Quote from copperbarrow
Hi, I need to write a plan of care for a wet to dry dressing, lots of steps and I'm not sure when the sterile gloves go on. Could you help?
Here is the scenerio I've come up with:
position patient pad bed, emesis basin handy for later irrigation
open and arrange supplies
remove old dressing
measure wound with cotton applicator tip
irrigate wound with NS and Toomey stringe
apply sterile gloves
pack wound with 4x4's
dry skin which is wet with irrigant
apply ABD pad and tape
Please rearrange these if they aren't in the right order. Add your rational so I'll understand better. Thank You!
Dressing Changes: Sterile Technique
Wash Hands then:
1. Explain the procedure to the patient/caregiver
2. Assemble the supplies at a convenient work area
3. Assist the patient to a comfortable position to expose the wound. Place a plastic sheet under the patient to prevent soiling the linen. Drape the patient for privacy.
4. Place a clean towel underneath the working area to minimize contamination.
5.Open the sterile dressings, the irrigation and cleaning solution, and the instrument set to provide a sterile field.
6. Wear a protective apron when caring for a patient with a draining wound. Don nonsterile gloves.
7. Gently remove and discard the old tape and soiled dressing in a plastic trash bag. If the dressing sticks to the wound to the wound, moisten with sterile nss and then remove.
8. remove and discard nonsterile gloves. Don sterile gloves.
9. Cleanse and irrigate the wound as prescribed by the physician. Clean from the least contaminated area to the most contaminated area.
10. Inspect the wound, and evaluate it for healing versus signs of infection.
11. Apply a (moist) dressing,(gently feed moist gauze into the wound with cotton-tip applicators if packing is required)Place dry gauze over wet gauze. Then cover with a gauze dressing,or ABD pad and secure it with hypoallergenic tape,Montgomery ties or a binder.
12. Provide patient comfort measures.
13. Clean and replace the equipment. Discard disposable items in a plastic trash bag, and secure.
These steps are from "Handbook of Home Health Nursing Procedures" by Robin Rice.