New nurse... Dressing change?

[*Butterfly8*]

I am a new nurse and I'm coming up with lots of little questions. when a doctor order says change dressing every day, and i am a day nurse does that mean i am supposed to change it and then the night nurse does not have to? or does that really mean change it once a shift so the morning nurse and night nurse both change it? And how are you supossed to know when they changed it last if they didn't document it in a place you can readily find? Do you just go by the date and time on the dressing itself?

[xtxrn, ASN, RN]

I am a new nurse and I'm coming up with lots of little questions. when a doctor order says change dressing every day, and i am a day nurse does that mean i am supposed to change it and then the night nurse does not have to? or does that really mean change it once a shift so the morning nurse and night nurse both change it? And how are you supossed to know when they changed it last if they didn't document it in a place you can readily find? Do you just go by the date and time on the dressing itself?

"Dressing change Q day" or "Dressing change Q shift"..... what does the order say? :)

Usually if it says daily, start it on whatever shift gets the order and continue it however your facility times things - some continue on the shift it was ordered- others do them on days....

Always leave your initials/date/time on a piece of tape on the dressing. Don't write after it's already on- you probably know that, but I've heard people talk about how it hurt to have the nurse write on the dressing Don't just chart it- label it :)

[registerednutrn, BSN, RN]

If the dr ordered daily dressing changes then that means once a day. On my floor sometimes the day nurse changes it and sometime the night nurse does depends on when the doc wrote the order example if doc wrote the order at 2130 then the nug nurse would do the dsg change. If he wrote the order at 0930 then the day nurse would do it. As for knowing when the dsg was changed last we actually write the time and date and our initials on the dressing it. That not only do we know when it was changed but so do the docs. It should be documented in the patients chart as well. Hope this helps

[merlee]

Once daily is just that. Your facility should have a policy about when they want it changed. Sometimes it may be determined by which unit they are on. And the dressing should be dated, timed, and initialed. There should be a note describing the wound, as well.

Check your facility policy.

[loriangel14, RN]

It should be clearly charted when it was last changed along with an assessment of the wound.Where I work daily changes are done on day shift.

[tyvin, BSN, RN]

Also depending on where you are they will break up the Q day wound changes so that each shift gets it's share (nights exempt of course). It certainly wouldn't be fair too have all the single wound changes done on only one shift.

[steelydanfan]

I am a new nurse and I'm coming up with lots of little questions. when a doctor order says change dressing every day, and i am a day nurse does that mean i am supposed to change it and then the night nurse does not have to? or does that really mean change it once a shift so the morning nurse and night nurse both change it? And how are you supossed to know when they changed it last if they didn't document it in a place you can readily find? Do you just go by the date and time on the dressing itself?

I don't understand why you are so confused about such a clear order. "Daily" means "Daily" or once every 24 hours. Why is this confusing?

If the dressing is signed and dated, yes by all means use that as your guide, if you can't find any other documentation. Though of course, YOU will document both in your nursing notes and on the dressing label.

[caliotter3]

Sometimes you can't go by what is written on the dressing, when you find that the dressing says it was done four days ago even though the order says 'daily'.

[xtxrn, ASN, RN]

Sometimes you can't go by what is written on the dressing, when you find that the dressing says it was done four days ago even though the order says 'daily'.

But you'd know it hadn't been changed Nobody dates it for yesterday when they do it :)

Ohhhhhh....... I see what you're saying Didn't read the one above it :)

[caliotter3]

I worked in LTC facilities where quite frequently nurses didn't do their treatments and they didn't care who knew it. However, most of them covered up the fact by not signing and dating dressings at all. Others were proud enough (she says sarcastically) to leave it there for four days! :uhoh21:

[kcksk]

At our hospital the dressings that are daily are usually done of the day shift. Why? because the MD comes in and opens it to check them and then we have to redress them. If they are saturated at night, the night shift will change and then I don't do it unless it needs it. If varies from pt to pt. I personally like doing the dressing changes so it gives me a chance to check out the wound and chart it as I see it.

[CareteamRN70]

I work in LTC and most dressing changes are Q Daily on the day shift. Most orders I have seen stipulate time or shift but also include a PRN change if soiled (lotta sacrum/coccyx decub dressings), has seepage, or just is coming apart so even tho I work third shift I still get a fair amount of dressing changes.