Cost Savings Interventions and Ideas

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1 Cost Savings Interventions and Ideas All types of settings SNFs, Assisted Living, Home Care, Acute Care, Rehab Care Good Skin Checks Good skin checks even on independent people p Check fat folds, between toes, bottom of feet, gluteal folds, perineal areas Older females wiping and wiping themselves after toileting do teaching with them Older females assess them during toileting how they are doing it before they happen do re teaching repeatedly catch problems Use bb baby wipes offers protection consistently 1

2 Dressings Education of staff on expense of dressings Do not take in whole box of dressings or whole package of unsterile gauze only take enough for a week s worth of dressings Once taken into a room or house cannot remove the dressings Skin breakdown r/t Incontinence Contact Dermatitis - Excoriation Skin Protective ointment (any type) cover with saran wrap keep ointment on Skin Protective ointment (any type) cover with saran wrap keep ointment on skin not being absorbed in the diaper/chuk/depends Once denuded thick ointment only remove soiled ointment Do not scrub down to bare skin damages fragile skin Buying skin protective ointment in bulk placing in denture cups label what it is and put resident s name on it Everyone gets skin protective ointment with their depends/diapers Routine q 2 hr incontinence checks also at same time offer hydration 2

3 Consistent checks thick ointment Protection a Must Supplies Be knowledgeable about the dressings you use Work with your supply company when was the last time your contract was looked at for better pricing Mostsupply supply companies have their own brand name of product do a product test compare brand name vs company name (i.e. Gulf South s brand of foam vs Convatec or Medline s foam) Do comparison shopping which one is cheaper in price and still does a good job Samples contact the primary company and ask for samples 3

4 Look at the use of the dressings can one type dressings (even though more expensive) be used for a longer period of time? Know your dressings and their use are they being used appropriately? Look at what is being used does it come in a smaller size tube (i.e. silvasorb gel, Iodosorb ointment) Don t need 3 sizes of one dressing go for the larger size and it can be cut down decrease your inventory If ordering by the carton dressings will expire before you use them up No dressings or ostomy supplies should be an overnight order or an immediate order they always cost more than normal (added cost for Immediate) Price out Catalog Companies (Byram and Edgepark) Replacement Dressings Using diapers for dressings cut off elastic edges wrap around draining legs Maxi pads work great over wounds instead of ABDs Knee High stockings great for keeping leg dressings in place can replace coban with knee high stockings if coban becomes too tight holds dressings together For home care patients once discharged from home care have them price out dressings at Walmart/ K Mart/ Dollar stores/internet/ Catalog Stores 4

5 Foam support Foams kyphosis abd normal sitting go to foam stores buy memory foam Cut out for curvature of back Helps to prevent skin breakdown of the spine If patient sits crooked in wc check by PT for pressure points Some DME companies or Rehab places do wheelchair sitting evaluations Check it out There is a life to wheelchairs and wheelchair cushions (usually 5 years) check it out Formulary Standardizes Dressings Use a set formulary with generic terms and par values use company where you can order by each not by the carton Par values ensure that you will never run out of the dressings Item Order Par Wound Cleanser Pink Bubbles 5 cc Skin Protective Ointment 2 box/ 5 each bx 1 box / 10 each 2box/ 5 each bx 1 bx 1 bx 1 bx Skin Prep 3 box/ 50 each bx 1 bx Adhesive Remover 3 box/50 each bx 1 bx Unsterile Gauze 3 box / 5 each bx 1 bx ABD Pads 5 box/ 25 each bx 1 bx 5

6 Brand names vs Generic Names If you write an order using name brands then you must use that brand of product Brand Dressing Names Change to Generic Terms All Dressings Do Not Use Brand Names on Orders Dermal Wound Cleanser Criticaid or Calmoseptine Tegaderm Nugauze Copa white foam Allevyn foam Allevyn Adhesive Foam Hypafix Tape Duoderm Thin Duoderm Thick Aquacel Aquacel Silver Silversorb Gel Unisolve Adhesive Remover Skin prep 3M, etc Coban Must Rewrite and resend to Physician Wound Cleanser or Normal Saline Skin Protective Ointment Transparent Dressing Plain Strip Packing White Foam Thick Foam Dressing Thick Adhesive Foam Dressing Tape Hydrocolloid Thin Hydrocolloid Thick Calcium Alginate Calcium Alginate Silver Silver Gel Adhesive Remover Skin Prep Cohesive Wrap Dressing Turning Program Turning Program a Must Skin Breakdown & Pressure Ulcers a NO NO! Music for turning q 2hr Turn Turn Turn Clock on wall for turning Have dedicated staff each shift for turning (A turning team for each hallway) Must be routine on those who need assist Must be routine on those who need assist with turning or those dependent on turning 6

7 Elevating heels - padding Padding between legs and ankles pillows Elevate heels using pillows folded dblankets Use foam wedges Body pillows Memory Foam Kyphosis Cut out Memory Foam Buying in Bulk 7

8 Buying in Bulk Medicaid eligible Receive incontinence products at no cost (cloth chuks, diapers, depends, wipes, gloves, etc) Many more sites on the internet Strong Odors Vicks nostrils for strong smell in chg ostomy pouches or other odors Odors in room coffee grounds cat litter If wound related Flagylin powder form Carbon Dressings Dakins Solution Dressings Shaving Cream Perineal Cleansers 8

9 Edematous Feet Can t find slippers that are safe Edematous Feet Do not fit into regular slippers Don t get so large chance of falling Soft Edema slippers internet has gripper soles p// FlexaMed Customer Service Contact Phone: $19.00 Spec L Inc Adaptive Wear $30 $35 www. clothingsolutions.com TOLL FREE: Normal Saline for Cleansing Pink Bubbles Use pink bubbles or 250ccNS for dressing changes then no expiration date needed Bottles of normal saline 500 cc or 1000cc (only good for 2 days) then must throw away for wound cleansing Contact lens solution Check the price cheaper than NS 9

10 Putting on TEDS or Pressure Stockings Fighting to put on stockings Cut off handles on grocery bag slip over heel and then pull it off once stocking is over the heel Candidiasis - Yeast Fat folds under breasts prevent yeast place pillow case/towel/ large pieces T shirts lightly powder Use of powder rather than ointment re: yeast in folds Yeast loves nice warm places want to keep dry not moist Corn Starch works fine don t over do it can clump up causing more problems Good daily cleansing is a must every day Lightly powder keep skin off of skin Over the counter anti fungal Gold Bond 2% Miconazole (anything higher is prescription (Nystatin) (Tinactin Spray Powder) of Coloplast,

11 Fragile Skin High risk for Skin Tears Moisten good hydrating lotion Do not use no rinse soap Protect skin sleeves Tube socks (cut foot off) Should have policy/procedure in place for care of Skin Tears Skin Tears Apply hydrating ointment to dry skin to prevent skin tears Arm protective sleeves Long athletic socks cut foot off and slide up the arms Tubigrip works fine to cover arms Dry skin care apply hydrating lotion right after bathing Non perfume non alcoholic ointments look them up in grocery store Use of emollient soap for cleansing to prevent skin tears Do not use no rinse soap very drying 11

12 Dry Mouth Dry mouth syndrome apply small amt of toothpaste and swab mouth stimulates salvia EHOB Waffle overlay mattress Can be purchased by facility or bought by patient for cost Washable Cost effective cheaper than buying through a DME store 30 day warranty $209/6/carton = $34.91 each Retails $ shipping and taxes (Internet Site) 90 day warranty $267.60/ 6/ carton = $44.60 Retails $ shipping and taxes (Internet Site) 180 day warranty $361.00/ 6/ carton = $60.31 Retails $92.78 = shipping and taxes (Internet Site) Can order direct from EHOB no middle man

13 EHOB Waffle cushion _ Washable Cost effective Can be purchased in bulk by facility or bought by patient for cost $ for 12/carton pre inflated 200 WCI 17 inch = $19.45 each Retails $ shipping and tax (buy over internet through web site) Can order direct from EHOB no middle man Lots to Think About??? I have given you lots to think about The only way things will change is to be a Change Person for your facility, Patient Advocate help your patients save $$ There are many more types of items out there these are ones I have found to be beneficial to me Would love to hear about your own cost savings ideas!!! Open to the Floor for Discussion.. 13

14 Thank You 14

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