Incontinence supplies are the highest disposable medical supply cost associated with Hospice Care.
Here are 3 ways to save money with incontinence care.
1. Give your patients the right size
Okay let's get down to the nitty gritty. One of the most common errors made in incontinence care is patients wearing the incorrect size brief. Typically the patient is in a size that is too large. And wouldn't you believe it, bigger briefs are more expensive per unit.
Briefs tend to be priced the same for each size with different quantities per size:
Medium sized briefs generally have 96 per case
Large have 72 per case
Extra Large have 60 per case
If a patient is incorrectly using a Large brief and can be moved to a Medium you would get 24 more briefs for the same price. Along with the product cost savings, this move in size also improves patient care. Accurate sizing provides comfort for the patient. A patient with accurate sizing is going to have less risk for skin breakdown and the brief will also be much less likely to leak. Leakage creates problems in addition to the obvious: changing the patient more often, moving them more frequently, and more linen changes can be disruptive to an efficient day and create higher overhead costs.
Often times a hospice patient will have a distended stomach because of various medications and smaller legs due to atrophy, this creates difficulty in sizing. A large brief may seem to fit comfortably around the waist but is too large around the leg area, this gap creates problems containing the void thus increasing the risk of leakage. Correct sizing and fewer chances of leakage leads to fewer briefs being used. Another common misconception is that the larger the brief a patient is wearing the more it absorbs. This is untrue, a large brief does not absorb any more than a medium brief (trust me on this one). With the technological advancements in the materials used in incontinence products, it is no longer true that a thicker larger brief contains more or stays drier for the patient.
2. Make sure you are using Pull Ups for the right reasons
Another cost saving opportunity is the correct usage of Pull Ups, also called Protective Underwear, in hospice care. Often times Pull Ups are used improperly with hospice patients. For example, many patient’s families will request Pull Ups thinking they bring more dignity to their loved one, however, the truth is they are not appropriate for all incontinent patients.
Pull Ups should only be worn by ambulatory patients that can toilet themselves.
They are designed to be pulled on like underwear which can create much difficulty in changing a patient that is in bed. They are not designed for heavy flow, multiple voids, or for fully incontinent patients. Instead Pull Ups are intended for patients having accidents or small leakage. The materials used do not absorb as much as a brief or as quickly, therefore a patient that is more highly incontinent will have a higher risk of leakage while wearing a Pull Up. Also, Pull Ups are generally more expensive than briefs and come with smaller case quantities. The opportunity to move a patient from a pull up to a brief can save a significant amount of money and can increase patient care. Briefs are more absorbent and will bring an instant savings for any patient wearing a Pull Up.
3. Pick one and stick to it
Simply put - incontinence products are generally not designed to be used in conjunction with one another.
A patient should never wear two briefs. Nor should a patient wear a Pull Up over a brief or an insert inside of a brief.
This layering defeats the purpose of the initial layer of product. It also creates a host of other problems such as tear and sheer of fragile skin, heat retention, and total patient discomfort (clearly not the direction we are wanting to go).
Wrapping it up
Proper incontinence product use is necessary for quality care for your patients and overall cost reduction. Providing in-service training to your clinical staff through your medical supply distributor in regard to these topics can create awareness to these cost saving initiatives and take a big step towards actualizing a higher level of patient care provided and savings that boost your bottom line (no pun intended).
Corporate Director Hospice Sales and Services at Concordance Healthcare Solutions