CNA Doing Sterile Dressing Change

[Multicollinearity, BSN, RN]

We have a CNA doing sterile wet-to-dry dressing changes on a patient where I work. It got started because she was with the MD when he did the first one, and he told her to do it. (MD and CNA are "friends" in this small town). The CNA does the dressing change, and the RNs glance at the wound before she redresses it. The RN charts it as dressing change delegated to CNA with an RN assessment of the wound's appearance.

I'm under the definite impression that CNAs cannot do sterile dressing changes in AZ. I've poked around the BON website, and the info is hard to find. I brought my concern to my nurse manager, and she does not care to say anything because she doesn't want to get into any conflict with the MD. The MD seems to love boosting this particular CNA's ego and implies at times that she knows more than some RNs.

I am correct - this is out of scope, right? I told my nurse manager that I believe it is a non-delegatable task and that I do not feel comfortable doing it.

[HJS27]

http://www.azbn.gov/Documents/education/CNA%20Competencies.pdf

[boomerfriend]

I had to look this up for myself (particularly because I didn't know the SOP for CNAs)....

It reads:

16.3 Assists with care of residents with special needs.

A. Observes and reports the condition of resident's dressings/wounds with

drainage.

B. Demonstrates care of resident with gravity drains.

C. Demonstrates care of resident/ resident with surgical evacuators.

D. Demonstrates care of client with sump drains.

E. Applies flexible abdominal binders.

F. Applies ace and non-sterile dressings.

G. Applies anti-embolism stockings and devices.

H. Applies immobilizing devices.

I. Demonstrates care of resident with feeding tube.

J. Demonstrates care of resident or resident receiving infusion therapy.

K. Demonstrates care of resident on a ventilator.

L. Demonstrates ostomy care.

Looks like that CNA is practicing outside her scope even though the RN is documenting what's being done. I personally wouldn't want to be in that RN's shoes when they have to defend themselves in this situation.