Time/date ON residents' briefs?

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Specializes in geriatrics, dementia, ortho.

This week at the AL Facility I work at, we had a big hoopla because apparently some of the residents' families complained to the manager that their loved ones pericare was not being done. :mad: Bad, right? I'm not sure how they determined that, but it sounded like it was because their briefs weren't changed. I'm not sure, since I only work there a few days a week and just heard about it second-hand.

The way it works at that place is that 'daily pericare' is one service and 'incontinent care' is a different one. So even if someone is continent, they can get a daily cleaning to prevent UTI's. Or if they're incontinent but able to change their own briefs, they get cleaned daily by someone else. Or some people are incontinent and get changed every 2 hours, but are able to clean themselves in the shower or whatever. So pericare and briefs don't always go hand-in-hand there.

So our manager, rather than adding a pericare chart to the pericare resident's bathrooms (which I'd think would make the most sense, because pericare residents are not always incontinent), she decided that we all need to start writing the date, time, and our name on their briefs. And if we check and the brief is dry, cross that out and add the new time.

I personally feel like that's okay for our more confused/less aware residents, but the alert ones don't like us writing on them, and I don't blame them.

Does anyone else have this policy? What do you think as far as it being a dignity issue vs. being sure care is done?

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I worked at a place that did this. It was kinda lame cuz it's still possible to put whatever time you want but anyways.....

I see what your saying about people don't want to be written on. Write on it before you put it on if it's a new one. As far as if it's still good, there's not a lot you can do. Maybe say "sorry I have to do this." maybe they'll do what we eventually started doing, and that is, you only had to write on them during the last round of your shift.

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Specializes in Med-Surg/urology.

Some of the caregivers at the AL i work for did this too.. haven't seen them do it in months though. I put it in the chart when they were changed last. Like if I'm working day shift, I'll change them between them between 1-2pm. And if I'm doing evening shift, I'll change them between 9-10 pm.

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We have to do this at my facility as well. The reason is that residents were being left for entire shifts with the same (usually dirty) brief on and there was no accountability for who wasn't doing their job. Write on the brief before you put it on the patient. Yes you can pretty much put any time but people can tell a brief that's timed 9pm and soaked to the point of wringing by 11p! I do report those aids, if talking to them myself hasn't had any effect.

This works for aids who aren't checking/changing their people or just re-timing them... write the name under the butt or on the back. Where it will be seen only when you are changing the resident. The lazy aid who sees no writing and simply puts his name/time on the front will get caught out completely. And deservedly so. We generally write on them at last round also. If a brief has already been re-timed once, I put on a new one anyway and write on it before I get to the patient. I've never had anyone complain about being written on for retiming after I explained it to them.

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We have done it in the past to help catch the lazy CNAs. Usually a nurse would initial, time, and date it with a Sharpie. If the CNA did not bring the brief with the writing on it and show it to the nurse within a specified time frame (2-3 hours), the CNA would get a verbal warning or write-up.

Occasionally I will mark briefs on my own while I am doing rounds if I am working with a dodgy person or if I know the person working after me is a "complainer." Those are the people that when confronted with a soaking wet brief will run whining to the nurse "Well, it was like that when I got here. XXXXXX didn't change him/her." They can't seem to take responsibility for themselves or their residents.

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Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.

I do this for one resident. No policy or anything. The daughter and son come in pretty frequently (2-3 times a day) just to check on their mom. Really nice people. We time & initial it just for their benefit. They will change her if it's been more than 1 1/2 to 2 hours. Or if she's super wet, which is constantly.

We changed this woman before the end of shift one day around 1:30. A friend of mine came in at 10:00 and her brief was still on! They saved it and we saw it the next morning. If her family had seen that....

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It's just sad that we have to do things like this, people should just change them....it's their job :mad: come on already

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I argree with everyone on here. It is an absolute shame that some CNA's are not changing dirty briefs or checking them all shift. What are they doing if not their jobs? If they can't do this they should be written up or fired it is definately neglect to say the least. Too bad they aren't given a dose of their own medicine and try being their patient for a day. I work in a ICU and we don't let people go for more then 10 min unless they are coding or something more serious like that. I have seen a lot of wounds that are so deep into the muscle from tissue breaking down from failure to address simple things like wet/ soiled attends. Simple abrasions occur and then MRSA or necrotizing fasciitis takes hold and they have to remove diseased tissue all the way to the bone. Not for the squeamish.

I am sure if the offenders see pics of this they would address patient care a lot more seriously.

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I have also worked long term care before ICU and it was never acceptable to leave anyone soiled. Especially more than 1hr at most. You can smell in the hall when they BM so it was completely unavoidable to say you didn't know if they did or not.

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Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.

I refuse to work places that make me do this.

Here is why:

*It does not really protect your job, in fact it can cost you a job.

Nurses or family who want to say you did not check the patient can just say you marked a dirty diaper. If you are working a large number of patients and get tied up and not able to get back in 2 hours, it can be used to say you are not making rounds.

*It is humiliation.

How would you like the symbol of your lack of independence emblazoned across YOUR crotch every 2 hours rather you are asleep or awake.

*It is not a legal document.

Unlike MARs, ISBAR, Hourly Round, or even the ADL sheets, no court is going to admit a marked, urine soaked diaper as proof you are not being neglectful.

Most of the time as a CNA, you will have NO say if administration tries to implement this. It is only to make supervision of CNAs as easy as lifting a cover and getting out of a patient room ASAP. Do not be fooled into thinking it protects CNAs or helps patients.

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Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
We have done it in the past to help catch the lazy CNAs. Usually a nurse would initial, time, and date it with a Sharpie. If the CNA did not bring the brief with the writing on it and show it to the nurse within a specified time frame (2-3 hours), the CNA would get a verbal warning or write-up.

Occasionally I will mark briefs on my own while I am doing rounds if I am working with a dodgy person or if I know the person working after me is a "complainer." Those are the people that when confronted with a soaking wet brief will run whining to the nurse "Well, it was like that when I got here. XXXXXX didn't change him/her." They can't seem to take responsibility for themselves or their residents.

Something like that - the nurse putting "secret" marks on diapers went to a union hearing at a VA one place an agency placed me.

Its called ENTRAPMENT.

Although with right to work laws, that can and does fly. (unfortunately)

Why did not you just change the thing? If the CNA is playing on a cell phone or is off the floor more than on, just report them for that!

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Why did not you just change the thing? If the CNA is playing on a cell phone or is off the floor more than on, just report them for that!

I DO change every dirty brief that I see. The main purpose I've used it for is for "protecting" myself against the next shift. I'll change someone on my last rounds, but then the person relieving me won't change the person for 3+ hours. By that time, the resident is obviously soaked and they will tell the nurse I hadn't changed people when I left. If the brief is marked by me and the charge nurse with the time, the facility will stand by me and my charge nurse as long as it's obvious the brief hasn't been on the resident all day. It's basically just a way of shutting up the complainers, because in reality they really don't have anything to complain about. :yawn: THEY are the ones that left the resident sitting there for 3 hours. They just don't want to take responsibility for themselves. :down:

If you've worked in health care (well, or any job :rolleyes:) for any amount of time, you know that there are some people that just LOVE to complain about anything and everything (Don't you love them? :hug:).

No, marking briefs not a perfect system. There are GAPING loopholes in it. But it's been instituted by my facility as an acceptable way to "protect" oneself, so I use it when necessary. I only wish it weren't necessary and that everyone would just do their jobs right the first time. :)

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