Help!!

Specialties Geriatric

Published

I recently started working on the 10-6 shift at a LTC center after working many years at a hospital. I'm an RN.

There are many things about it that I enjoy - and a few that I don't. The center where I work still uses cloth pads on the residents beds - and regular washclothes to clean their bottoms. Aside from the esthetics of washing a face with the same cloth that was covered with feces the day before - I'm thinking that these cloth pads hold the wetness and are harder on the people's skin. They seem to have a lot of bedsores, and the aides do seem to be turning them as they should.

Give me your wisdom on the subject, please.

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With the washers we have at our facility, I am sure the wash clothes are washed quite well.

As for the pads, we are discouraged from using "Chux", as they are thinner, and promote breakdown a bit more. Plus, the pads are easier to help lift the patients. Never use more than two pads, though.

Suebird :p

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I don't know what the research says about the difference in skin breakdown/hygiene between paper/plastic chux vs. cloth ones. But I would love for it to be proven that the cloth ones are better. I hate those plastic/paper things - they tear easily, never stay in place (how many times have you walked in a Pt's room and found the plastic chux underneath their shoulders. Lot of good that does.) Plus, with the paper things you have to add an extra draw sheet so you can move the Pt. The cloth ones are great for moving Pts. My new hospital has the crappy plastic ones and I miss the cloth ones. Anyone know of research out there? Maybe I can present it to my manager.

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I would figure the cost between buying those "cheep" plastic things and the cloth ones would be one obvious clue. Mind you, I use the blue chux for setting up treatments; I loathe using them on thin, tender elderly skin.

Suebird :p

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Specializes in Gerontology, Med surg, Home Health.

We recently took all the paper/plastic chux out of the closets and replaced them with cloth soakers. The staff is happier because they are easier to use, the residents seem happier because the cloth is soft and the business department likes them because it'll save about $17,000 per month!!! which we can spend on other items....no increase either in skin issues. We do NOT use briefs at night.

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Specializes in LTC, dementia, geriatrics.

We also use the paper/plastic blue chux. Everyone that is incontinent wears pull ups or diapers. We only have 2 decubs at this time. That is the most we have had in 3 years. Also our facility does not smell of urine. We have 42 beds.

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We use the cloth bed pads and adult briefs. We have no decubs that occured in house. I think as long as the residents are actually checked q 2 hours it doesn't matter but if they are not then the cloth is definitely better. The plastic allows more moisture not to mention heat!

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Now I'm looking back on it after a few months experience - and I still hate those cloth pads - I find that they end up around a patients shoulders, and wrinkle just as bad as the 'chux'. Plus we have residents that end up with 2 or 3 complete bed changes every nite - these cloth pads are fairly sizable, but the urine just seems to spread everywhere.

My son had worked at another facility where they used some type of disposable that was bigger and thicker than the chux. And they were supposed to draw the wetness away - kinda like the disposable diapers.

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I do not think that either type of chux is better than the other.However I know that admin uses cloth because it is cheaper to wash,rather than buy more disposible.

I also like the cloth chux for lifting.

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what must be looked at with skin breakdown is checking/changing Q2H and whether or not ALL shifts do this. Also look at how often they are being washed. Just one shift failing to properly cclense and wash a resident can result in skin breakdown. Cloth pads are generally better for the skin because they wick the moisture away form the skin, where the paper chux hold the moisture and heat. they also bunch up and make pressure "points" under a resident.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

Did you go into nursing because it was trendy? You were taught nursing theory to help you deal with these issues. You also use your creativity to solve these problems that nurses have had to deal with for years. Not all places have the financial means to stock all the newest new-fangled supplies. What do you think the nurses in the third world countries and even poorer areas have to contend with? Wake up! Nursing is not a fashion show.

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when i worked in ltc, i was doing rounds one noc and many of the residents needed a total bed change.

i guess the adon was trying to cut costs and ordered some very poor quality attends.

1 month later: doing rounds.

all beds dry.

the other nurse brought me to a resident, who had 3 attends on!!!

i ended up checking every single resident.

over half of them had either 2 or 3 attends on!

that came to a stop immediately.

and the cna's were not happy w/me for awhile.

leslie

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