Most everyone at Mom's NH uses some sort of incontinence brief. At night or during naps they also lay down a machine washable cotton bed pad to stop leaks from getting onto the bedding, in case the resident leaks through during sleep. For those who get changed on the bed, it also catches accidents or messes that happen during changing. At the Family Council meeting last night we were informed that if a resident uses a brief, they are doing away with these bed pads, as they’re considered “double briefing”, and CNAs have been using them to help position residents in bed...evidently a no no. I am so upset. Bedding is usually only changed once a week, and we all let them know that they better be ready to change bedding almost daily, as we’re not going to accept wet, smelly bedding. If the CNAs are using them improperly, address that, but not this way. I have never heard of this “double briefing” concept applied to a brief plus a bed pad! The Ombudsman was at the meeting but didn’t have much to say about it, and the administration didn’t say much when challenged. My DH told them he wants to see in writing how this decision was made and by whom, and they told him OK. Any advice??
Wow. I’d be calling administrators of the facility and if you are told the same thing, I’d find your local agency who overseas facilities and give them a call.
If a person soils bedding, I doubt if its left on the bed and if so I would think its against some State regulation.
I would want to know just how the NH is going to provide the additional protection to prevent the various diseases and infections this may cause.
The slow response of the hospital to soiled protective underwear was bad enough.
Double briefing bad. Increases length of time between changes = higher risk of skin breakdown. Agreed? Sure! Of course, we're all agreed on that.
Ergo anything that lengthens time between changes is bad. Ummm...
Ergo, anything that *could* be used to enable longer intervals between changes is bad. Even if that's not what you're actually using them for, nor what they are actually designed for. What?! NO!!!
Cotton bed pads aren't great as slide sheets because you get too much friction if there's a shearing risk.
I'm fascinated to hear how much extra time they're scheduling in for all the bedding changes. And extra time for having to move bed occupants while they do that - or are they going to change the bed with the occupant in situ, and have they thought through the additional health and safety factors with that..?
Or, they could threaten any CNA found misusing the pads with keel-hauling. Can't see anything wrong with that option...
I feel badly for the CNAs who are already stretched thin...usually 4 for 40 residents on 1st shift. I spoke with one yesterday who was warning me about the upcoming change (as I was changing moms bed) and I told her I hope they were prepared to change bedding much more frequently. She said it will have to be done almost daily! And I swear some of the CNAs have wooden noses. But I sure don’t!
My DH is not letting this go without a methodical rational for the change. He’s an engineer who deals with data, facts, then action, and they couldn’t provide him with any data or facts, just jumped right to action. The ceo is supposed to meet with him next week. I’m going to meet with the head Rn today to see how she envisions implementing this.
If a person is lying in bed and has a bowel movement, where do you think the faeces will go? The idea that they will politely skirt the genitals, even if they didn't also bedaub the rest of the unfortunate person from waist to knee, is... bonkers.
I had a fairly large pad for my Husband and I think if I had not had it the sheets would have been changes several times a day. I also used the pad as a "draw sheet" to help position him up or down or side to side in the bed.
Is it possible to change the term of the particular piece of fabric from a bed pad to a draw sheet?
If they still insist on removing and doing away with pads I would...
Make more frequent visits and check the bedding carefully and if it is in the least soiled complain until it is changed.
If this happens more than once file a complaint with the State Health Department.
Post a "review" on Yelp
File a complaint with the BBB
Any other way that you can bring attention to this do it.
It is possible that the short sighted view is doing away with bed pads will cut cost for the laundry. I bet they will find just the opposite will happen.
DH will be there today and he’s on the warpath anyway since I told him she was soaked through to her wheelchair yesterday when I got there. Not really a bedpad issue, but another symptom of a poor toileting process. Grr.
This won't be the only area he cuts, expect your chicken pot pie to contain lots of gravy and carrots but only one sliver of chicken.
Likewise toilet paper will be put in those dispensers which only allow you to tear off two sheets.
The days of blanket warmers will also be gone and cold drinks will be at room temperature.
Now I have seen really stupid waste. A CNA lined a commode bucket with four disposable chucks - not to the seat, the interior of the town. What was the purpose of that you may ask. (I should say see my answer next week for the reply!!!!!!!!!!)
Well it was to save having to empty and clean the commode. She had first put in a large garbage bag then the chucks. When the patient had finished she was able to just gather up the entire thing and dump it in the "infected" trash container. Took me a while to get my eyes back in my head on that one.
My advice to the original poster is keep after it. No patient should ever be left in soiled underwear or bedding. you can call your State health board if things don't get settled.
If in fact, “They” were ever having to do any of the actual work - this moronic policy would have never come to be.
Guaranteed they’ll be plenty of folks - especially the poor souls who have no one from the outside world seeing to their care - stewing in bedding that is repeatedly soiled, left to dry and soiled again.
Its heartbreakingly tragic.
p.s. If your or your husband know and are on friendly terms with any of the other residents - particularly those who are on their own - it would be nice if you could discreetly check on them - and the condition of their bedding. Cause you know that it is the neglected residents who will suffer the most with this further neglect. While it isn’t a pleasant task it would certainly be appreciated by the resident AND it may bolster your position towards reversing this inhuman policy.
p.p.s. - This place is gonna start smelling like a urinal in a freeway rest-stop men’s bathroom.
Moving an old person who cannot assist in repositioning himself or herself without a draw sheet or Chux causes shearing forces on the skin. Examine your mother's skin - bony prominences, buttocks - for pressure ulcers. Learn about pressure ulcers and how they are staged. Check out the National Pressure Ulcer Advisory Panel.
Went into the tv room tonite to check on DW since she was not in the bed.
OMG! found a kitchen chair spotted in large dark brown spots. She was on the love seat wrapped in her huggie. Checked her. Huggie stained as well. Furiously headed to bedroom. Found two over sized things looking like hershey's kisses on the carpet, bed sheet stained also.
Rushed her into bathroom to clean and headoff any infections. She has pressure wounds on her bottom.
Returned to kitchen to clean and disinfect chair. Removed huggie to treat stain. Discovered easy chair with Bed pad had stains on it. Thankfully I keep pads on it.
Chest at foot of the bed has a pad on it, stained also.
Removed stained bed sheet and treated stains. Cleaned carpet with shampoo and vacuumed.
Last but not least, Treated MY SHIRT she was wearing in place of gown for stains.
Sheet, huggie, and shirt to the laundry for wash and dry.(note: it is a king sized bed.
I get to make the bed for the second time this week. Making a king sized bed is no easy task for a 70+ year old, old man ain't easy. It is not consided to be exercise by the FEDs either.
And these resident facilities want to discontinue using pads? It is evident to me they have very little experience cleaning up a person and room for this type of incident. Their plan will cause other patients to go without routine service and care. Not to mention this will lead to our family members exposed to fecal waste and infection.
I agree that this is all just a scheme to increase charges and wonder what may be next on their list.
DW is back in the hospital and they have discontinued using briefs. Claiming a reduction in infections.Well last night Dw needed to answer the cal to nature. Being a former CNA slipping the big fall prevention belt was easy. so was figuring out which side of the bed to use. Three of the rails were up, the fourth, her exit route was easily the choice.
But, she has a fear of walking and falling so when I noticed what was going on I tried , in vain, to get her to the bathroom. But the bladder was having now of thi
and emptied right there onto the floor. I called for assistance. the RN responded quickly and proceeded to wipe the floor with towels, no custodial care at night, and sanitizing wipes. then checked the bed and proceeded to clean DW. Requiring more than normal wiping because she had stood in the urine.
Was anything saved by not using briefs.
Then this afternoon came the double whammy. bowel and bladder discharges. I again called for assistance. Two people to strip and change the bed and clean DW.
Almost sounds like labor is cheaper than briefs. Leave it to the bean counter to screw up a good thing. Their hands don't get soiled in the discharged product.
Meanwhile another patient is going without scheduled care.
DW is back in the hospital and they have discontinued using briefs. Claiming a reduction in infections.Well last night Dw needed to answer the cal to nature. Being a former CNA slipping the big fall prevention belt was easy. so was figuring out which side of the bed to use. Three of the rails were up, the fourth, her exit route was easily the choice.
But, she has a fear of walking and falling so when I noticed what was going on I tried , in vain, to get her to the bathroom. But the bladder was having now of thi
and emptied right there onto the floor. I called for assistance. the RN responded quickly and proceeded to wipe the floor with towels, no custodial care at night, and sanitizing wipes. then checked the bed and proceeded to clean DW. Requiring more than normal wiping because she had stood in the urine.
Was anything saved by not using briefs.
Then this afternoon came the double whammy. bowel and bladder discharges. I again called for assistance. Two people to strip and change the bed and clean DW.
Almost sounds like labor is cheaper than briefs. Leave it to the bean counter to screw up a good thing. Their hands don't get soiled in the discharged product.
Meanwhile another patient is going without scheduled care. And a big sack of laundry.
Write a letter to to administration and the owners telling them how this new policy effects your mother.
Contact the state and inquire as to the law that says this is double briefing. It is not in my state. Double briefing is using two briefs. Not a pad and a brief.
Start shopping around for another nursing home! If this issue impacts your loved one this much you may have no other choice.
Mask if you can have it care planned that your loved one is to have the pad in addition to the brief. Especially once you learn that this is not double briefing in your state either.
They obviously haven’t invested in cloth bed protectors. If they had this would not be a cost issue. If they are under Medicare or Medicaid payers they cannot charge you for her items necessary for their care. AND they must provide everything necessary for their care too.
Regarding the pressure ulcers they are liable for there development and any worsening of them. This is indicative of inadequate care unless they are extremely malnourished or at the end of life which doesn’t sound like it’s the case.
Report them to state for this also.
Honestly, it sounds like they are not running a good home at all.
The fact that families are upset regarding this decision and they have had no response to this for you, is highly indicative of this.
Nursing homes are often census dependent on whether or not they are actually making money. What is the census vs capacity? That should tell a lot. They are often not the huge money makers that the owners estimated them to be. But that never means they can cut on care or care items!
You are in charge of the care they receive never let them tell you differently. If their interpretation of the double briefing regulations is false, which I believe it is, they need to be educated and remedy this immediately. The state can be called to rectify the misinformation. I hope this helps! Best of wishes.