not affect the majority of ovarian cancers. Experimental toxicology studies have suggested carcinogenicity of inhaled, asbestos-free talc powder in some rodent species but not in others. The most recent publication on this topic, a prospective study (considered to generally be the most informative) found no effect on ovarian cancer overall but a 40% increase risk in one type -- invasive serous cancers.

No increased risk of human lung cancer has been reported in association with the use of cosmetic talcum powder. Although some studies of talc miners and millers have suggested an increased risk of lung cancer and other respiratory diseases, the industrial grade talc to which such workers are exposed contains varying amounts of silica and asbestos, unlike the purified talc sold to consumers. One study of pottery workers exposed to silica dust and nonasbestiform talc showed an excess risk of lung cancer, while other studies of occupational talc exposure have not found an increased risk. While experimental evidence suggests that some forms of silica may cause cancer in animals, observational studies in humans are not conclusive.

REFERENCES

Cook LS, Kamb ML, Weiss NS. Perineal powder exposure and the risk of ovarian cancer. Am J Epidemiol 1997; 145:459-465.

Gertrg DM, Hunter DJ, Cramer DW, Colditz GA, Speizer FE, Willett WC, Hankinson SE. Prospective study of talc use and ovarian cancer. J Natl Cancer Inst; 2000: 92:249-252.

Harlow BL, Cramer DW, Bell DA, Welch WR. Perineal exposure to talc and ovarian cancer risk. Obstet Gynecol 1992; 80: 19-26.

Hartge P, Stewart PA. Occupation and ovarian cancer: a case-control study in the Washington DC metropolitan area, 1978-1981. J Occup Med 1994; 36 (8): 924-927.

Thomas TL, Stewart PA. Mortality from lung cancer and respiratory disease among pottery workers exposed to silica and talc. Am J Epidemiol 1987; 125 (1): 35-43.

Revised: 02/03/2000

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Marie_LPN, RN, LPN, RN · Sep 14, 2004

When i worked day shift, i would make "bag baths" for the all the pts, and would make "powder bags" for the bedbound pts. The powder bags (two washclothes dusted with some powder put in a baggie) were used to 'pat' under breasts, and skin folds. NEVER the perineal area.

And i made the powder bags at the end of the hall in the "water closet"(the room where the sink and supplies were to make bag baths. So no powder flying through the pt.'s room. And i only used just enough powder, never to the point that you even saw white on the pt.'s skin.

I also dusted a pt.'s bedpan (did that in their bathrooms though). A little bit sprinkled on, then spread on the seat (excess dusted into the toilet) kept the pan from sticking to the pt.

Marie_LPN, RN, LPN, RN · Sep 14, 2004

Oh, and if any skinfolds or breasts were red, i put Greer's Goo on them instead.

allnurses Guide · Sep 14, 2004

Well, actually yes we do use powder. It is the baby cornstarch powder. Our patients are bathed regularly so they don't get the sticky powder residue.

Thanks for the info above about talc and cancer. Interesting. I've used powder probably twice in 20 years on myself.

steph

nurseygrrl, LPN · Sep 14, 2004

We use powder occasionally...in the ways that Marie was describing, mostly. We have one particular pt. who was taken care of in his home by his sister for many years. She wanted us to use Gold Bond in his skin folds. The NP wouldn't hear of it, and you should have seen the rashes on this poor man. The NP finally gave in and he's fine now.

not now, RN · Sep 14, 2004

the facility where i go to clinical has cna's that are powder crazy. don't get me wrong, i love those cna's they are constantly on the ball and always willing to help but when i pull my patient's fitted sheet up to change linens and a cloud o' powder comes up, i shake my head. they basically sprinkle baby powder over the entire fitted sheet. they also use it generously on patients who wear briefs.

when we did our stay in ltc my poor obese patient had baby powder caked in her peri area and her skin folds. i felt so bad because a bed bath wasn't enough to remove the powder.

Monica RN,BSN · Sep 14, 2004

I am a first year nursing student. The other day one of our instructers informed us to never ever put powder on a patient. She said if they asked us to, we should inform them that we won't do it. Then let them know how bad it is for their skin. Today we had another instructor encourage us to use powder. She said it won't harm patients as long as their skin is dry and it works great to freshen them up. Do you use powder in your health care facility? Do you find it beneficial or harmful? Just looking for opinions from you more experienced nurses out there. Thanks

Powder is bad especially in a long term care facility.

Reasom One: It cakes in the creases causing skin breakdown in folds, especially in overweight patients who perspire alot in the folds and cracks.

Reason Two: we had an incident in our LTC facility where a fine powder film was on the floor after powdering the bed "to freshen it up and make the patient more comfortable" . Needless to say, The CNA transfered the patient in a pivit transfer from chair to bed. The floor was soooo slick, the CNA and patient went to the floor. The patient ended up with a fractured C-Spine,

and later died.

So powder is an absolute NO in our facility and should be in all facilities, IMO.

Marie_LPN, RN, LPN, RN · Sep 15, 2004

It angers me to no end to see cakes of powder in peri areas. I'd like to go up to the people who do that to them and loudly say "do YOU cake yourself THAT bad with powder???"

begalli · Sep 15, 2004

Thank you so much for this thread.

This whole powder thing is something that needs to be addressed in my ICU. We stock Johnson's Baby Powder and some nurses use it profusely. Even though I've been known to apply this powder to some of my patients axillary areas, it's always been a concern to me. As of right now, I will no longer do this.

I think I'm going to look into this further and present it to my nurse manager.

lovinghands · Sep 15, 2004

I also want to thank you for this thread. When I was doing my preceptorship at a local hospital it was common practice to powder the pt's peri-area after cares. More than one nurse said it was for odor - personally I didn't agree with this and refused to powder my patients. I remember my preceptor throwing a fit one evening over this - I wish I'd had the time to do a little research to back up my position as I'd heard of the cancer link in the past. Again, many thanks! :)

mamaof3 · Sep 15, 2004

:) Thank you for all your information on this. I knew powder was bad for the lungs and also can cause yeast infection. But I wasn't aware of the cancer link. I think I will try to avoid using it on my future patients. Thanks for all your great responses.