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Discussion

Simple Dressing Changes?

I had an STNA come up to me during report/shift change, and state that a dressing had come off a pt's pressure wound (stage II/ borderline III). Since I was almost finished report I finished, and then went to assess the situation. When I arrived in the pt's room the STNA was doing the dressing change. When questioned, she said she was allowed to do "simple dressing changes". I had never heard of this, so I wanted to ask you all. Also, what constitutes as simple? This pt's dressing was to be aquacel, with a duoderm on top (after cleaning with NSS). The STNA only put the duoderm on (so i had to redo it), when I told her this dressing was incorrect her answer was "well that's what i pulled off". Thoughts, opinions?

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    Out of the scope of practice for an STNA. Facility to factility is different with what their techs are allowed to do, but most sterile dressing changes are taught during training/schooling.

    Simply state that while another nurse may be comfortable with him/her doing the dressing change, you are not. It might be worth confirming in the policies and procedures manual for your facility as well as the job description to make sure those in the assistant role don't have that ability where you work.

    Either way, address it with the STNA first, look through policies second, and then bring it up to your unit manager/supervisor if confirmed out of scope of practice.

    Beyond that, I assume the previous dressing change was documented. Talk to that nurse as well about not following the specified orders for the prescribed dressing.

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