"Peenie-wraps"?

[BrandonLPN, LPN]

Has anyone else heard of these? At my facility (90% male residents) we put them on most of our incontinent residents. Basically it's where you take a brief, poke a hole through it, pull the member through the hole and wrap it around the member in a ball. So the member is all "wrapped" up. Then you just dress the resident in another brief and pants like normal. This is done so the guys don't soak their pants, sheets, wheel chair, etc. They've been doing it this way for at least 20 years. A new nurse just started, and she says this is "illegal" anywhere else. I have to admit, I was shocked and appalled at this practice when I started, but it really doesn't seem to cause any skin issues. I DO think we have more UTIs because of them. When i started, the staff educator told me they were harmless. I had never seen them before this place, does anyone else use them? Does it seem like a health issue?

[Asystole RN]

I am curious as to the advantage of utilizing two briefs for a single soiling versus one. Are your male patients so well-endowed that a separate brief must be used to contain their massive genitalia? Do they urinate in such vast quantity that a single brief simply cannot contain the deluge? Or is this so that they can be left for a longer period of time between brief changes?

This could very much so be a patient dignity issue but I am curious as to what a clarified rationale would be.

[Animal3]

Why not use a condom cath?

[traumaRUs, MSN, APRN]

Yeah, Texas cath seems a lot easier.

[BrandonLPN, LPN]

No, we use them on all incontinent male residents. They're used to decrease the frequency of brief changes. Most of them get a brief change once, maybe twice, a shift. It should be noted the residents prefer them. They can go about their day without soaking their pants. And most of them request (demand) not to be woken during the night and third shift only changes them once, shortly before first shift comes in.

Again, I was stunned by all this when I started, but it really does seem to work well. We have less skin issues than most other facilities I've seen. And the guys seem happier and have more freedom to go about their activities. We have a garden, a wood shop, a cafe, a pool room and a bowling alley all on site and lots of volunteers tom help them out. I think the wraps are just used to enable the incontinent residents to be off the floor for extended times and to sleep through the night. It sounds lazy/shady, I know, but if the guys are healthy and happy, isn't that all that matters?

Sometimes I just wonder if having soaking wraps pressed against the member causes UTIs?

[merlee]

I am having a hard time visualizing this, and am not sure if a male incontinence brief would not be more appropriate. Does this wrap act like a clamping device of sorts?

There are a variety of incontinence systems that would seem to be better overall. Is this a financial issue, as well?

Interesting!

[caliotter3]

First I've heard of this. One of the other CNAs showed me her famous burrito wrap when I first started out. We did this on night shift. Cut down on number of entire bed changes.

[blessedmomma247]

I have been in LTC for a long time and this is a first for me. To me, this would be both a diginity and health concern. I would also think this is cause of your increase UTI's because the residents are not getting proper peri-care done. Generally, in most LTC, residents should be offered to be toileted every two hours and more if needed. If a resident is constantly soaking thru the brief, his clothes, and down to wheel chair; then that should be evaulated further rather than covered up. Do they have an over active bladder? UTI? Is it related to their meds? I also understand that residents have the right to refuse to be changed or toileted, they are busy with daily activities and therapy; however I think having a toileting program in place is better than "peenie wraps".

[IamBSN]

I'd be worried about skin integrity due to prolonged exposure also. You don't have increased skin issues using these?

[CapeCodMermaid, RN]

I've been a nurse for 30 years and NEVER heard of such a thing. It seems to be a huge dignity issue. "Pardon me while I wrap your member".

[BrandonLPN, LPN]

No, no skin issues. I had never heard of it either and thought it seemed outrageous, too, at first. Like I said though, the guys prefer it. It cuts way down on actual brief and/or linen changes. One can just undo the briefs, change the peenie-wrap real quick, and retape the briefs back up during rounds. No tiring or changing linens required. It seems to work fine. :shrug:

Thanks for the responses. Interesting to know I wasn't the only one who hadn't heard of this.

[SuzieeQ]

If using the wrap to decrease full bed changes, wouldn't a soaker pad be sufficient? There are plenty of other incontinence products available for nocturnal incontinence.

In LTC, I have seen the females insist on putting 2 pads inside their brief at night time and refusing to be changed during the night by staff, so I guess this is the same thing but for males...