Transparent dressing

Your first reaction was right - always go by the policy. The transparent dressings for skin protection is there to prevent advancement of Stage 1 or 2, or skin tears and the like. Our policy states RN's are to change the dressing once a week, or prn assessment.

http://www.accessmedicalusa.com/cms/Tegaderm-QA.pdf

Depends on what the dressing is used for: anywhere from q3days for IV sites to as long as its not compromised by drainage, etc for a healing wound.

It really depends..Our place has a policy for them to be changed q 3rd day and prn. The current thinking is every 5-7 days (or at least that is what the reps and product info state)

We use them on skin tears and simple stage 2s without alot of drainage. For the most part, if it is in an area that gets soiled or rubbed alot..the 3rd day is better than the 5-7 days. The whole idea of using the transparent dressing is so that you can see the wound, need to change it less often than once a day and the drainage keeps it moist and helps it heal (the correct term for that is escaping me..auto something)

our policy is every third day

I'm glad to see this question...I'm in my first level of nursing clinicals and yesterday i saw something that i thought was completely odd. We had a very elderly patient who was combative and got a skin tear on her hand. The nurse wrapped then hand in gauze to absorb the blood. The patient has dementia and kept tearing and the guaze and eventually got it on and irritated it so much that it began to bleed pretty badly. When i let the nurse know she came in with a transparent dressing and just slapped in on the wound. I was shocked! The pt then had an oozing, bleeding wound just covered up woth a transparent dressing? Is this as inappropriate as i think it is? Do you still see it happen? What would you have done instead?

Go by policy and the policy depends on what it is you're covering with the dressing. A peripheral IV is different than a PICC or a central line, etc.

I'm glad to see this question...I'm in my first level of nursing clinicals and yesterday i saw something that i thought was completely odd. We had a very elderly patient who was combative and got a skin tear on her hand. The nurse wrapped then hand in gauze to absorb the blood. The patient has dementia and kept tearing and the guaze and eventually got it on and irritated it so much that it began to bleed pretty badly. When i let the nurse know she came in with a transparent dressing and just slapped in on the wound. I was shocked! The pt then had an oozing, bleeding wound just covered up woth a transparent dressing? Is this as inappropriate as i think it is? Do you still see it happen? What would you have done instead?

Our policy for skin tears is to clean the area, then to steri strip skin tear if able . Often a tegraderm is placed over the area. Before I jump on the nurse in the example you give. I think she put the tegraderm on in the hopes that the patient would not be able to get it off as easy to inflict more damage to her skin. In which case most likely the tegraderm would be changed either later in the shift or on the next shift.

The other alternative this nurse might have used was to put soft wrist restraints of the patient to prevent her tearing a dressing. I am glad she did not do this.

I ask what would you have done differently?

If this is LTC, you won't find soft wrist restraints anywhere. (there is a thread similar to this in the LTC forum but deals with a cast and the resident pulling at it)

yeah, steri strips then cover it. Sometimes transparent dressings do more harm to the wound due to the pts already fragile/ thin and easy to tear skin.

When you are dealing with demented or confused pts, you have to get very creative and sometimes not follow the p and p to the T.