Intro. (~1 min)

Hello  and welcome, my name is Susan Rice, I am a clinical educator for UI Medical. I’m here today to introduce you to our QuickChange Wrap. 

What is a QuickChange wrap?  Well, The QuickChange is a new, non-invasive urine management device that we genuinely believe is going to have a wonderful impact on the effort and time involved with managing your patient or resident’s urine needs. You’ll see that it takes as little as 60 seconds to change a wrap, minimizing contact with the patient,  without any indwelling items or without requiring the usual lifting and rolling, and wipes and barrier creams normally associated with pads and briefs.

In this video I'll be showing you the different ways to apply the wrap and how to best address your patient’s situation and needs, I am also going to be covering a few tips and tricks, and then I’ll walk through some of the most frequently asked questions.

Quick Summary (~3.25 mins)

[Description (~1 minute)]

As I mentioned, the QuickChange wrap, or penile or incontinence wrap, is a new type of urine management device, used to replace adult diapers and briefs as well as urinary catheters, though wraps can often be used in conjunction with them.

So it shouldn't be surprising that QuickChanges are used across the entire healthcare spectrum, from acute care hospitals to long term care facilities, from skilled nursing to home health and hospice.

Let's take a look at a graphic. QuickChanges fold around a male patient’s penis and absorb urine as soon as it is voided, keeping the urine immediately contained and off the skin. 

By keeping urine off the skin, wraps have been clinically shown to prevent certain pressure injuries and to prevent incontinence associated dermatitis and MASD.  

And by replacing catheters, QuickChanges reduce, if not wholly prevent, CAUTI events.

Wraps are extremely flexible and are great in difficult situations like retracted or indwelling penises, with enlarged scrotums, and with bariatric patients, requiring only minor tweaks in the folding process. We’ll cover each of those situations in this video.

[Wraps (~45 seconds)]

Let’s talk some details of the QuickChange. 

The patterned or printed side, is your breathable and waterproof side. This is what will go against the skin. The white side is your absorbent side. And you’ll notice a hook and loop velcro on the straight flap that holds the wrap closed by attaching to any part of the printed side.

Inside each wrap are super absorbent polymer beads that absorb liquid and turn into a gel, locking in the liquid and moisture. This allows the top sheet against your patient’s skin to be dry to the touch in under two minutes.

QuickChanges hold about 500 ccs of urine

Dry wraps weigh 31 grams each, 

One size fits all

The QuickChange is Latex free.

[Profile (~1.5 Mins )]

An important aspect of QuickChanges to discuss is the patient profile.

Now, we have two main profiles, incontinent men and continent men, and each requires a different approach.

Your first and easiest profile is either incontinent men of any age, or men sixty and over; basically, men with a low pressure urine stream. One wrap will work perfectly for these men.

Your second profile is a fully continent man, or at least a younger man, basically, men with a high pressure stream.  For these high pressure patients, I will show you a technique using two wraps.  We do want to warn you, your mileage may vary for this profile.

Wraps are also best used on non or minimally ambulatory men - bed bound, chair bound, or with only light ambulation, like walking between a bed and bathroom, or maybe down a hall with an IV pole or in rehab.

And of course, always follow your facilities guidelines and practices

 

[Closing]

 If in the future you ever just need to touch up on something specific, for example, how to apply a wrap on a bariatric patient, look for our short clips on our website or our YouTube channel that deal specifically with the application you need to review.

We are constantly updating our videos and adding new content to cover additional situations, so please check back regularly for new posts.

Standard - Incontinence profile (~2.25mins)

So let's get started

We’ll start with a “standard” patient, which basically means that there is a shaft to work with, and we’ll start with our first profile of an incontinent patient with low urine pressure using one wrap.

Now, for demonstration purposes, this is our mannequin and these are the legs of our male. In almost all applications,  the wrap will be placed so the tabs align with the legs. Legs to Legs.

Place the wrap on the abdomen with the white absorbent side up. 

Make sure the round edge is towards the head of the body and the two flaps are towards the legs.

Slide the wrap down so that the inner ring is as low towards the base of the shaft as possible.

Adjust the penis so that it rests in the middle of the wrap. 

The tip of penis should not be closer than 2-3 “ from the top, if it is, just adjust by sliding the wrap up.  In this case, we have a good fit.

Fold the pointed flap diagonally across and over the shaft of the penis at a 45 degree angle.

Make sure the top round edges are aligned.

Now take the other flap and fold it over the first, pulling up and to the right, making sure there is a snug, semi tight fit around the base of penis to prevent possible leakage down the shaft.

Again, make sure the top round edges match up. As you can see, a flat, fan shape is the result. 

So with two fingers, give the hook fastener and the inner flap a good pinch to make sure there is a good grip between the two. 

Remember, the top, rounded side is not sealed or closed so that heat and moisture can escape and so that air can circulate. 

The 360 degree fan shape ensures that urine is trapped within the wrap and doesn’t migrate between or over the legs, or pool underneath the buttocks.

These are the key features that will help drive down your dermatitis, your MASDs, your IADs.

That's it for the standard application.  So let's talk about some tips. (~2mins)

Make sure to pinch the Velcro good and hard to the underside. A simple push with a finger tip may not be enough to get a good grip between the two surfaces.

[Repositioning and side sleepers]. When you’re repositioning or turning your patient on his side, please consider changing the patient first. The weight of a soiled wrap will likely pull and become uncomfortable for your patient.

 If the patient sleeps a lot on his side, slide a second wrap underneath the first wrap and attach the fastener from the second wrap to the folded one. The traction of the second wrap should keep both in place.  

If you have a patient with severe spasms, use mesh briefs or a jersey fitted underwear or something similar to hold the wrap in place.

Standard - Second Profile (~1.75mins)

Let’s move onto our second profile that uses two wraps.

You may have a patient that you really want to use QuickChanges on, but he doesn't quite fit the primary profile: maybe he has a medium pressure stream, or he’s a new patient and you’re not familiar with his profile. 

Maybe he’s on LASIX or diuretics and you're afraid that he’ll void more than 500ccs in one episode.

Maybe you are just looking to never use a foley cath, 

Well, there are two modified methods we can recommend for this secondary profile.  Both start with the standard wrap above.

Method one is for medium urine pressure patients: after folding the wrap, simply add one to three pieces of tape to the round part of the wrap to somewhat close the top.  This should knock a stream down back into the wrap, while allowing air circulation. This is a very effective approach. 

Method two is a bit more foolproof: use a second wrap to close off most of the top and absorb any overflow.

Let’s demonstrate

I find it easier if you start with two wraps on top of each other.  

Fold the first QuickChange in a standard wrap.

Line up the second wrap about half way down the first and make sure the middles align. 

Pull the top center down and fold across the first wrap. 

Bring the straight flap up and give it a quick pinch to secure.  Make sure you have a tight fold and grip.

You now have a barrier across the majority of the wrap that should prevent urine from escaping while still leaving a large opening for heat and moisture to escape.  

Indwelling / Retracted Penis (~2.5mins)

For your patients and residents with retracted or indwelling penises, you will fold the wrap around the scrotum as well as the penis in order to secure the wrap.

We suggest you apply either zinc spray or barrier cream on the scrotum, as the scrotum will be in the wrap.

Place the wrap on the abdomen with the white absorbent side up.

Again, make sure the round edge is towards the head of the body and the two flaps are towards the legs. Legs to legs.

Slide the wrap down so that the inner ring is as low towards the base of the shaft as possible, or, if totally retracted, the tip of the penis.

Slide the pointed flap between the thigh and scrotum, and then scoop up the entire scrotum, lifting upwards. Make sure the folded flap is close to a 45 degree angle.

Then fold the second side over, slightly pulling upwards.  Like last time, you want to make sure there is snug, semi tight fit at the base of the genitals to prevent possible leakage.

Then make sure to pinch the hook fastener and inner flap together to get good adhesion.

You’re not quite going to get a perfect flat fan shape like with a standard application, as there is more volume inside the QuickChange. And again the top remains open to allow heat and moisture to escape.

Now, let's review some tips.  

It’s really important to make sure you give that Velcro a really good pinch.   

 When repositioning a patient, or turning him on his side, consider changing him first as a soiled wrap can pull away from the patient. You can place a second wrap underneath to hold a wrap in place if he is spending a lot of time on his side. You can use mesh briefs or underwear for patients with severe spasms.

For your patients with heavy flow, or high urine pressure, or again if you just want to stay away from catheters, you can tape the wrap or use a second wrap as with the standard application.  

Bariatric (~2mins)

For your obese patients, there is most likely a pannus or large belly likely covering the genitals.  Because of this, using a wrap in the traditional method isn’t possible.  In this application, we’ll be using two wraps.

It’s not required, but it will be helpful if there are two caregivers involved.

First, cover up the Velcro hooks so that it doesn't abrade the skin.  You’re just turning it into the absorbent side of the wrap. Cover the Velcro on both wraps.

Then your helper is going to come in and move the belly from the area around the genitals, so that the genital area is exposed. 

The first wrap is going to be brought as far underneath the scrotum as possible

Tuck the QuickChange gently between the legs. This is going to catch any runoff, and it will help with skin integrity on the patients legs.

Then take the second wrap and create a circle.

Now while the belly is up and away from the genitals, you're going to fold the second wrap over the source of the urine so that the absorbent part is centered right up against the source of the urine. 

And then imagine my hands are the pannus coming back over the top and resting on top of the QuickChange, holding it down in place. 

This approach will also keep any moisture or urine from going up and under the pannus and causing any further moisture or fungal type of irritation. 

The approach with two wraps is also very useful for patients where the penis is buried under subcutaneous fat and nothing is really available at all. 

Scrotal Edemas / 1-2 wraps (~3.45 mins)

Description (~45 seconds)

Wraps are also a great product in case of enlarged scrotums and scrotal edema, far more effective than the typical sheets-and-towels approach used and without any of the cleaning agents, like bleach, that can further irritate this sensitive skin.

For edemas, the QuickChange is wrapped around the penis and scrotum in an open, cone/bowl shape. Besides absorbing the urine, this approach will be doing two additional things:

We’re capturing any perspiration or excretion, or seepage from the swollen scrotum, which is usually red, raw, and painful, and sensitive to moisture.

And you’re preventing the scrotum from migrating back down in between the legs

Let’s walk through our two methods:

Medium Sized Edema - 2 wraps. (~2 mins)

We’ll start with a medium/large sized edema, about the size of a large grapefruit.

Make sure you treat the underside of the scrotum with any type of barrier cream or zinc spray that you have or whatever your protocol is for protecting that sensitive skin from urine.

We are going to take two QuickChanges and create one large wrap by connecting two ends using the velcro tabs.

Don’t worry about the location at first, the velcro will go anywhere on the backing, and we’re going to be adjusting the size of the QuickChange to accommodate your patient.

So, make your double sized wrap and place it on the patient

Flip the two legs upwards to get them out of the way and help you slide the wrap in place.

Gently lift the scrotum up separating it from the legs.

Take the pointed side and bring it under between the scrotum and the legs

Now take the straight velcro side, and using the pointed side as a lever, you're going to pull them together slightly and then attach the two together. Make sure the attachment is secure.

So you've got a circular wrap. Now, to make it as comfortable and effective as possible, you’ve got to tighten the sides. You won't be able to do this from the bottom, so take the two ends towards the head and pull them towards each other. You’ll see that the wrap becomes a bowl.

You can see it from this angle.

To recap, we are doing three things here:

Capturing urine on the top because the penis is resting against the wrap

We’re capturing any perspiration or seeping from the swollen scrotum 

And you’re preventing the scrotum from migrating back down in between the legs

If you're concerned about your patients' linens or clothes, just attach another wrap over the top so you keep that circulation going without fear of any urine coming out over the top. Make sure to give it a good pinch.

[Small Edema - 1 wrap (~1 min)]

If the edema is closer to the size of an orange, only one wrap is required.

Place the wrap on the abdomen with the white absorbent side up.

Again, make sure the round edge is towards the head of the body and the two flaps are towards the legs. Legs to legs.

Slide the wrap down so that the inner ring is as low towards the base of the shaft as possible, or, if totally retracted, the tip of the penis.

Gently lift the scrotum up, separating it from the legs.

Using the pointed side as a lever, you're going to place it under the scrotum.

Then fold the second side over, slightly pulling upwards.  Like last time, you want to make sure there is snug, semi tight fit at the base of the genitals to prevent possible leakage.

Then make sure to pinch the hook fastener and inner flap together to get good adhesion.

Questions:

We typical get asked the following questions by staff in professional facilities

When should the QuickChanges be changed?

If the wrap is soiled it should be changed. Most facilities are checking/moving their patients every two hours and changing when necessary. 

Is the QuickChange appropriate for a bariatric chamber?

Yes, if the velcro tab is removed

How many wraps does a patient require daily?

On average, a patient will go through 5-6 wraps in a 24 hour period.

How do I order the QuickChanges?

Depending on your facility’s protocol, reach out to materials management, supply chain or your Nurse Manager.

Are the QuickChange Wraps reusable, or single use disposal?

The wraps are single use disposable and should be disposed of in the same manner as an adult disposable brief or underpad.

How do we calculate I’s and O’s

I’s and O’s can be determined in the same fashion as in the pediatric units. A plastic bag and dry QuickChange Wrap are weighed together on the scale. Then the soiled wrap is placed in the same bag, calibrate your scale to reflect the original dry weight and place the soiled wrap in bag on scale to establish final output.

Can the QuickChanges be used in concert with a catheter?

Yes, if you have a patient with an ill fitting leaky catheter, apply the wrap using the instructions that reflect your patient’s anatomy. All residual urine will be captured.

If you have any additional questions on the QuickChange wrap and how it can be more effective for your usage, you can find us at our website, QuickChange.com where we have several videos on the wraps as well as various materials and instruction guides for downloading. We also offer virtual inservicing live from our broadcast studio over platforms such as Zoom and Skype where you and your team can interact with our clinical educators.

Feel free to call us any time at 1-800-206-2816 where we can walk you through any situation.