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Is this common?

Posted

Specializes in Telemetry.

I was just wondering if it is common practice in LTC to only have wash cloths, soap and water for all brief changes, peri care and disinfecting things like shower chairs? Oh yeah, and ONE thermometer for about 90 residents? Really??

Absolutely not. At the LTC that I did my clinicals at back in December had roughly 100 patients. We have atleast 2 dynamaps per wing (3 wings), a huge cart of towels, wash rags, etc per wing, and a large supply closet with all of the bed linens.

redhead04073

Specializes in Geriatrics. Has 8 years experience.

I know we have one rectal and one oral thermometer for one floor, 48 residents. And one O2 stat machine. We really need more vital sign equipment....

fuzzywuzzy, CNA

Specializes in LTC. Has 3 years experience.

We have one dynamap (or maybe it's a different brand) per wing and I hate it. I don't think it's very accurate. The blood pressure thing usually takes forever and if I recheck it manually I get something different. The temperatures are all really similar- everyone will be between 97.0 and 97.6 on one day, then the next day they'll all be 96.2-96.9. It looks like I just made it up! I usually borrow a cuff and stethoscope and sometimes an O2 sat probe (if she has one) from the nurse, but we have no other thermometers.

asun21ta

Specializes in LTC, Home Health. Has 5 years experience.

I onced worked at a facility where we had to use soap and water to do our changes. A pain? Yes, but you get used to it. I'll tell you what, out of the several facilities I worked for, this particular LTC had hardly any pressure sores. Wipes are good, but they do not remove all the fecal & urine matter. That combined with sitting in one spot all day creates pressure sores. So while it's a pain if wipes are not available, it is better for the patient.

Each bathroom with a shower or bath should have a thermometer. The bathroom should be wiped clean with rags that are NOT used on people. If they are using the same rags, that is an infection control issue, and it should be brought up to your DON.

chickapea

Specializes in Telemetry.

Thanks for the responces. I was thinking like 4-5 thermometers would have been more accurate. There were 2 portable vital stations, 1 was broken. Lame. I would have liked to disinfect shower chairs with alcohol wipes or something other than wash cloths. I think LTC should be forced to go that extra mile, I mean how much more could it really cost when it makes such a difference on the quality of care... jmo

fuzzywuzzy, CNA

Specializes in LTC. Has 3 years experience.

we don't have wipes either. we use washcloths for peri-care.

redhead04073

Specializes in Geriatrics. Has 8 years experience.

We aren't allowed to use washcloths for peri-care. And if we were to get caught throwing a washcloth that was too poopy to be saved.......ooooooooh boy, big trouble!

chickapea

Specializes in Telemetry.

Yes, I think wipes are way better and less time consuming in the long run which leads to better care over all (especially if you have a peri spray). And someone stated above that wipes don't get the fecal and urine off as well as wash cloths do... I disagree. I think it's the effort the CNA puts forth that determines how clean the resident gets. Also, I still love alcohol wipes for disinfecting surfaces... that's how I'd want the shower chair to be cleaned that my butt was going to be on after everyone else's. That should be mandated.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

Wipes are convenient, but expensive and often irritating to sensitive tissue. I see a lot of that with my residents and would rather do peri-care with warm wet washcloths, plus shaving cream PRN for the grime that gets caked on when people sit in it all day.

Oh, and a big YES to disinfecting surfaces with alcohol or a bleach solution. I get the heebie-jeebies whenever I so much as think about sitting in someone else's bathtub........I know I'd refuse to have anything whatsoever to do with bathing if I had to park my butt on a shower chair someone else had used (and done Lord knows what else in). Yeccccccccccccchhhhhhhhhhhhh.

asun21ta

Specializes in LTC, Home Health. Has 5 years experience.

Yes, I think wipes are way better and less time consuming in the long run which leads to better care over all (especially if you have a peri spray). And someone stated above that wipes don't get the fecal and urine off as well as wash cloths do... I disagree. I think it's the effort the CNA puts forth that determines how clean the resident gets.

In my CNA class, we were taught that wipes do not remove all fecal matter, only soap and water can do that. For that reason, that particular nursing home choose not to use wipes. I'm sure the cost & potential skin sensitivity was the factor in this decision as well. Just a few months ago, my doctor gave me a friendly reminder at my daughter's well baby checkup. She wanted to remind me it's best to wash my baby's behind with soap and water after a poo as wipes are not capable of removing all fecal matter from the skin. Now, that does not mean that I believe that wipes don't get you clean. I believe wipes get you clean to a certain extent. I am in no way against them. But, wipes can leave behind residue and bacteria we cannot see.

chickapea

Specializes in Telemetry.

Good to know wash cloths are better. In my clinicals and in some facilities we used both. We used wipes with a peri spray (not alone) to clean. If the mess was everywhere we used soapy wash cloths first and of course a towel to dry. At the last place I worked they did not seem to have much of what was needed in many areas of care. It was not just the wipes the list went on and on...

asun21ta

Specializes in LTC, Home Health. Has 5 years experience.

I worked for an LTC where they would constantly run out of supplies. Towels, wash cloths. One week they didn't even have breifs! All we had were small breifs. I was on vacation that week, but I was told that people were taping two breifs together! The residents were still complaining about it when I returned a week later. Now thats bad!:nono:

cjcsoon2bnp, MSN, RN, NP

Specializes in Emergency Nursing.

Try working for a LTC facility that has a limit on how many washcloths and towels you can use on each resident (in this case it was two washcloths and one towel per person per shift.) This means that once you use your two washcloths and one towel to clean a resident in the morning if they are incontinent before the second shift you will have nothing to clean them up with unless you borrow them from the next resident because the towels and washcloths are closely counted and the linen closets are locked up so that you cannot get any extras if necessary. This was my experience as a nursing student during my gerontology clinical and I know as a CNA I would never work at a place like that but unfortunately I don't think its as uncommon as people may think. LTC in this country really needs an overhaul, badly.

!Chris :specs:

asun21ta

Specializes in LTC, Home Health. Has 5 years experience.

It was that bad where I worked! Conditions for the residents were terrible. It was so bad some days residents could not get showers because there were no wash cloths or towels. I am happy to say I no longer work there. I still think about the patients from time to time though. I wonder if the quality of care is still as poor as it was when I left last year.

rachelgeorgina

Specializes in ..

In the nursing home I work in we use high care pads (fancy wipes, basically) but in all the hospitals I've done clinical on it's a tub of warm soapy water and wash cloths

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