Dec 31, 2019

Sighs Matter

When it comes to incontinence care, I’ve never met a Director of Nursing who didn’t sigh deeply and comment, “so many things can get in the way!”

Properly caring for our residents who are incontinent is very easy from a conceptual perspective:  it’s all about keeping the skin dry.  However, how that is accomplished is the challenge.  There is a bountiful amount of published research on this topic that addresses all aspects of this clinical challenge.  Studies show that if a nursing home resident is able to express their preference of incontinence care (toilet schedule versus use of incontinence brief), they have a positive clinical outcome.  Additionally, there is research that shows that restorative therapy also has a positive impact on preventing further deterioration in this area.  For those residents who have limited ability to communicate or to benefit from restorative therapy, research demonstrates the usefulness of portable bladder scanners and the creation of toileting schedules that are based upon the resident’s physiology.  Yet for a large portion of nursing home population, the best intervention is the use of incontinence briefs.

The efficacy of incontinence briefs has improved significantly over the last ten years thanks to new technology. As a result, there are more options available benefiting both residents and staff. The resident is drier and more comfortable and the staff has a range of quality products to choose from that are easy to use. Yet the general trend toward increased incontinence continues to grow and the resulting negative outcomes are drawing greater government scrutiny and fines.

The Director of Nursing juggles many issues regarding the well being of the residents of which incontinence care is just one.  Often the DON does not have the resources to carefully supervise this aspect of resident care, and so the CNAs are often overlooked for the crucial role they play in incontinence care. After all, they are the ones using the product.  CNAs are prone to fall back into old habits that are not consistent with their incontinence care training due to any number of factors least of which is the need to accomplish many tasks during a given shift.  Consequently, some CNAs may use extra-large incontinence briefs for all their residents perceiving it as a shortcut that will make them more efficient.

They assume that extra-large means extra absorbency, forgetting that proper fit is essential for skin protection. This is a common issue that Caretech addresses with many of its new customers.  It’s a no brainer that curbing the use of larger briefs yields better outcomes both clinically and financially; the residents will be drier with a better fit, and the budget will be on target because you purchased appropriate sized and lower cost product.

From a clinical angle, working collaboratively with the Director of Nursing, Caretech provides a sizing tool that ensures that incontinent residents are properly fitted for their incontinence product.  CNAs are also trained in this matter and given ongoing support, and their actual practices are reviewed regularly.  In addition, Caretech’s industry knowledge is applied to establish inventory requirements by product and size.

From a financial perspective Caretech dashboards provide analysis on purchasing and usage trends and will communicate variances immediately.  In addition, Caretech provides ongoing analysis of the data. Since financial data can be an early indicator that clinical outcomes may be changing, incontinence products are a Key Performance Indicator (KPI), an effective tool we use, to help nursing home leader’s better monitor changes and address them before they become a problem.

Our industry is now bracing itself for the many hurdles that accompany reductions in reimbursement that stem from reduced Medicaid funding.  How an organization uses its incontinence supplies is of greater importance, since it can have a significant impact on spending and care outcomes.  The DON has many other issues that result in a “heavy sigh.”  Incontinence care does not have to be one of them if Caretech is your strategic partner.

Categorized in LTC Budgeting, LTC in New York State, Materials Management, Medical Supply Procurement and Medicare & Medicaid Reimbursement, Incontinence Care, Medical Supply Procurement

Tags: , , , , , , , , , ,