Incontinence products are necessary for millions of adults, and proper application technique maintains comfort and dignity. The two main types are tab-style briefs, which use adhesive tapes for a customizable fit, and pull-up style underwear, worn and removed like traditional undergarments. The choice depends on the user’s mobility. Tab-style briefs are preferred for non-ambulatory individuals, while pull-ups are for those who can stand with assistance. Correct application ensures absorbency and prevents skin irritation and pressure injuries, especially in bedridden patients.
Gathering Materials and Preparation
Gathering all necessary supplies ensures a smooth and hygienic change. Supplies include a clean adult brief or pull-up, disposable gloves, cleansing wipes or a no-rinse perineal cleanser, a moisture barrier cream, and a disposal bag or pail. Hand hygiene is the first step, followed by donning fresh disposable gloves to minimize contamination risk for both the caregiver and the patient.
The patient should be positioned comfortably, and their privacy must be respected. Before applying the new product, inspect the skin for redness, rash, or broken areas, which may indicate incontinence-associated dermatitis or the beginning of a pressure injury. Applying a thin layer of barrier cream, often containing zinc oxide, to clean, dry skin provides a protective layer against moisture and irritants from urine or feces.
Applying the Diaper to a Standing Patient
Changing a product for a patient who is partially mobile or can stand with assistance often utilizes pull-up style underwear. The patient should hold onto a stable surface, such as a grab bar or the back of a chair, to ensure safety and stability during the change. If the previous product was a pull-up, the side seams can be torn open to remove it without needing to pull it down the legs, especially if it is soiled.
The skin is then gently cleaned from front to back using wipes, and a thin layer of barrier cream is applied if necessary. The new pull-up style product is then slid up the legs like regular underwear, or a tab-style brief can be wrapped around the waist and secured. This technique encourages patient participation and maintains a sense of independence.
Applying the Diaper to a Bedridden Patient
Applying a tab-style brief to a bedridden patient requires a rolling technique to prevent lifting and to ensure proper placement of the absorbent material. Gently roll the patient onto their side, away from the caregiver, guiding them at the hips and shoulder. The soiled brief is then rolled inward to contain any waste and removed from underneath the patient.
While the patient is on their side, thoroughly clean the perineal area and buttocks, wiping from front to back to prevent the introduction of bacteria into the urinary tract. Prepare the new brief by folding it lengthwise to create a boat shape, which helps activate the leak guards and allows for easier placement. The folded half of the clean brief is tucked under the patient’s hip and positioned against their back.
Gently roll the patient back over the folded portion of the new brief onto their back. Pull the unfolded side through the legs, center the brief, and pull the front panel up over the abdomen. Fasten the tabs to the front panel. Angle the bottom tabs upward to cup the buttocks, and the upper tabs downward to secure the waist, which helps achieve a customized fit that reduces the chance of gapping.
Tips for Securing and Checking the Fit
Once the brief is fastened, a final check is necessary to ensure comfort and leak protection. The fit should be snug but not restrictive. A general guideline is that two fingers should be able to slide comfortably between the brief and the patient’s skin at the waist. If the tabs meet or overlap significantly in the middle of the abdomen, the brief is likely too large and may create gaps that allow for leakage.
Ensure the leg gathers, or standing leak guards, are pulled out and flared against the groin. These internal barriers are designed to create a seal around the legs. If they are tucked inward, the brief’s ability to contain fluid is compromised. A properly sized brief should fit high in the crease of the groin to prevent leaks from the leg openings.