Diapering

Table of Contents

The reasons a child needs to wear incontinence briefs vary, ranging from a long-term disability to a short-term medical or developmental condition. If your learner wears an incontinence brief, they likely will need partial or full assistance with changing and hygiene. Incontinence briefs may need to be weighed for learners that require their output monitored. The instructional steps assist the registered nurse working under the auspices of the school or program in professional judgement and accountability of delegation. Additional steps may be required depending on the learner’s health needs.

Steps

  1. Explain the procedure to the student at his/her level of understanding
  2. Wash hands and apply gloves
  3. Have or help the student wash their hands
  4. Cover the diaper changing surface with a disposable pad (if applicable)
  5. Transfer student to cot/bed with the disposable pad under the student
  6. If you will use a diaper cream, dispense it on a tissue now
  7. Remove clothing & soiled diaper.
    1. Remove only enough clothing to gain access to the perineal area.
    2. If the student is in a diaper, position the student in a comfortable position
    3. Laying down on their side, gently roll the soiled brief inwards while pulling it away from the child’s body
  8. Wash the perineal area
    1. Female: wash the area with cleaning wipes starting at the top of the labia moving toward the anus, front or back
    2. Male: begin at urethral opening and in a circular motion wash away from the meatus toward the base of the penis, if a bowel movement wipe front to back always
  9. Inspect student’s skin
    1. Report any rashes, bruises or breaks in the skin to the school nurse
  10. Keep soiled diapers and clothing away from any surfaces that cannot be easily cleaned and secure any bag of soiled clothing.
  11. Remove dirty gloves and apply a clean pair of gloves
  12. Apply a clean diaper by sliding the diaper under the student or child or clean clothing
    1. If the student is laying on their side, roll half of the clean diaper and tuck it under the rolled soiled diaper
  13. If there is an order to use skin barriers, apply at this time with your gloved hand
  14. Assist student by fastening the diaper and/or assist in dressing the student
    1. If the child is laying, roll them to the other side, remove the dirty diaper and pull through the clean diaper to fasten.
  15. Use soap and water to wash the child’s hands thoroughly
  16. Return the child or learner to a supervised area or classroom after you have helped or they have washed their hands.
  17. Remove the pad from the changing area or surface and discard in the trash can
  18. Clean cot/bed using antibacterial cleaning agent
  19. Remove gloves and wash hands.
  20. Document the date, time, procedure, learner’s  response, your initials and signature