black angel

Patients are put on diapers due to incontinence. Practise has changed since patient develop skin break down due to the incontinence state. some of the Seniors suggested using incopad instead of diapers. WHen they suggested that I start to query, the rationale of using incopad. the function of incopad is to be used as a protective sheet to prevent soiling of the bedsheet, etc... A diaper is made and designed for elimination incontinence. How then can a incopad supercede the original function of a diaper?? A collegue asked me when she saw this practise on the ground.. she was shocked:eek: to see that the seniors are teaching the young the wrong thing... Actually, skin break down is not so much b'cos of diapers but due to nursing care to begin with. How then can prevention of skin ulcers be prevented just by using incopad??? Incopad: does not contour to the body like a diaper does, it's not designed to be used like a diaper, & worse if not changed regularly. The only advantage of it prob would be it is visibly wet/soaked if patient should wet/soil themselves. Both of us tried to convince the rest to stop this practise but to no avail... When we pointed out the rationales.. they look so lost.. Someone please tell me how can I review and change this practise?? bcos... The seniors are astonished when I told them to change this wrong practises... Many of us just can't convince ourselves to allow the use of incopad as a diaper... OMG.. its like putting incopad for a baby who needs diapers.. I need help.... Thank you...

Hey there, Nursing documentation is in deed a headache. As per taught in school " what is NOT documentated is NOT considered done in the eye of laws." It's perfectly fine to qoute exactly what the Dr, Patient or relatives say however, all these depends on circumstances too. I usually quote when it is gona be a potential complain ot affects the patient's health care professionals or relatives safety. This is to protect not just your patients but your license as a nurse.. Alot of time U nvr know when things will happen and u may be called to the court after a few years And your documentations will savw you alot of trouble.... i sahre one incident with you. I Had a patient who needs to be transferred to the other ward due to discipline over flow. When I was at the receiving ward, my collegue called me and told me that the lab staff wana speak to me. I was informed by the lab staff that patient is MRSA +ve for blood culture. I informed the the receiving nurse about the results and also told her to informed to informed the team drs about it as the team drs were in her ward making rounds then. I documentated what I done. 3 weeks later, I was on annual leave and when I came bk, I was told by my NM that the patient whom I transferred had been disharged without treatment and was readmitted one week later and passed away in ICU for sepsis. When they tracked back the notes... Cos it was considered a negligence event.... So My documentations had saved me to go through the interrogations by the onvestigating board. It's better to write more then not write at all... U need to be factual and summarise the key points so that it will not become a essay.. hope this helps.:loveya:

Hey, U can explain to the patients by making it simple to understand. PT(promthrombin time), PTT(Partial Thromboplastin time), INR (International Normalised Rate)are a set of tests to measure the coagulation profile. So if the PT/ PTT results is prolonged, it means pt is at risk of bleeding, easy brusing etc eg, when u off iv plug for the patient, it will take alonger time to stop the bleeding as compared to a pt with normal pt/ptt value. PT/PTT is a set of tests to measure the coagulation profile, which measures the clotting time it takes to stop bleeding in a person. (eg: in a trauma, need to ensure that the PT/PTT is normal, if it's abnormal, need to give iv ffp or platelets.) PT= 1) evaulates the adequacy of the extrinsic pathway and common pathway in the clotting mechanism; 2) provides a control for pts on long-term anti-coagulant therapy such as heparin.warfarin) Therefore, PT value will tell u how fast/slow the clotting time is PTT= 1)evaulates the intrinsic coagualtion system 2)Monitor pts on heparin therapy to aid in detecting Hemophilia A, Christmas disease, Congenital deficiency in clotting factors II, V,VIII, IX,X,XI & XII 3) screens for DIC, Liver failure & congenital clotting factors deficiency INR= 1) measures how thin the blood is. (normal usually keep INR 2-3 for patients on anti-coagulant therapy:heparin, warfarin) 2) usually done for pts on anti-coagulant therapy I hope this helps u understand better.