Are orders needed for dressing changes? QI project question

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I am on a new unit in a new hospital for my clinical rotation and we have to do a QI project. I've run into an issue that I haven't seen in my previous clinical locations related to bandage changes. At previous locations I've always seen orders for bandage changes in the nursing orders. At this hospital I haven't found any. This past week I had 3 patients, one that has 2 bandages for pressure ulcers, two that had surgical incisions (one was one day post-op, the other a few days post op), two with freshly installed JP drains, and one with a bandage placed over a surgical incision that had spurted purulent material during morning rounds.... So a whole lot of bandages around. I couldn't find a nursing order for any of them. I asked my partner nurse and she said bandages are changed once a shift at assessment, unless soiled, then they are changed again. But there wasn't a specification for materials used, that was nursing judgement.I've been trying to find out if orders are legally required or if nursing judgement is within scope of practice and that has been very difficult to figure out. Can someone give my input on your experience? Or better yet, point me to legal regulations or best practice resources for this? I'm finding a lot about how to do a bandage change but not about orders or protocols to have consistency. Thanks.

Thank you for the input everyone. Sorry for the delay in reading/replying, I was crazy busy yesterday and since I didn't get an email alert for replies, I didn't realize there were responses to look at.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Eseme - I searched on the intranet at the hospital where I'm in clinicals & found lots of protocols for bandage changes, but not an umbrella policy for bandage changes in general. Not to say it wasn't there, but I wasn't able to easily locate it.

what kind of bandage specifically....it may be they don't have a blanket policy and have written policies for each type of drsg change.

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My settings have been updated, thanks.

It does appear the policy/procedures are by type of bandage/wound/etc. It's not quite what I was looking for, so I think I may go a different direction. Two days of research without a lot of good leads makes me think I should look at other options. I appreciate all of the help!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

what are you looking for? If you tell me maybe I can help you know where to search

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