Clean vs Sterile Technique

Blee O'Myacin, BSN, RN · May 18, 2007

Mommy Nurse2b said:
I was reading another thread about protecting your license and there was mention of a nurse not using clean technique to change a dressing (which leads me to wonder what technique DID she use?)
Anyway, when we chart there is a place to check clean or sterile among other things. Of course I know you should mark what you actually DID do..but I worry about things like this and marking clean..then them using that against me down the road saying "she should have used sterile" well of course I'm not going to mark sterile if I didn't use sterile...but..I was wondering....
What types of dressings SHOULD you use sterile for? I know central line dressings are sterile dressing changes.
What about decubitus? Or incisions?

Every facility has their own policy on this issue. Check orders and policy before you do anything that might come into question. And home care is an entirely different arena. Straight cathing yourself in your own bathroom is considered a "clean" procedure, but a "sterile" procedure when a nurse does it for a patient at the hospital.

Blee

GingerSue · May 18, 2007

My textbook says that sometimes a surgeon will leave a surgical wound uncovered

For wounds that heal by primary intention, it is common to cover the incision with a dry, sterile dressing that is removed as soon as the drainage stops or in two to three days.

Red wounds - ... usually covered with a sterile dressing.

ChristyMNOP · May 18, 2007

I'd like some input on this as well-I intern at a facility where I do dressing changes regularly. I wonder if I should be indicating the technique I used when I document it. Usually I say 'd: dressing change ordered/needed due to saturation a: removed old dressing, drainage description, replaced 4x4 or whatever is ordered r: pt tolerated well' Most if not all of the dressing change orders do not indicate that it should be sterile technique, which I always take to mean clean technique.

TazziRN, RN · May 18, 2007

ChristyMNOP said:
Most if not all of the dressing change orders do not indicate that it should be sterile technique, which I always take to mean clean technique.

Just because it's not indicated is not an absolute that it doesn't have to be sterile. If the doc ordered a central line dressing change, would you think it's okay to use clean technique just because he didn't write "using sterile technique"?

Cardiolyte · May 18, 2007

I'm orienting to a new facility. When doing a w-d drsg change, I was taught it was a sterile procedure...yet, I observed a w-d drsg change using clean technique....this on a 2 day post-op...I'm still uncomfortable about it, should I be?

cory39 · Dec 4, 2009

TazziRN said:
Just because it's not indicated is not an absolute that it doesn't have to be sterile. If the doc ordered a central line dressing change, would you think it's okay to use clean technique just because he didn't write "using sterile technique"?

And that goes both ways; Just because it's not indicated is not an absolute that it doesn't have to be clean either : )

cory39 · Dec 4, 2009

GingerSue said:
my textbook says that sometimes a surgeon will leave a surgical wound uncovered
and for wounds that heal by primary intention, it is common to cover the incision with a dry, sterile dressing that is removed as soon as the drainage stops or in two to three days.
Red wounds - ... usually covered with a sterile dressing.

Just because it is covered with a sterile 4X4 does not mean you have to use sterile technique. I'm not sure where you were trying to go with your comment