Are orders needed for dressing changes? QI project question

Sorry, I am of no help, but just wanted to say that that is a good question. Maybe it varies per state, have you tried reviewing your nurse practice acts to scope out wound dressing change protocol. I just know that I am a student in AZ that has been told we NEVER change a bandage without orders. THe orders can say to change bandages PRN, but will usually state what kind of dressing are required. We are also told we never remove post op bandages without specific orders from the surgeon and only after they have removed the initial dressing and viewed the incision site. However, I know they wound nurses do not need orders and use judgement when dressing a wound, so it does make me wonder if it is just facility policy that dictates dressing change protocol or law. HMM. Hoepfully someone has more info on this for you.

All dressings are changed every 24 hours. No orders needed. We require a order to NOT change them. We have a few dressings the MDs like to change themselves.

ALL dressings should NOT be changed every 24 hours. Some, such as alginate dressings, are left in place from 3-7 days routinely.

All dressings are changed every 24 hours. No orders needed. We require a order to NOT change them. We have a few dressings the MDs like to change themselves.

What? No. That is wrong. You change at specific times. The only time that you would actually actively change it is if it is soiled or wet from blood. Tegaderm can last longer than 24 hours.

At my place of employment nurses can put in wound care orders and consult the wound care nurse. This is done under protocol. The rule is before doing any dressing change there must be an order. This doesn't always happen. Also, patients will come up from the OR with a dressing over a surgical incision sometimes the surgeons will put in wound care orders and sometimes they won't. If they want staff the change the dressing they will put in an order. Otherwise they'll do the dressing change themselves.

Maybe I should have been more specific. I am not talking about specialty dressings. I'm talking basic dressings like chest tube dressings, island dressings etc. those are changed every day. aqua cel dressings etc are left until due to be changed. I'm also not talking about pressure ulcers etc dressings or special wound care dressings that are seen/changed by wound care.

Thank you for the input. I have checked the NC board of nursing site, but wasn't easily able to find it. Obviously bandage changes are in the scope of practice, but not about orders/no orders. Not to say it isn't in there!

I did find that wound care nurses (specialization) can and do put bandage change orders in - but I haven't yet found out if they can do it independently (which means it is in scope, with the training) or if they are operating with an MD that technically is doing the orders... I had no idea figuring something out like this would be so tough! :)

Sun0408 - in what state do you practice?

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.

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.