"Maternity Care Cost Saving Ideas" Please Share

rn/writer, RN · Aug 14, 2005

We use 12 x 12 cloth diapers instead of wipes. I understand the need to save money but this is awfully messy and you have to turn on the faucet the minute you come in the room if you want warm water to wet them. Some patients bring in their own wipes. Maybe that was the administration's hope all along.

We also dispense self-med packs to the new moms. Ibuprofen and stool softeners for the vag moms. Ibuprofen, stool softeners, and anti-flatulants to the section moms. We give them sheets to tell them when to take each one and to record the times they took them. The section moms come to the floor with PCA hydromorphone and can have IV toradol as well for breakthrough. The vag moms can have percocet or darvocet if they're having serious pain. After the first 24 hours, many women say the ibuprofen (taken at regular intervals) is sufficient. And because they are keeping track of it themselves, we are not constantly running to fetch it for them. At first, I was surprised by this approach. Not all that long ago, the thought of patients dispensing their own meds was considered heresy. But I have to say it works well and actually promotes independence and self-determination.

Re: the perineal ice packs. Before there were commercially-made packs, I remember using a latex glove filled with ice chips on my stitches. It worked but it DID feel a bit odd to have a disembodied " hand" down there.

Miranda

palesarah · Aug 14, 2005

Two pairs of panties per pt? That's awful It must feel terrible to have to be cutting costs like that. As our census has increased (but not our budget) I'm finding that we have fewer "extras" available for our patients, but about the worst that we've had to do was discontinue giving meal coupons to Dad. We do also use washclothes in lieu of baby wipes, as the hospital finds it cheaper to do the extra laundry (but the ecologic benefit of not disposing of all those wipes is nice too).

My initial thought when reading that they're no longer supplying you with ice packs was to be a bit shocked, but honestly, homemade ones work a lot better for many of our patients than the ones we're supplied with. For serious swelling after delivery we like to use real ice anyway- most people use gloved ice, but I find that separating the top lining of a pad or even a baby diaper on one end and filling it with ice is so much nicer- more comfortable, and it absorbs itself as it melts!

I'm having trouble thinking of ways to cut costs, but I'll think on it and maybe ask a few people at work later... there must be ways to cut costs without making your patients feel like they're missing out.

daisybaby, LPN · Aug 14, 2005

We don't feed dads, either- and surprisingly, only the families who believe they are entitled to everything under the sun complain about it. We also do not have a coffee/pastry cart in the mornings, whereas other hospitals I've worked at do. I do agree with the ice glove concept. They do work better that the cold peri pads- half the time they don't activate and get thrown in the trash.

The two pairs of panties thing is a little over the top, I think. Goodness knows they get soiled easily enough!

BETSRN · Aug 14, 2005

We don't feed dads, either- and surprisingly, only the families who believe they are entitled to everything under the sun complain about it. We also do not have a coffee/pastry cart in the mornings, whereas other hospitals I've worked at do. I do agree with the ice glove concept. They do work better that the cold peri pads- half the time they don't activate and get thrown in the trash.
The two pairs of panties thing is a little over the top, I think. Goodness knows they get soiled easily enough!

I have to agree with the panties thing. There must be other ways to cut (like extra nourishmants) instead of making the moms go without undies. I'd go with NOT feeding dad (more than once and being far more careful with those kinds of things that really do not impact patient care.

Is your facility careful about how things are charged? I know that when we finally got a Pyxis for our meds, we really did better. Look into making sure everything is charged out corrcetly before you start cutting the underwear!

We used to have the self medication packs but we got rid of those as well. First, the patients didn't like them not to mention a lot of meds are wasted when they aren't needed. We find it is better to give patients meds when they request them and then the patient gets a far more thorough assessment. Patients like their nurses to care FOR them and giving meds on an individual basis is far moer personal than the self medication packs.

palesarah · Aug 14, 2005

what sort of unit do you work on? Tertiary care center, community hospital? How many deliveries a month? LDRP or is post-partum separatw, do you have a staffed well-baby nursing and what do they do? Do you have or can you get volunteers?

As doula care has been shown to reduce the # of C-sections (among other wonderful things) perhaps starting a volunteer doula program would help, especially for teens and "needy" patients, and those whose goal is to have a natural delivery .... Hmmm, I wonder if I could start up something like that?

BETSRN · Aug 14, 2005

what sort of unit do you work on? Tertiary care center, community hospital? How many deliveries a month? LDRP or is post-partum separatw, do you have a staffed well-baby nursing and what do they do? Do you have or can you get volunteers?
As doula care has been shown to reduce the # of C-sections (among other wonderful things) perhaps starting a volunteer doula program would help, especially for teens and "needy" patients, and those whose goal is to have a natural delivery .... Hmmm, I wonder if I could start up something like that?

If you are talking to me, it's a community hospital (LDRP) and we do somewhat over 800 deliveries a year. We have nurse midwives as well and only 2 out of 10 of our OB's are men. Women rule at my place. We have a nursery but try and encourage 24 hour rooming in. We do NOT use volunteers at all for any patient related things. We have the occasional patient come through with a doula.

MOM2TWO · Aug 14, 2005

Our unit is charged per item for things we use from the dietary dept. We still serve dad a meal at meal times(for now) but to save money we stopped ordering the laboring mom's clear liquid trays at meal times and just let them know we are now better stocked with the liquid diet items in our kitchenette and we can get them what they want throughout the day. Most of the trays from dietary sat because they either weren't hungry at the time, or were just delivering. It also makes for less trays to pass now. So far it seems to work great. :)

palesarah · Aug 14, 2005

If you are talking to me

thanks for your response, I always enjoy reading what you have to contribute :), but I was actually meaning to direct my ?s to the OP

prmenrs, RN · Aug 15, 2005

We started a policy a few months ago that works absolutely great, but only because our hospital is

Might not work in PA, tho...

jrring1019 · Aug 15, 2005

Hello Everyone,
Cost Savings.....We are at it again in our department....Does anyone out there have any suggestions? We have become pretty good at cost savings and I cannot think of anymore. We have eliminated our maternity care pack, perineal ice packs(we now make our own), limited 2 pairs of net panties per patient, and so on.....We now have to pay for glucose water and sterile water (the formula compaies now charge for this).
I just thought I would drop a line here to see if anyone had any suggestions. Please feel free to drop any suggestions at all....I will gladly take them.....
Thanks :)

At the hospital I used to work at we used an omnicell which means EVERYTHING you take out for the pt is charged to the pts account. So if the pt needs more of anything (soap, panties, pads, etc...) you have to remove it under her name. At the hospitals I work at now all of the supplies are out on shelves to just grab, which I can see would loose a lot of money for the hospital if everyone is charged a flat fee.

I can't imagine rationing panties. What do you say when a pt calls out for more? If you eliminated the maternity care pack what do you give the patients? Can you use a system to charge pts for all the extras?

sbic56, BSN, RN · Aug 15, 2005

The rational with limiting moms to 2 pair of panties is that the patient can rinse out the soiled pair and they'll be dry when needed. It works and since they cost like $12/pr, it's worth it.