Tips for changing adult briefs?

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Hello all. I'm actually an LPN student with 0 CNA experience. I'm in my med-surg clinicals right now, but we still have to do bedbaths, brief changes, linen changes, toileting + dressings, catheter insertions, tube feeds, etc. During our CNA clinical rotation, I didn't get to practice my basic patient care as much as I wanted to.

This is going to sound silly, but the thing I have the worst time with is changing adult briefs on bed-ridden patients. Last Thursday, I had a coherent patient almost freak out on me because she thought the back of her brief was up too high on her back (it wasn't), and on Monday I took so long trying to get one on an elderly lady with dementia that she got pretty upset with me (she had a BM right after I did perineal care on her and just as I was about to put the new brief on, so that didn't help matters, ended up having to change all her bed linens). Is it just something that takes lots of practice? I'd really appreciate it if y'all can give me any tips. I hate learning by trial-and-error at the expense of my patients. Thank you. :o

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Specializes in geriatrics, dementia, ortho.

Side tab fastening ones are easier than the pull-up type if your patient can't get up. Unfasten the tape holding it on, and roll them onto their side. Pull the brief out, and throw it away. Clean the person up with wipes or peri-wash or whatever you're going to use. Lay the clean brief out on the bed, so it's in position, then roll them back onto it. Clean their front as needed. Roll them side to side as needed to get them centered so you can fasten it up.

If they have the pull-up type, you can just rip the sides to remove it, do the same thing (roll to side for cleanup, then onto back so you can reach directly between their legs to clean further). Slide it up their body and if they can lift their hips at all to help you, have them do so. Otherwise, side-to-side rolling again to get it on.

Good luck! Hope that helps! You'll get faster with practice and figure out what works best for you. If your patient wants it adjusted, I always just move it around a little bit and then put it back where it belongs. Since they can't see what you're doing, this usually satisfies them that you fixed the problem, even if there wasn't one to start with! :)

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Thank you! It sounds so easy when you type out how to do it but actually doing it is a different story! The lady who thought her brief was up too high actually asked me if I worked as a CNA before nursing school. I told her no. She said, "That's what I'm worried about." How encouraging. :(

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Specializes in geriatrics, dementia, ortho.

Oh, yeah, it's much harder in real life. If it's a very large patient, try to get someone to help you turn them/hold them on their side once they're turned. And try not to take what the patients say to heart; they don't feel good, they don't have control, and they're cranky. I've heard some doozies too but I promise they would have said it to anyone that was in the room at that moment. Hang in there! :redpinkhe

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Specializes in LTC.

Is it just placement that you're having a problem with? Always put it lower than you think it should go, and it usually comes out right. If the person doesn't have big legs you can actually push the front of the brief through their legs while they're still on their side and fasten the tape before you lay them on their back again.

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when they are on their side and you put the brief down, push it more between them and the sheets, sort of tucking the side of the brief under them so you have enough to pull out from under them to fasten it when you roll them back onto their back. kind of push it under their hip they are laying on.

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Specializes in Med Surg, Home Health.

Someone on this forum posted something that has been invaluable to me: even if the resident is skinny but especially if they're big, make sure the brief is up and then PRY APART THE CREASE BETWEEN THEIR GROIN AND THEIR THIGHS in front and BETWEEN THEIR THIGH AND THEIR BUTTOCK in back. Make sure the brief is tucked into these creases instead of skimming over them.

Why is this important? Just think of those creases as cracks through which pee and poo can escape the brief. You want those stopped up, not left open!

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Specializes in LTC.

You want to line up the padding area (usually white) the top of that with the top of their butt crack. I wish I had a picture or a diagram, but that is how I usually get it to be the right level. I dont know how else to explain it, but like the other lady said, you want to tuck it in under their hip before you roll them, then roll them towards you and pull that part out. You get it...just keep practicing!

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It takes practice. When I started, I'd put them way too high on the back and have nothing in the front. You really will get better. Just make sure the diaper is just coming al ittle higher than the buttcrack basically. Don't unfold the front flaps until the patient is back on their back.

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