Is this a new trend?

Red Kryptonite · Jun 17, 2015

With the wisdom of some of the cost cutting decisions I've seen, I wouldn't put it past them, but I sure hope this isn't a new trend.

Farawyn · Jun 17, 2015

No, it's not. I've also seen towels wrapped in a diaper and taped. Horrible breakdown.

flyersfan88 · Jun 18, 2015

Reminds me of the anti-bedpan post going on a few weeks ago.

This is not new practice. This is, however, awful/lazy practice.

ahorton75 · Jun 18, 2015

In my major hospital system, we are no longer allowed to use briefs. We are to use bed pans or bed side commodes. For our incontinent patients we use a towel and a chuck.

The reasoning is that briefs hold moisture and lead to skin breakdown. With no brief, it is believed that the stool or urine will be caught sooner and taken care of quicker.

ClearBlueOctoberSky · Jun 18, 2015

With the new types of briefs available, they do not hold moisture next to skin. It is wicked and held in gel form...much like Pampers for babies.

Using a towel is just going to contribute to moisture and dermatitis breakdown, unless you stand there and change it immediately. I know that you, nor anyone else, has the time to accomplish that.

mvm2 · Jun 18, 2015

Though i agree on bed pans and commodes being used i do not agree on people being exposed or just having to eliminate on chucks and towels. Briefs if changed q2 and person is cleaned up properly will not cause that many skin breakdowns. No more then a diaper on an infant's bottom. We seem to think this is acceptable but not on an adult. Talk about dignity issues. I am not understanding the thinking behind being caught quicker if using towel. As many times as you would change a towel you change the brief instead

erroridiot · Jun 18, 2015

Is barrier cream or ointment used?

Examples: Calmoseptine, A & D, Zinc Oxide, Desitin

allnurses Guide · Jun 18, 2015

Is barrier cream or ointment used?
Examples: Calmoseptine, A & D, Zinc Oxide, Desitin

Once we get them yes but you know how rough an industrial terry cloth towel is -it's like san paper on tender old skin when they arrive it does not appear that any barrier cream has been used.

hppy

Libby1987 · Jun 18, 2015

Coming from home health perspective, Depends type briefs are commonly worn voluntarily, whether or not they try to make to urinal or toilet first. The bedfast, usually with a single caregiver at a time, do most often wear adult diapers.

If changed timely and skin barriers are used we either avoid or resolve incontinence related breakdown and as far as dignity, that's been their choice.

I don't know where it came from that those products strip their dignity.

MunoRN, RN · Jun 18, 2015

As threads here have shown, avoiding the use of briefs in hospitalized patients is actually becoming somewhat common, the reason being that incontinence should be managed with immediate clean-up and pan or linen changing and the use of a brief is often just an excuse not to do that. Generally dermatitis is more closely related to the use of briefs, not the lack of briefs.

Unfortunately, even when incontinence is made harder to ignore by not using a brief the laws of time still come into play. With the acuity relative to staffing that now exists in hospitals patient don't always get cleaned up as soon as they should.

RNperdiem, RN · Jun 18, 2015

I wonder if the towel trick is a work-around nurses used when briefs were eliminated. Instead of prompt clean up of the chux with good skin care, which eliminating briefs were supposed to do, nurses made things worse by using towels instead. The patients would have been better off in briefs which at least are more absorbent.

My hospital went to great lengths to educate staff on the newest policies on skin care, virtually eliminated briefs and has policies on how much linen can be used under a patient. I work in ICU, and skin breakdown and excoriation is a big risk that we take seriously.