Pure Wick

[sistrmoon, BSN, RN]

Does anyone use the Pure Wick system at their facility? We are about to start using it. I'm intrigued but am wondering how well it really works in practice. For those wondering, it's a female incontinence wicking system that you attach to wall suction, like an external catheter for a female. You can use the collected urine for a UA as well.

[NuGuyNurse2b]

Well in theory it works for pts who are required to maintain bedrest, which are the immediate post ops or someone who's recovering, but they are already arriving with foleys. Most of our population who require it are confused, and thus, are unable to maintain it between their legs. It just ends up being another patient equipment that has the potential for skin breakdown. either that or they pull apart the applicator and play with the suction hose. we started using it at our facility last year. they're the female equivalent of the male condom catheters that rarely stay on.

[Okami_CCRN, BSN, RN]

I have to disagree with NuGuyNurse2b, my unit/hospital has had great success with the Purewick female incontinence system to the point that it has decreased our foley catheter utilization rate. The thing is you have to truly assess the patient and determine if it will work for them and educate them about how it works etc.

Some tips and tricks

-if you reposition the patient then you have to reposition the purewick

-tape the suction tubing to pannus/abdomen to prevent dislodgement

-set the suction to 40-80

-the device needs to be changed every 8-12 hours.

[sistrmoon, BSN, RN]

Thanks for the feedback! The training did say it can't be used on a confused/agitated patient which is a downside. I did also wonder how it didn't cause skin breakdown since it stays damp. Nice to hear opinions from both sides.

[Okami_CCRN, BSN, RN]

sistrmoon said:

Thanks for the feedback! The training did say it can't be used on a confused/agitated patient which is a downside. I did also wonder how it didn't cause skin breakdown since it stays damp. Nice to hear opinions from both sides.

It doesn't actually stay damp, the constant suction keeps it pretty dry. Oh almost forgot, you can't use it on people with latex allergies.

[sistrmoon, BSN, RN]

Oh the education said it stays damp. That's good it's mostly dry.

[meggiepie24, BSN]

I've seen this at conferences and I'm just still in shock. And how do you keep the urine from smelling when it's in the suction container? What do you say to family members when they ask you what's in the suction canister? How does this work with intentional progressive mobility programs? These are all questions I had for the reps ... and none could really be answered.

[Okami_CCRN, BSN, RN]

meggiepie24 said:

I've seen this at conferences and I'm just still in shock. And how do you keep the urine from smelling when it's in the suction container? What do you say to family members when they ask you what's in the suction canister? How does this work with intentional progressive mobility programs? These are all questions I had for the reps ... and none could really be answered.

The suction canister is emptied every 6-8 hours and as needed, it does not smell. When family members ask what is in the canister (which is seldom), I simply state in an effort to reduce the risk of a urinary tract infection we utilize a device called purewick to collect urine.

When I am getting a patient out of bed I simple ask them if they would like an incontinence brief while ambulating, once they are out of bed to chair I simply remove the brief and reposition the purewick.

[catsmeow1972, BSN, RN]

My facility uses them. Like a condom cath, they are notoriously hard to keep in place, but if done so correctly, and on the right patient, they are a delightful little thing to keep a patient who's been given a massive dose of Lasix from constantly peeing on themselves as well as a better way to measure output. i find it difficult to keep in place if the patient is very thin and there isn't a lot of ahh...extra flesh to keep it in place. My facility only has the one size. Do they come in other sizes?

[nursemols, ADN, BSN, RN]

We use them at my facility as well. They work well for my stroke patients who are completely down on one side or for hip fractures. That said if the patient is having diarrhea than purewick is. Or an option for that patient..otherwise it's a nifty thing to utilize

[KMRN81]

I'm seeing this post so late in the game!! I work at an inpatient hospice unit and we use it for select patients. I LOVE this thing. First of all, as mentioned by some other posters, it's not for every patient (agitation/restlessness, frequent ambulation, etc.). However, I've used it with great success on the ladies with tumor burden r/t ovarian ca, on lasix and too dyspneic to get OOB and unable to tolerate in general r/t pressure, burning, spasms, etc. I've strongly advocated for this product on my unit and have networked with nurses in the hospital setting who are also using it to share ideas. I will also say this. PureWick the company was bought out by Bard, in part because the small smart-up couldn't handle the volume of orders. Guys. This is *likely* the future of female incontinence, and better models are likely to come about as a result of hospital requirements to reduce CAUTI.

TIPS FOR USE:

-Set suction to 40-60mmHg CONTINUOUS - not intermittent. It won't suction pee that is already soaked into the bed pad or diaper so you need a continuous suction. This should go without saying, but it's happened. Also, higher than that setting may result in the patient feeling the sensation of air "down there"...which...they might not complain about...LOL

-Replace it every 8-12 hours (once on your shift) OR if soiled with FECES or BLOOD - not urine. It's expected to have some urine on the wick itself, which will dry d/t continuous suction.

-Reposition PureWick every time you reposition the patient

-Make sure you have the bottom of the PureWick at the perineum to best catch all the urine (watch the videos on their site)

PROS:

-Suctions most urine away from the skin

-No odor in the suction canister - similar to anything else you would suction to a canister

-Easy to position

-Prevents excoriation from frequent urination - preserves skin integrity much better than plain old incontinence ?

CONS:

-It doesn't catch every last drop of urine, especially if not properly placed or if the patient self-positions in bed and the PureWick isn't adjusted accordingly

-Harder to keep in place for thinner people without some MacGyvering (mesh underwear or taping the PureWick to the patient)

-It can be a hard sell to patients/families/other nurses who are skeptical about its use

-Currently, there is only one size/model available

-It's expensive

[therapy456]

My mother is incontinent at night X 5-7 and lives at home. She hires caregivers to assist her to the bathroom and still there are times she wets the bed. She has mild dementia but can follow directions and has good use of her arms and hands.

We want to introduce the PureWick to her for night use only. We have 3 questions. Can you help?

1. Is she a good candidate for the PureWick from your experience?

2. How is the best way to introduce and instruct my mother to use the PureWick at home when the primary caregiver (husband) and the caregivers (unskilled) have never used or seen this device before?

2. How much does the PureWick move when rolling over in bed? Does it need to be repositioned each time the person rolls over? And how much effort or physical realignment is needed to reposition it?

thank you so much for your help!