Barrier Cream

  1. My DON wants to switch to Vaseline as a barrier cream for incontinence as a cost saving measure. Does anyone else have experience with this?

    We were using Smith -Nephew, but switched to Medline and are not happy with their products.

    Vaseline is fine with me, but how does it work if the skin is already irritated?

    As usual, consulting me, the WCC is only done after the fact!
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    About sharlynn

    Joined: Mar '03; Posts: 320; Likes: 89
    Wound Nurse, LTC, Hospice; from US
    Specialty: 43 year(s) of experience in ICU, CCU,Wound Care,LTC, Hospice, MDS

    13 Comments

  3. by   suebird3
    A & D ointment is just as effective. If there is any excoriation, Critic Aide is good, also. I have used Calmoseptine, but that may sting some.

    My orders always read 'A & D oint as needed after each incontinent episode.'

    Suebird
  4. by   Marie_LPN, RN
    I remember as an aide we were given huge jars of generic Vasoline to use as a barrier cream, to save money. It seemed to rub off very easily, people who were already sore from urinary incontinence took a very long time to heal, yet here we were told to keep using the Vasoline on them.

    Luckily we had a DON that listened when we said we needed something for the people that already had irritated skin, so were we told to use our own judgement for the use of Desitin or A and D oinment. Critic Aid was only used on the bigger irritations.

    I typically used the vasoline on the regular skin, the A and D oinment on people that were prone to dryness or the white tube Desitin (the creamy brand just wasn't as good) on irritations.
  5. by   UM Review RN
    I personally prefer A&D. I like Baza because it's an antifungal as well.

    It might be more effective for the facility to develop a policy on skin ointments. Perhaps a decision tree for the most effective ointment.

    Use Vaseline for a barrier ointment. If a rash develops, document appearance and begin treatment with an antifungal till rash is gone, then go back to the Vaseline.

    Heavy diarrhea problems would also require a treatment regimen, maybe something like Triple Thick Baza to minimize excoriation.
    Last edit by suebird3 on Aug 21, '06 : Reason: double post
  6. by   suebird3
    I know that the manufacturer of Baza and Critic Aide has made a 'clear' version of the stuff. Now to get my hands on some. One of my aides is terrific at cleaning up people, but despite my grousing, gets the Critic Aide off! Oh, well. The rezzies hardly break down after that, none-the-less!

    SueB
  7. by   Marie_LPN, RN
    Unfortunately some of the clear versions of things have some sort of alcohol product in them. Didn't know there was a clear form of Critic-Aid.
  8. by   Marie_LPN, RN
    And it takes a sand blaster to get Critic-Aid off.
  9. by   suzieqlpn
    Our facility uses the protective ointment from smith-nephew..the aides call it blue gel (it is a blue gel), epc(extra protective ointment--white creamy cream) on our incontinent patients. EPC for excoriations and blue gel for those that are incontinent but not excoriated.

    The problem with the EPC is that it is difficult to wash off with regular soap and water and the aides have a really hard time understanding---a little goes a long way. These two products work well at our facility.

    We also use their brand of peri-wash incontinent spray to wash them up after incontinent episodes to get the urine off the skin.
  10. by   Marie_LPN, RN
    I love that Aloe Vesta foam for pericare. That stuff worked well, and was gentle to the skin.
  11. by   sharlynn
    [QUOTE=suzieqlpn]Our facility uses the protective ointment from smith-nephew....
    The problem with the EPC is that it is difficult to wash off with regular soap and water and the aides have a really hard time understanding---a little goes a long way.

    Mineral oil removes the white cream easily-and is good for the skin,too! These are the products I want to go back to again, but DON is very cost conscious.
  12. by   suebird3
    Critic Aide is NOT meant to be 'scrubbed off'; need to let the stuff do its' job.

  13. by   qaqueen
    I work as an aide and know what you mean about not understanding that a little goes a loooong way. At the beginning of my shift, I see caked on barrier cream used with baby powder. Nice combo . It balls up very nicely in skin folds.

    In the defense of the aides, no one ever told me how much to use. So I do understand the thought process, if some is good, more is better.
  14. by   gkrn
    My favorite through the years has been Bohan's butt paste, now sold as Flander's. It is one that is tan in color and the objective is to leave the bottom layer on when cleaning up the person and apply it fairly thick so that you can wipe off the top layer and still leave some on. It is gentle on the skin so it doesn't burn, it has color so that you know it is there, and usually worked with half a tube. Then when the redness was gone, something like vaseline could be started and it would help take off the bottom layer without a lot of rubbing. I also like the Aloe Vesta 2 in 1 perineal skin cleanser.

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