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tid dressing changes

Med-Surg   (3,528 Views 11 Comments)
by snwflknurse snwflknurse (Member)

2,947 Profile Views; 66 Posts

Order states:

"Wet-to-dry dressing changes to ______ tid."

No scheduled times. I work afternoons and am increasingly becoming frustrated that when I report off at 2300, it is somehow my fault that it didn't get done three times that day. In the past three instances, dressing changes were done in AM's at 1000 or 1100. I would do it once my shift, usually between 1700 and 2000, and then report off and be questioned as to why it wasn't done three times. More specifically "you should have done it twice then".

I realize patients don't want to be woken at night for dressing changes but it really doesn't make sense to do a tid dressing change at 1100, 1600, and 2200 does it? That's not very spaced out....I would think close to q8hours would be more ideal...?

Can anyone tell me how this is handled in your facility? The last instance I am speaking of my patient went to surgery at 1300 before I came on, I did dressing change at 2000 when he was back, and STILL got grief about not doing it twice! Argh!

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joyflnoyz has 7 years experience and specializes in home health.

349 Posts; 4,105 Profile Views

No, it doesn't make much sense. I would get the order changed to read q shift or q 8 hours. More evenly spaced out. (for example 0600, 1400, 2200 - chances are the patient has meds due around those time anyway..)

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3 Articles; 10,428 Posts; 89,164 Profile Views

Dressing changes that are TID are 0600, 1400, 2200. Exception is if it's in a spot that's likely to get soiled before the next change is due, and it's done earlier. Usually not done more often than TID, but sometimes.....

Anyway, sometimes meds that are TID are done closer together, if the doc wants those meds during "daytime" hours as opposed to very early morning and hs.

I do 12-hour nights, and that means TID dressing changes DO get done twice on my shift: 2200, and then 0600 the next morning, because it falls over two shifts. That leaves the middle of the day one for someone else ;)

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29 Posts; 1,216 Profile Views

I have always done them twice on my evening shift, as in our part of the world they are done around 0800, or with an am bath, 1600, and hs. Check with your floor policy as facilities times may vary. If all else fails, have the Dr. specifically state in the orders. You are right about not doing them at night when we promote sleep.

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st4wb3rr33sh0rtc4k3 has 3 years experience and specializes in Tele/ICU/MedSurg/Peds/SubAcute/LTC/Alz.

253 Posts; 4,211 Profile Views

TID means Q shift in my world.

That is what we would do. If it was a twelve hour shift, if it wasn't done twice by the first shift, then I would do it twice. Definately, depends on the policy of the facilty as well.

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meownsmile is a BSN, RN and specializes in Med/Surg, Ortho.

2,532 Posts; 10,319 Profile Views

Would be once a shift in my world too. I would automatically put it on q 8 and make a note on the MAR with scheduled times,, easiest would be at the end of each shift. 1400,2200 and 0600. That way it is done most reasonably when the patient is not going to be interrupted as much during sleep.

Occasionally when a doctor comes in and removes the dressing in the middle of shifts with rounds, you may just have to use that change as the one for that shift but it doesnt mean you cant keep the schedule. It just means it was done a bit earlier than scheduled for that shift.

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94 Posts; 2,806 Profile Views

TID where I am means every shift(we are 8 hours). I usually try to make sure they are atleast 8 hours apart but you know if you are handling 6-7 high acuity patients per shift the dressing may get done a little sooner or occassionally a little later. The one complaining is just mad because he/she might have to actually do his/her job. If an MD makes rounds and takes off the dressing that counts as my dressing change-plain and simple...

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