Creams and ointment...foley care..

lpn1313 · May 13, 2005

Where I work, we are allowed to give the STNA's anything that is an OTC- A&D, Baza, etc. While there is no written policy, we can also give them xenaderm to apply- usually because we only apply it q shift or q day. As far as foley care, it's on both our TARS and NA sheets.

stidget99 · May 13, 2005

As nurses, we can delegate many tasks to the CNA as long as they have been provided the necessary knowledge and demonstrate the skill appropriately....as long as it is approved by management. I would talk to management as ask if there is are written policies re: these issues. If not, request that they be written.

LPN01112005 · May 13, 2005

If they are ordered with each brief change, are you actually doing this or your CNAs? Techincally if its ordered as a treatment...I know nurses should, but can you imagine the time spent on this? I'm talking Xenaderms, Zinc oxide etc...I have a great bunch of CNAs that will ask for it and apply them when needed. Of course I'm checking the areas also. Just wondering what everyone else does?
What about foley care q shift? We have this as an order and its on our TAR. Isn't this a standard of care? I've been fighting them to take it off of the TAR orders and place it on the CNA sheets.

If it's a prescription ointment, the nurses have to do it. The ointment will be locked in the tx. cart. If it's just sealant or A&D that is being applied, the CNA's can do this. We have a few who get tx with every brief change and I do try to "schedule" these as best I can, but sometimes it just doesn't work out that way. Sometimes these tx's take both me and the CNA to get them done, however, if it's one I can handle on my own, I just do it and the CNA doesn't even change the resident unless I ask for assistance.

leslie :-D · May 13, 2005

re:foley care, yes the cna's are supposed to wash the area.

but when i've checked the skin and foley a/o, do you know how many times i found remnants of feces right around the urethral meatus?

when i pointed it out to the cna who was assigned, i discovered she (et al) was afraid to clean around the foley site....all i could envision was e coli festering its way up the urethra.

so that's why i make it a point to do a very thorough cleansing of that particular area.

plus as a nurse, i like to take a peek at the urine to see if its' characteristics have changed, i.e., from cloudy/turbid to clear.

leslie

sassynurse78 · May 14, 2005

Luckily we do not have too much skin problems, and our CNA's can apply any OTC stuff like A&D, Baza etc. I only have a few that need prescription meds and usually I etheir do it myself or tell the CNA's to yell for me when they are ready to turn and reposition the pt. It works out pretty well that way. I do have a CNA that has completed her first year of the RN program and so I will send her in with some things.

robin_mds_nurse · May 14, 2005

We wrote a policy a couple of years ago that states cnts may apply some topicals to unbroken skin. So if there is an open area involved, the TX nurse or nurse assigned must do the applying. Also, we don't get orders for barrier ointments, it is on the care plan.

As far as F/C, I took these off our TARs several years ago. It is a standard of practice to do this. I have it on the care plans for the cnts to do during am care/bath daily and prn after incontinent bowel movements. ~Robin