Peroxide usage

[Keepstanding]

Just wanted to see how many of you use peroxide when cleaning out a student's wound?

I still use it, but have been hearing some bad info. on the use of it. Let me know what you use in your clinic's to clean out fresh wounds. Thanks ! :heartbeat

[bergren]

To write this government endorsed clinical guideline, a systematic review of all of the available literature was used to locate the best evidence, the best practice. Then their findings, their decisions, were reviewed by school nurse and wound care content experts.

They describe their methodology :

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10196&nbr=5380#s22

So once that happens, and until this clinical guideline is replaced with one that looks over research studies that will be performed in the future, you would have to make a strong argument and rationale for not following their recommendation of tap water. That is, there would need to be specific circumstances that would preclude the use of tap water or a specific reason why it could not be used on a particular child. By publishing and vetting these recommendations, they set the standard of care.

So in a school setting, with a tap water supply that is not compromised, you should flush the wound with tap water.

There are some other clinical guidelines for school nurses and for problems we treat in schools at http://www.guidelines.gov

[CareBearnurse]

What about the use of water in a camp setting. The water is potable and used for drinking, but the spickets are outside in locations around the camp, and easily accesable. I feel it is okay to use to wash wounds, but another nurse feels it isn't safe, so uses H2O2.

[sChOOLRN48]

I use water and soap. I had read something a while back about new skin growth. Some kids ask for H2O2, but I refuse and tell them to let thier mom when they get home. I use H2O2 for cleaning blood out of clothing to send kids back to class and not have to call Mom. Oh and teachers can use it for whatever...with in reason...they are adults!

I can't wait to look throught the link! Thanks Berg!

[bergren]

"What about the use of water in a camp setting. The water is potable and used for drinking, but the spickets are outside in locations around the camp, and easily accesable. I feel it is okay to use to wash wounds, but another nurse feels it isn't safe, so uses H2O2. "

If you are concerned about using the tap water, then clean bottled water would be the best substitute. According to the science, peroxide actually damages cells and should not be used.

It is really hard to accept changes in practice when we had such standards drilled into us and believed in them. Melnyk says it takes 15 - 17 years for evidence to change practice.

These are links for a free tutorials in evidence based practice:

http://www.uic.edu/depts/lib/projects/ebphn/modulesmain.html

http://www.publichealthsolutions.org

Melnyk B. & Fineout-Overholt, E. (Eds.) (2005). Evidence-based practice

in nursing and healthcare: A guide to best practice. Philadelphia:

Lippincott

[CareBearnurse]

Melnyk says it takes 15 - 17 years for evidence to change practice.

It takes that long!!!!! I'm surprised that nurses would be that hard to get educated, and change, especially with the continuing ed we are required to have. I think that is one very good reason nurses should be members of their specialty fields, and get their regularly published magz, to keep up with new research that affects practice.