Choose products based on cost and effectiveness
Keep up to date to educate patients
Although the patient is responsible for providing day-to-day products related to incontinence, it is important for home health clinicians to be aware of products and educate patients about their proper use and good choices, says Gloria Harrison, RN, CCCN, continence consultant with Griffiths Urodynamics and Pro-Continence Consulting, Northern Alberta Continence Service in Edmonton, Alberta, Canada.
"Visit local stores and health care product vendors to see what is available and how costly the products are," Harrison suggests.
It’s important to realize that some patients may choose less expensive products if they don’t understand the different benefits, she says.
For this reason, the home health clinician needs to be prepared to explain that a pad that doesn’t absorb well may result in skin problems that require medical care, Harrison explains.
"Women are accustomed to using sanitary products and may use them for urinary leaking as well," she says. "A nurse needs to point out that pads designed for menstruation do not control urine odor or absorb urine well."
After you recommend a product, get feedback, she recommends. Asking for feedback gives the clinician a chance to re-educate the patient about products if they are being misused, she explains.
Harrison has found that patients will wear two pads at nighttime if one doesn’t work. "That is not effective because the pads are not designed to be worn two at a time. Their protective barriers keep the second pad from absorbing correctly," she says. Instead, recommend patients purchase inexpensive liners that have no protective backing to keep the urine from being absorbed by the pad, she suggests.
Cost-conscious patients, usually women, will roll up toilet paper to stick inside the pad or briefs to make the pad last longer, Harrison says. "Explain that the paper doesn’t pull moisture away from the skin or control odor, so it is not helpful. Also, make sure your patients are changing their pads or briefs frequently enough to protect the skin," she says.
There is a wide range of skin barrier creams that can be used effectively, Harrison says.
"I like to recommend products that are a combination of cleanser, protector, and moisturizer." The combination product makes it simple for patients and increases the likelihood that they will use it properly, she adds.
The worst mistake Harrison sees patients and home health clinicians making in terms of incontinence products is to use only one. "To be effective, you have to look at using a combination of products," she says.
"Many patients are comfortable with a light pad in the day and full briefs at night for extra protection," Harrison says. "The key is to find the combination that works for the patient."