Nephrostomy Dressing Changes

Hi, i change nephrostomy dressings in my clinic in CA. This is how I do it. Setup: Per tube: 2 tegaderms, 2 2x2, 2 boxes of 4x4, StatLock, Normal Saline, adhesive catheter holder, tape, extra skin barrier (one pad usually comes with the stat lock but I usually need a little more).

Procedure: remove old dressing, pour NS into one of the 4x4 boxes and use to clean skin around stoma to surrounding skin area and tube. Let air dry, apply barrier, let dry. Put tube into statlock, leaving some slack going to the stoma, adhere statlock to skin close to the stoma, take a 2x2, fold it in half and place under the neph tube between the statlock and stoma. Take up the slack This helps in protecting the stoma and also helps to prevent the tube from being dislodged. Take the other 2x2, fold in half and place on the other side of the statlock. Now here is where I get a little creative, I take 2 dry 4x4 from the 2nd box, fold them in half and place over the plastic lock of the statlock, I use the date, initial and time tape from the tegaderm to hold it in place. Place the 2 tegaderms over the statlock/stoma so that all the gauze is enclosed and the neph tube is coming out of the side of the dressing. I use the 2nd tegaderm tape as an extra secure piece where that tube is coming out to the side. Use another 4x4, folded in half and wrap it around the hard plastic piece that holds the wire, tape that in place. Use the adhesive cath holder on the patient's side to hold the urine bag tube to prevent it from flopping around on the patient. Apply skin barrier before attaching it. I change the urine bags once a month unless they need it sooner. If pt has bilateral tubes then do the same for the other side.

I, too, have looked for some links on the internet, but cannot find any. Hope this helps.

Janice