Dr. Order for band aid?????

[Shell5]

Sounds elementary, but sometimes we have residents in long term care that will need a band aid and a nurse will put one on and not write an order. This happens a lot. I think they need to be writing orders, but they don't. We had a resident come in the other day who had an appx 1/2 cm open area to back of calf and a nurse put a band aid on it. I didn't find out for a few days when it became a blister. The lady is on coumadin. The open area turned into a bruise, then blister filled with serous fluid. Now, there is brown crust on top that is either a scab or eschar. It is very difficult to determine at this point. We called in a wound specialist, surgeon. Our DON is acting as if it was no big deal; we didn't need to write an order to put a band aid on it at first. Nothing has come on it, but one day it might. What is your opinion? There is an order to for wet to dry until wound specialist can come.

Thanks in advance.

[student987]

As a nursing student when I did my rotation in LTC my pt needed a bandaid and I was told where they were so that I could just grab one (he was actually a short term rehab pt however)

as a patient -- I was just in the hospital, i had burned myself with nair the night before I went to the ER for a totally unrealated problem and ended up admitted. a couple of days later it had scabbed but I scratched and knocked the scab off, I asked for a bandaid for it (the didnt even know about it on admit) and the nurse just gave it to me there was no order that I know of

[mommy.19, MSN, RN, APRN]

I have never worked in LTC but things continue to surprise me. One is the fact that wet to dry dressings are still used. This is an archaic form of wound care and I find it appalling that, with all the things we now know, that this is still a common physician's order! If she is on coumadin, mechanical debridement of the tissue with wet to dry is just going to make her bleed.

As far as needing an order for a band aid? It's not a medication, why would there need to be an order? Maybe someone can fill me in on this... But as far as I'm concerned, what you did calling in someone with more experience was the right move, since there seem to be some other risk factors regarding wound healing here.

[brillohead, ADN, RN]

I'm doing my school nurse rotation in nursing school right now. I can put a bandaid on someone, but I can't put triple antibiotic ointment on them -- the bandaid is "first aid" and the neosporin is a "medication".

In the hospital when I've taken out an IV catheter, I folded up the gauze and taped it down to make a bandage -- only order was to d/c the IV, not to bandage the puncture hole afterward.

[LEN-RN]

I think they need to be writing orders, but they don't. We had a resident come in the other day who had an appx 1/2 cm open area to back of calf and a nurse put a band aid on it. I didn't find out for a few days when it became a blister. The lady is on coumadin. The open area turned into a bruise, then blister filled with serous fluid. Now, there is brown crust on top that is either a scab or eschar. It is very difficult to determine at this point. We called in a wound specialist, surgeon. Our DON is acting as if it was no big deal; we didn't need to write an order to put a band aid on it at first. Nothing has come on it, but one day it might. What is your opinion? There is an order to for wet to dry until wound specialist can come.

Thanks in advance.

If the bandaid was put on an open area, the area should have been measured and an order should have been written. Incident report?

My opinion is document when you find a bandaid that is not found in the TAR. (as well as find out what is UNDER the bandaid) That will CYA if there is ever any question.

Any time a bandaid is needed, the nurse who puts it on should document that it was done - and why. Date and initials included on bandaid. Unfortunately there are a number of reasons some dont do this. (Even when d/c IV - documenting what the site looks/feels and that put clean dressing on - even if just write bandaid)

[nursetiffany.]

I work in LTC and yes we need an order for a bandaid. It gets repetitive and seems dumb but saves you in the long run!