Dude you are so right on!

FP/CNA Adrian. First I want to thank you for POSTING - THANK YOU!!!!!
I also want to thank you for your insight into skin care and the prevention of skin breakdown. One of the goals that we as care providers are all tasked to is the found in the Hippocratic oath - Do no harm. Great health care is just that, doing no harm. One of the goals of a new program (Transforming Care at the Bedside)is by doing one hour rounding on each and every patient, even the ones that are completely alert, oriented and mobile. When I walk into the room for the one hour rounding I ask them if they have pain, reposition them if they are unable to do this themselves, ask them if they would like to use the bedside commode/bathroom/urinal/bedpan, and if there is anything I could do for them. One hour rounding is one of the keys that not only helps to prevent skin breakdown, but also falls from those pts that have to use the facilities but end up falling because they are to physically weak to walk.
As for urinary incontinence and what should we do. Hourly rounding where you would do the even hour and the rn the odd hour to see if the pt is soiled/wet. If you get in report that the pt is incontinent, use the barrier cream to coat the area(s) and then pay special attention to their bathroom needs. As for the use of diapers, I find them a real bummer, and next to giving someone a suppository, I hate to put them on anyone. I have found them depressing to the patient as it takes away their essence or locus of control - Depression is not to far around the corner when this happens. Diapers are just a coverup that don't really make our job easier. Only the illusion of making it easier.

Again, great job and thanks much for your keen insight!

Let me know if I can help you with anything,

beeman