Gloves. Continence. Skincare

Transcription

1 Continence Handbook Gloves. Continence. Skincare

2 Abena and the Environment It is important to Abena that our products have the least possible impact on the climate and the environment We are the only manufacturer in the world to hold the Nordic Eco-label for a number of continence products. The Nordic Eco-label is one of only three official environmental labels, and the only one with criteria for continence products The Nordic Eco-label (the Swan) means Abena has to adhere to the following: Allergy-tested raw material with no PVC, perfume, lotion or optical whitener in the products A minimum level of renewable plastics A maximum limit for production waste Datasheets for all oils, lubricants, janitorial, printing colour etc. used in production Abena s other certifications: ISO 9001 ISO OHSAS BRC, British Retailer Consortium UN Global Compact Asthma-Allergy Association (Denmark) Life Cycle Assessment (LCA) 2

3 Features & Benefits of Abena Continence Products A unique Top Dry system provides rapid absorption and a dry surface. This is good for the skin and minimises the risk of leakage Efficient barriers and latex-free elastics ensure a snug body fit, minimising the risk of leakage Abena s well-known super soft and fully breathable textile-like backsheet makes the product more discreet, and promotes superior comfort and healthier skin A special odour system reduces the risk of unpleasant smells, enabling the user to feel confident with wearing the product Wetness indicator Dry Wet The wetness indicators on the back enables you to identify when the product needs to be changed. The colour goes from yellow to blue, showing how much of the product has been used. This can also be used in documentation to record times and frequency of product changes to ensure the client s needs are being met. The product being used should be as small as possible but as large as necessary. Pad no. Graduation scale Colour showing the size The capacity has been fully utilised Has there been any leakage? The right pad with the right absorbency has been used. Assess whether: the changing frequency should be changed or... a higher absorbency pad should be used Half or less of the capacity has been utilised Has there been any leakage? Assess whether: a lower absorbency pad should be used. Assess whether: The pad has been applied correctly or... If another pad size should be used or... If a pad with another absorbency should be used 3 Call:

4 Common Problems Flow Chart Has the user been assessed for continence products in the last 12 months? Pad Leakage Pad isn t absor Are the wetness indicators 2/3 full? This could indicate a fitting issue. Product size should also be considered Are barrier creams being used? Are the wetness indicators blue continuous lines? Is the cream being used sparingly and only on the areas affected? The user may require a more absorbent product. Toilet frequency should also be considered Barrier creams can affect the absorbency of a pad so should be used sparingly and allow to be absorbed into the skin. A water soluble product could also be considered NB Certain medication, lifting & handling techniques should also be considered with regard to skin 4

5 A full continence assessment needs to be completed bing correctly Skin complaints Advise of correct fitting technique This could indicate a fitting issue. Product size should also be considered Red marking around groin area Is the skin blistered? Is it a fitting issue? This could be excessive use of a barrier cream which can compromise the absorbency of the pad. Washing procedures should be continuously reviewed Is the sacral area red? (The Pressure Ulcer Risk Assessment should be considered & referred to) A re-assessment maybe required. The Assessing Nurse should be contacted if there is a query with regard to the correct product to prescribe Is the user faecally incontinent? Identify the bowel pattern & change the product appropriately Refer to GP for further investigation for underlying infections problems. Some odours may indicate underlying problems 5 Call:

6 Individual Assessment Choice of Pad The aim of a continence product is to promote dignity by ensuring the client has a product which is as small as possible but as large as necessary. A smaller product is generally more comfortable for the user. When choosing a pad the physical ability of the user should also be considered and a product should never replace visits to the toilet. General Rules of Application The product when opened is anatomically shaped to assist in fitting The inside of the pad should not be touched The product should ideally be applied front to back and removed from the back when used The product should fit as close to the groin as possible; the backsheet should not be touching the skin When a shaped product is being used close fitting pants are required Creams should be used sparingly and only on the areas affected. Any excess cream should not be wiped on the inside of the pad as this could stop the pad from absorbing urine effectively Wetness indicator Dry Wet As small as possible as large as necessary Factors to Consider The type of product being used and frequency of changing should be recorded. The wetness indicators can assist in recognising appropriate times of changes. If the product is not being fully utilised this may be an indication that a smaller product could be more suitable. Ideally, a product should be changed approx. every 4 hours during the day and a product should be left for at least 8 hours at night to promote a good night s sleep for the user. If the indicators have uneven colour changes and clothes are wet this could be an indication that a product has not been fitted correctly. If the indicators are fully utilised and clothes are wet this may indicate a more absorbent product is required. Products of different absorbencies may need to be considered for the user during a 24 hr period to meet their clinical need. Product Selection Problems can occur when it s an: Inappropriate choice of pad Inappropriate handling of the pad Inappropriate changing frequency Inappropriate soap/skin care product Insufficient toilet routine Insufficient fixing and application of the pad Insufficient intimate hygiene routine Insufficient hand hygiene routine 6

7 Product Storage Clients are individually assessed for products so whenever possible these should be stored in the client s room Products are for the named client and should not be used for other clients within the home. Products should be stored in a clean and dry environment and packets opened as required. Used products should be disposed of appropriately. Fluids To help maintain a healthy bladder and bowel it is important that we drink enough fluid every day. On average a healthy person should aim to drink between 6-8 glasses of fluid a day (between litres or 3-4 pints). However, this amount will vary depending on the person s weight (i.e. a heavier person should aim to drink more) and/or any medication being taken. Your GP or Nurse will be able to help you to establish how much each individual should be aiming to drink on a daily basis. Bladder problems can often be helped by improving the amount and type of fluids consumed. Drinks containing caffeine, if possible, should be reduced as they can irritate the bladder. For further information on fluid intake please contact your Healthcare Professional. 7 Call:

8 Assessment of patient s output The amount of urine should be recorded every time the patient visits the toilet. Take note of any physical activities that are being undertaken, if leakage occurs e.g. coughing, sneezing, exercising, getting out of bed etc. This form helps to document a chronic problem in an easy way. Name: Date: Time Liquid (no. of cup NHS Number: Urination Leakage Activity Light Medium Heavy Servere Liquid intake (no. of cups) Total urination Urination frequency No. of leakages 8

9 Fixation Pants All Abri-San Products from Abri-San 5 and up should be worn in combination with special fitting products, such as our Abri-Net. Compared to ordinary underwear, fixation products offer a wider crotch area and extra elasticity in order to support the pad in the best possible way to offer optimum security against leakage. In order to obtain the correct size of fixation product, both the waist and hip should be measured and the largest measurement used. Abri-San Abri-Net can be washed up to times and Abri-Fix Super (stretch) can be washed up to 100 times. To ensure you get the best out of these products, please refer to the label for the full washing instructions. NB! fixation products should never be tumble dried, as this will cause the product to lose its elasticity and become ineffective. Abri-Fix Ordinary underwear Fixation Pants Abri-Net Product Product Size (cm) Product Product Description Size (cm) Code Description Code (Stretch pants) 9249 Abri-Net Small Abri-Fix Super Small Abri-Net Medium Abri-Fix Super Medium Abri-Net Large Abri-Fix Super Large Abri-Net XL Abri-Fix Super XL Abri-Net 2XL Abri-Fix Super 2XL Abri-Fix Super 3XL Abri-Fix Super 4XL Abri-Fix Super 5XL Call:

10 Washables Briefs Washables can be used as an alternative to disposable light absorbency products, but are not suitable for faecal incontinence. They look like normal underwear and are inconspicuous on the washing line; they can be cost effective and environmentally friendly. They can promote dignity and independence and are available in a range of styles and sizes. Excess use of creams and talc will impair the absorbency of the product. Ladies Available in 2 styles (full and mini brief) with attractive lace detail 2 absorbencies (125mls and 250mls) Hip measurement required Washing Instructions o 50 C Wash at 50 o C Can be tumble dried at a low temperature Do not use bleach Do not dry clean Do not iron Gentlemen Available in 3 styles (Y front, brief and boxer short) Absorbency 250mls Waist measurement required Do not use fabric conditioner Bed Pads Bed pads can be used as an alternative to body worn products at night. If a specialised mattress is being used, please discuss with a Continence Nurse Specialist or Tissue Viability Nurse before using. Excess use of creams and talc will impair the absorbency of the product. Absorbencies of mls Cost effective and environmentally friendly Can be tumble dried at a low/medium heat Guaranteed for 350 washes, if the manufacturer s instructions are followed 10 Washing Instructions o 95 C Wash at temperatures up to 95 o C Can be tumble dried Do not use bleach Do not dry clean Do not iron Do not use fabric conditioner

11 Hand Hygiene Help to stop the spread of viruses by following these 9 essential steps: 1 Wet your hands with water 2 6 Apply enough soap to cover your hands and rub your palms together Rotationally rub left thumb with right thumb, then vice versa 3 Rub your left palm over your right dorsum and then vice versa 7 Rotationally rub right palm with fingers of left hand held together, then vice versa 4 Rub palm to palm with fingers interlaced 8 Rinse hands thoroughly with water 5 9 Rub backs of fingers in opposing palms with fingers interlocked Dry hands thoroughly 11 Call:

12 Recommendations to Maintain Skin Integrity 1. Ensure the patient has been assessed for the correct product, and it is fitted correctly. Use the lowest pad absorbency possible; making sure it is appropriate for the users needs. 2. Ensure the product is changed quickly after an episode of faecal incontinence and the skin should be washed immediately. However, wetness indicators should be used when dealing with urinary incontinence. 3. Cleansers, as opposed to soap and water, are used to cleanse skin of those patients who are incontinent (Cooper & Gray 2001, Whittingham & May 1998). No-rinse skin cleansers can be soothing and effective as they generally contain a gentle, non-irritant surfactant, which helps to emulsify and loosen faeces and cleanse the skin, negating the need to rub and cause further damage (Scardillo and Aronovitch 1999). 4. After the skin has been cleansed, use the patient s own clean towel, disposable wash glove or dry wipe to pat dry the skin. 5. The skin of patients with incontinence is sensitive and is more at risk from skin breakdown. If the skin becomes red a water based barrier cream should be applied, sparingly, onto the affected skin. However, prescribed cream should be used as directed. A Healthcare Professional should be informed immediately of any changes in skin condition. 6. Excess barrier cream on the products blocks the absorbing layer and greatly reduces the absorbency. Therefore, take extra care when applying barrier creams. 7. Always work within your local NHS Trust skin care guidelines and policies and use local pressure risk assessment tool. Wash Gloves A practical pocket shaped wash cloth available in 4 different materials: molton, airlaid with and without PE and nonwoven. This product can be used wet or dry and is a useful alternative to a dry wipe. Wash Foam Washing foam is a mild but effective alternative to soap and water. The foam is ph 4.5 and leaves a protective membrane on the skin. It should be used without water. This product also contains allantoin to help reduce any inflammation of the skin. Intimate Care Very mild soap for daily intimate hygiene that leaves the skin soft and clean, making it suitable for delicate and sensitive skin. This product has a ph of 3.5 and is unscented and without colour. Intimate Care has also been awarded with the Nordic Eco-label (the swan) and Danish Asthma and Allergy certifications Airlaid Wash Glove Molton Wash Glove Non-woven blue Wash Glove Airlaid with PE foil Wash Glove Washing Foam 6665 Intimate Care 12

13 Moisture lesions vs pressure Ulcers What is a Moisture Lesion? Definition: Partial thickness skin loss caused by either physical irritation ie friction or a chemical irritation involving urine and faeces. A combination results in weakened skin and can lead to breakdown. What is a Pressure Ulcer? Definition: A localised area of skin damage usually over a bony prominence caused by pressure and/or shear (EPUAP, 2009). The depth is determined by the grade and anatomical location on the body. Location Moisture Lesions A combination of moisture and friction may cause moisture lesions in skin folds, but commonly they are found in the anal or natal cleft Pressure Ulcers Most likely to occur over a boney prominence Shape Diffuse different superficial spots, kissing ulcer, anal cleft linear Circular wounds, regular shape Depth Superficial partial thickness skin loss. Can enlarge if infection is present Pressure ulcers vary in depth depending on the classification Necrosis No necrosis Present depending on the category of ulcer Edges Diffuse and irregular edges Distinct edges Colour Non uniform redness. Pink/white surrounding the skin. Peri- anal redness Redness is non- blanchable. Slough and necrosis may be present Combination Combination wounds of pressure and moisture are very common. Any necrosis present means there has been an element of pressure that has damaged the circulation and the tissue has become ischaemic (i.e. an inadaquate supply of blood to the affected part of the body caused by partial or total blockage of an artery). Moisture alone cannot disrupt the blood flow. This type of wound has to be reported as a pressure ulcer in combination with moisture. If you suspect that a patient has a moisture lesion or pressure ulcer please contact your Healthcare Provider for further holistic assessment Abena UK Ltd would like to thank Birmingham Community Healthcare NHS Trust for their help in creating this document 13 Call:

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