MatthewCanUK

This may be a duplicate post and if so I apologize. I wanted to ask a question to any diabetes nurses/educators, nurses with diabetes or anyone who sees a lot of diabetes patients in their practice. I have been a nurse for about 20 years but decided to go back to school to become a computer programmer. Part of the requirements of my program is to design a user-based program for a final project. The idea I had was to do a diabetes app for the phone directed at patients. So, the question I have is this: What kind of features have you heard patients suggest or would you want to see in an app that is supposed to help patients track and manage their diabetes effectively? (ie. reminders for medications, alerts about low blood sugars, etc...) Any comments would be greatly appreciated!

So. Pick up the wet, sterile gauze in the non-dominant/clean hand then drop it into the dominant/dirty hand. That is hopefully easy enough. Are there any tricks to actually placing the dressing? Or can you just use both hands as long as you don't touch the bandage/pad part of the dressing?

I wanted to ask some UK nurses about the procedure for inserting a foley catheter in either a male or a female. I have read the Royal Marsden but I have to take an OSCE for UK licensure soon and I'm worried that there are some pit-falls hiding in the procedure. In the US/Canada we would use forceps to clean around the urethra, thus leaving our dominant hand sterile for insertion of the catheter. The non-dominant hand keeps either the member or labia in place for insertion. However, in the Marsden example they simply say "use one hand to hold X and the other to clean. Then insert the foley". My worry is that hidden behind that statement is either a glove change, change in hands, etc... One thing to point out is that, at least when I was trained, we did not have this idea of "one hand dirty, one hand clean" we used the disposable forceps that come in the tray (both for foley insertion and for dressings) thus you had at least one sterile hand left (for foley insertion) or both sterile (for dressing changes). I was penalised once before for not using this technique. But the way the protocol is written I can't see that I actually have a "clean" hand left after cleansing the area. The simplest solution would seem to be replacing my gloves, which I have seen done in some UK MD videos. But since I will be marked on the "proper" way of doing this I wanted to ask for some advice.

Thanks Shellie-anne. That does help. My one question is: what about when you have used your "dirty hand" to do something to the patient. In this case it is holding a gauze to clean a surgical wound. Can you then use the same hand to take the next gauze from the sterile field? I guess I get hung up on the word "dirty". When I went to school if your hand was dirty/contaminated there was no way you were ever bringing it back to the sterile field for fear of contaminating it. Is the assumption here that as long as you are holding the gauze, and only the gauze (not your glove) touches the patient, you can then go back and take the next item from your field? Sorry to be picky and to quiz you like this.

Hi, I am looking for some advice on how to do "clean hand, dirty hand" when doing asceptic non-touch technique for a dressing change. When I trained we used forceps, but recently I was being tested and there were no forceps to be found so you could only use your hands (with sterile gloves of course). One of the things I was cited on was not using the "hands" idea. Is it really just as simple as only using one hand to cleanse the wound while leaving the other sterile? (I would think that this would contaminate the sterile field when you went back to get the next wet gauze). Am I over-thinking this?

I contacted Northampton to ask and they assured me that you do NOT need to cite current evidence. Sorry to cause concern.

I do plan on using the AL model. Mainly because this is what the NMC is asking for and I have not found them to be very forgiving when you don't follow their directions to the letter. Reading the book that the model comes from they are much more concerned with nursing diagnoses rather than "medical" ones. The system here seems to be more divided between RNs and MDs than in the US. The power point is under "Some learning materials (ADULT) supporting planning care. The Introduction to planning care tab and it is panel #13 of the power-point. I did e-mail Northampton and they assured me that you do not need to cite current evidence. So that was good new.

I know that there is considerable secrecy about the OSCE (Test of Competence Part 2). But can anyone confirm or deny that when we are doing nursing care plans we need to have rationales and citations of current research with them? The sample documents they provide don't seem to have any place to add this but there is one power point that seems to suggest that it is a requirement.