Money and Time Saving Strategies for Caregivers - Part I ©
By: Clare Absher RN, BSN
As a long-term caregiver RN with a diverse professional background I often find myself sharing useful tricks of the trade with other caregivers who likewise convey insightful ideas. I have compiled a collection of handy tips, creative shortcuts and practical approaches derived from professional experiences and respected fellow colleagues that I hope you will deem useful.
PART I: Disposable healthcare supplies is the first area of focus of a sequence of articles aimed at saving time and money, easing busy caregiver workloads, and providing better patient care at the same time.
First and foremost your consistent approach must be to buy everything possible in bulk especially when it pertains to disposables such as gloves, diapers, bed pads, and dressing supplies. This may seem to be stating the obvious, but today especially due to easy access of ordering healthcare supplies online, paying a one time shipping fee or no shipping costs, you will save a large sum each month. Online health supply stores typically offer more choices at cheaper costs due to lower overhead operating expenses in contrast to brick and mortar retail supply stores. Compare pricing on several brands as they vary alot and don't rule out generics as they are often manufactured by the same brand name companies. Determine which brand suits your needs and research suppliers that have arrangements with certain manufacturers to reduce cost. However if you live in a competitive metropolitan area where your brands can be purchased at discounted prices in local stores then by all means take advantage and stock up. If storage is a problem then make it your priority to find an alternate solution to stockpile your supply cases in order to appreciate these significant savings. Again at the risk of stating the obvious, also consider the unrivaled task of time consuming shopping and carrying around huge boxes of diapers and pads in your car versus the convenience of doorstep delivery from online suppliers. Furthermore envision the unwelcome scenario of discovering that you used your last glove causing rise for a late night run to a local drugstore to buy whatever they have on hand and for whatever cost. Strategize using cost-effective methods that include buying in bulk, planning ahead to avoid depleting supplies, comparing similar brands and generics, and finding an accessible location to store your bulk supply.
Now turn your attention to learning methods to conserve usage of these disposables which are exceedingly needed by our patients resulting in enormous expenses. As a loyal member of the throw away generation and nurse with sensible concerns for personal protection, it is often difficult to justify relying on re-usable products even when proven better, equally safe, and less costly. With that said please disregard this rationale when it comes to gloves. Exam gloves as they are known come in boxes of hundred and like tissues are just simply a necessity, cheap, and not a place to cut corners for your own protection and that of your patients. Disposable wipes or wash cloths similarly are inexpensive plus a matter of convenient personal hygiene with sizeable laundry saving rewards. Instead concentrate on effective methods to trim back on using large quantities of essential but expensive incontinence supplies such as diapers, pull ups, and bed pads. In certain situations for those with milder incontinence, try re-usable, washable incontinence wear as often more comfortable and equally effective. Buy a few pairs of specially designed thick washable panties or briefs and insert pads in them for milder or periodic incontinent incidents. Add more absorbent pads (whether compatible mate designed for certain brands or simple generic female sanitary pads) inside disposable diapers or pull-ups for those with moderate incontinence facilitating in between changes. Conserve your supply of costly thick style briefs for more severe night time incontinence and save costs avoiding unnecessary changes using less expensive thinner daytime types with refastenable Velcro closures. Reduce caregiver workload without sacrificing patient comfort plus stretch your dollars at the same time by relying on washable incontinence wear when applicable and employing tactics to increase absorbency with disposables.
Using fewer disposable bed pads sometimes referred to as Chux is another area to cut significant costs and improve care. Soft quilted type washable bad pads in my opinion are by far one of most cost-saving, underused, but more efficient means of providing protection and enhancing patient comfort. Spend the money initially to buy two or three reusable bed pads, one to wash, another to use, and forget using disposables all together or use only in conjunction with reusable pads. Yes saving laundry workload is important for busy caregivers but compromise by using disposable pads sparingly with washable pad under the disposable for added protection. Bear in mind that washable pads will not only serve to better protect bed linens then disposable counterparts but double as a sturdy draw sheet for moving patients in bed. Your patient will justly prefer resting on soft cozy cotton quilted pads and benefit improved skin integrity versus that of irritating paper plastic-like disposables. Keep in mind that washing a single reusable pad still doesn't weigh against the time-consuming task of changing and washing the entire bed linens due to an accident. The same rationale applies to buying a couple reusable chair pads or bed pads to protect furniture in order to spare additional clean up jobs. Employ reusable pads as replacement for disposables entirely or use in combination with disposables to improve patient comfort and save appreciable money without adding to caregiver workloads.
Dressing supplies although not needed as often when required are very costly and deserve special attention in regard to effective management. Prepping generously with protective skin barrier products under dressings effectively extends the application period intended and recommended with hydrocolloids or hydrogels dressings such as Duoderm or other transparent ones like Tegaderm. Acting as a protective film, skin barriers improve skin integrity by allowing dressings to remain intact and avoid too frequent changes resulting in overall better wound care management. Skin barriers products such as Skin Prep whether in prep pads, swabs, or spray form are underused, inexpensive, multifunctional, and improve patient skin care reinforcing that caregivers should never be without. Keep in mind with any of these expensive special wound care dressings to order in larger packs when available and better yet order larger size dressings to cut in half or quarters for multiple applications when feasible. Applying adhesive tapes known as Montgomery straps is another favorite trick to protect fragile skin and cut costs when frequent dressing changes are needed. Using these secure skin friendly anchor tapes on each side of a wound with Twill ties to secure dressing allows for changing gauze type pads without reapplying tape each time. Buy un-sterile 4 x 4 s gauze dressings in bulk packages or even use absorbent feminine sanitary pads as outer dressing covers similar to that of ABD pads when following clean non-sterile wound care procedures. Purchase sterile supplies when specified for certain types of wound care such as for surgical wounds or otherwise required. Improve skin integrity with methodical skin prepping prior to adhesive-type dressing applications, buy appropriate dressing supplies that correspond to wound care requirements and employ creative techniques that extend specialty dressing supplies to cut overall costs.
Diabetic, ostomy and urologicals are another ongoing expenditure but fortunately most are usually covered by 3rd party health insurance benefits. However due to limitations on amounts of certain reimbursed products supplied focusing your approach on measures to avoid waste is critical. Extend the wear of stoma barrier flanges or wafers by prepping with skin barrier protection products to allow longer adherence reducing unnecessary appliance changes and disruption to skin integrity. Ostomies unlike urological supplies are not sterile so don't throw away money on costly sterile gauzes for cleaning stoma areas when a warm cloth or disposable wipe will suffice. An ostomy specialist once revealed her trick for best results with urostomy appliance changes by barely inserting a feminine tampax (¼") into stoma to keep skin clean and dry during procedure. Prepping with same skin barrier protection prior to applying external urinary catheters, sometimes known as Texas catheters, is another efficient method of stretching your supplies. Urinary drainage bags, leg bags and ostomy pouches can be safely re-used by washing with white vinegar (1 part vinegar to 3 part H20). However never be frugal with regards to disposable diabetic supplies by strictly complying with 1 time only use of diabetic lancets, needles, syringes, alcohol preps and cautiously observing expiration dates on glucometer test strips. Re-use disposables safely, extend supplies by using measures to ensure effective application and verify that you are receiving necessary supplies entitled to under your insurance plan to minimize out of pocket costs.