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Author	Draw sheets and plastic macs
Neil (offline) Joined: Jun 2005 Location: Balmain Posts: 11	Tue Jun 07, 2005 6:06 pm Last edited Jun 07, 2005, 06:26 pm Update #1 Having come to Australia from the UK, I am wondering if all eldely care wards (I hate the term Geriatric) use plastic macs and draw sheets, or if not how do they deal with incontinence. I am trying to find some research on the subject as I want to have evidence to enable me to put a case forward for withdrawing them, both from the tissue viability and the cost angle. If any one can help please feel free to contact me. Comments and suggestions welcome folks! Thanks Neil modified: Thursday 18 August 2005 5:29:27 am - Neil

Darren (offline) Joined: Mar 2005 Location: Adelaide Posts: 179	Jun 08, 2005, 08:30 pm In my experience, draw sheets are no longer commonly used. My aged care nursing is not very current, but having been in administration more over recent times, I was aware of ongoing isssues with continence management. The nurses in the facilities I was managing were preferring use of kylies and or incontinence pads. I think there would be a lot of available evidence for moving to more current forms of incontinence management. Anyone got some tips for Neil?

netty (offline) Joined: Jun 2005 Location: Perth Posts: 2	Jun 09, 2005, 12:43 am Hi Folks From my experience in nursing the elderly the trend is towards Kylies or incontinence pads etc or both. Of course the problem with kylies is unless you bother to put a sheet of plastic between it and the bottom sheet you end up changing the whole lot anyway, which is time consuming in acute medical settings. There are still some hospitals using the draw sheet and plastic method too, obviouslymore cost effective.

Neil (offline) Joined: Jun 2005 Location: Balmain Posts: 11	Jun 09, 2005, 05:59 am Last edited Jun 09, 2005, 05:59 am update #1 Thanks Darren and Netty, If there is research out there I would appreciate some links as I can't seem to track it down. The use of Kylies has been researched in the UK and found them ineffective particularly after constant laundering. If you need to put plastic under them you may as well just use draw sheets. As Kylies need to be laundered after every use they may not prove to be that cost effective. I am interested to know which "incomtinence pads" peolpe are using. Thanks again for the information. I have just noticed that in my original post there were a couple of typos, thats what happens when you write these things in the middle of the night! eldely should be elderly and cosy should be cost. By the way any opinions on the "Geriatric" title for our elderly services. Glad to hear from you all, its good to know that the forum is working. Thanks Neil modified: Thursday 09 June 2005 6:01:15 am - Neil

Darren (offline) Joined: Mar 2005 Location: Adelaide Posts: 179	Jun 09, 2005, 09:28 am Last edited Jun 09, 2005, 09:28 am update #2 (Neil, a tip for the forum - you can edit your own posts by clicking on the little pencil icon in the top left of your post to make any corrections.) I agree that finding published research is difficult. I have found a few allied links, but nothing really definitive. I do know that many organisations and continence advisers have undertaken their own action research which guides their practice in their own organisations. Perhaps a few would like to share their results here, even though they may not be "scientifically valid". http://www.refer.nhs.uk/ViewRecord.asp?ID=1013 http://www.seekwellness.com/incontinence/managing_with_pads.htm http://www.ability.org.uk/Incontinence.html http://www.nevdgp.org.au/geninf/incontinence/i_helpline.htm Some government funded research projects http://www.health.gov.au/internet/wcms/publishing.nsf/Content/continence-ncms-res.htm-copy2 Hopefully there is something useful in there. modified: Thursday 09 June 2005 9:32:22 am - Darren

Nurse Binky (offline) Joined: Jun 2005 Location: Melbourne Posts: 14	Jun 09, 2005, 06:41 pm My First Post....WOOHOO~!!! Now back to the matters at hand. At my workplace with use a mix of all of the above: kylies (with plastic macs) and draw sheet's (with pads and plastic mac) i guess the mac's just protect the mattress even if a kylies on top 'just incase' because it is a real pain to have a heaps of full bed changes to do everyshift.

Darren (offline) Joined: Mar 2005 Location: Adelaide Posts: 179	Jun 09, 2005, 06:53 pm Last edited Jun 09, 2005, 06:53 pm update #2 Hey good work, Nurse Binky - great to hear from you. Can you describe why you use different aids in different situations? Is based on clinical assessment, mobility, cost, nurse preference, or something else? cheers btw - you should be able to come up with a great avatar to go with your username :) modified: Thursday 09 June 2005 11:05:22 pm - Darren

Nurse Binky (offline) Joined: Jun 2005 Location: Melbourne Posts: 14	Jun 09, 2005, 07:15 pm Gosh... hate to sound dumb but i wouldnt know. I guess its a mix of cost, Pt. mobility, levels of incontinence and a whole lot of other things. In my 'vast' experience night pads are usually bigger and most have a wrap around system (the simple ones have sticky tabs). ps. thanks darren, any suggestions for an avatar :)..

nurserosie (offline) Joined: May 2005 Location: Mount Gambier Posts: 4	Jun 09, 2005, 10:44 pm Hi, molicare pants are really good, and work just like babies nappies. They are stretchy and absorbent and can last the night. Hoever, they may not be cost effecftive.

Darren (offline) Joined: Mar 2005 Location: Adelaide Posts: 179	Jun 10, 2005, 07:19 pm Last edited Jun 10, 2005, 07:19 pm update #1 Nurse Binky, I have put together a bit of a tutorial and links for Avatars. Hope it Helps. modified: Friday 10 June 2005 7:19:54 pm - Darren

mattycat (offline) Joined: Jun 2005 Location: Davoren Park Posts: 19	Jun 18, 2005, 01:15 am Trivial question from a student who's had too much caffeine. But no one can tell me... Why are they called Kylies? Are they named after a famous patient??? ;-)

Nurse Binky (offline) Joined: Jun 2005 Location: Melbourne Posts: 14	Jun 19, 2005, 05:56 pm It's the generic brand name. Although being named after patient would be amusing...lol

Nurse Nancy (offline) Joined: Jun 2005 Location: Gippsland Posts: 3	Jun 23, 2005, 06:10 pm Used different systems at different hospitals and nursing homes. So the story goes, the macs tend to make patients sweat, whereas the kylies absorb and are easier to change. Of course, pants and pads, pullup pants and full wrap-around type pads are used according to the amount of (usual) overnight output, with differing levels of absorbancy. Phew - sorry about the waffling-on. Hope that made sense. (p.s. my first time using a forum)

Neil (offline) Joined: Jun 2005 Location: Balmain Posts: 11	Jun 24, 2005, 03:05 am Last edited Jun 24, 2005, 03:05 am update #1 Thanks for that Nancy, and every one else who took part. The point I was trying to make is that if we use all these special pants / pads etc, why do we still need to have plastic and draw sheets on the bed as well. Yes Kylies are supposed to be more absorbent than sheets, but after a number of washes Kylies lose their absorbency. In the UK it was quoted that after 100 washes they were no good. Who would count how many washes and would the hospitals be prepared to purchase new ones after the 100 washes (I think not). It is obvious that we need to have some form of protection for both bed and patient, but with the new continence aids do we still need to use both, or is it nurses that don't want to let go? I am trying to look at this from the aspect of patient comfort and cost of resources, including tissue viability issues. Please keep your views coming on this one Neil modified: Thursday 18 August 2005 5:33:50 am - Neil

Nurse Nancy (offline) Joined: Jun 2005 Location: Gippsland Posts: 3	Jun 24, 2005, 02:35 pm I actually didn't know about the 100 washes thing - good point - maybe it's just become one more nursing ritual!

Darren (offline) Joined: Mar 2005 Location: Adelaide Posts: 179	Jun 24, 2005, 03:00 pm I didnt know about the 100 washes either. It would be good to have a reference for that study if anyone has one, or if anyone knows what the Kylie sales reps report as being their useful life.

Neil (offline) Joined: Jun 2005 Location: Balmain Posts: 11	Jun 25, 2005, 04:30 am Apparently there is one company stating: "Kylie bedsheets can be washed 300 times and still retain their outstanding absorbency properties." At: www.westons.com/hh98_32_6.htm Neil

miss jenny (offline) Joined: Jul 2005 Location: Posts: 1	Jul 20, 2005, 10:21 pm In my place of employment we use TENA pads. Many varieties of day pads and night pads. By management and our incontinence team we have been told not to use Kylies and pads - its either one or the other. Of course this does not happen especially on night shift where I work. It is pointless using a Kylie without a mac underneath - otherwise you will be forever having to change the bottom sheet as well. Although I find Kylies are very good, they are not the answer - sometimes they make SOME staff very lazy who leave residents lying on wet kylies. They can only take so much fluid and in this instance is not good for skin integrity. I can't believe they would last 300 washes, but saying that - some of ours look like they would have been washed 500 times, they are so thin and therefore serve no purpose. The other thing that annoys me with Kylies is, over time from all the washing and drying they lose the ends that get tucked into the bed. Gosh I haven't seen a drawsheet in the nursing homes I have worked in for years...only when an ambulance leaves them behind and becomes the facilities property!

jajac (offline) Joined: Aug 2005 Location: Posts: 5	Aug 05, 2005, 10:19 am Hi, I work in an acute care of the elderly (ACE) unit in a large teaching hospital. We only use kylies on our beds, not drawsheets, macs etc. Incontinent patients have either a pad (usually when in bed or sitting out of bed) or a pair of "pull ups"-look like normal undies but are very stretchy and disposable. We get around the incontinence issue by regular toileting for pt's able to use a toilet, commode or pan and 2-3hourly pressure area care for those unable to weght bear. We have recently had training in a new patient transfer system called O'Shea to prevent injury when moving pt's. Most staff would use a kylie to "lift" a pt up the bed but we now use slide sheets. There has been a rumour that the hospital is chaning to disposabel kylies to prevent this happening. I know it sounds like extra work, but regular toileting and bed checks at night really does cut down on the number of bed changes. Hope this helps.

jajac (offline) Joined: Aug 2005 Location: Posts: 5	Aug 05, 2005, 10:23 am Hi, forgot to post my opinion on the term "geriatrics". As far as I'm concerned it's just the name for a specialty area of nursing/medicine, same as orthopedics etc. If you have any suggestions for a new, professional sounding non-condescending name, put it forward.

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Draw sheets and plastic macs