Wound dressing

[MM2007]

How can a nurse therapeutically intervene within the dressing of a wound. Anyone have any ideas.

Thankyou.

[TazziRN, RN]

Hmm.....need a bit more information. You mean how to bring up the subject with a doc? With the family? Initiate a dressing procedure?

[MM2007]

Hi sorry dressing procedure.

[CaLLaCoDe, BSN, RN]

offer to premedicate the patient with an anelgesic

document in detail the description of the wound

use steril gloves and steril technique

position bed height to a working level

and don't mention how grim the wound looks to the client! :-) :paw: :paw: :paw:

[jimthorp]

offer to premedicate the patient with an anelgesic

document in detail the description of the wound

use steril gloves and steril technique

position bed height to a working level

and don't mention how grim the wound looks to the client! :-) :paw: :paw: :paw:

sterile technique is not appropriate and is overkill. wounds outside the confines of the integument are not themselves sterile. aseptic technique is sufficient.

where i work, ltc/rehab, the docs pretty much go along with what ever treatment me or the other nurses recommend.

[NRSKarenRN, BSN, RN]

1. Wash your hands BEFORE gathering supplies.

2. Gather needed supplies and exam wrappers for contamination/soiling (leaky ceiling tiles do drip down onto supply exchange cart underneath)

Extra pairs of gloves for removing soiled dressings

3. Examine solutions for expiration date and signs contamination (that bottle of peroxide open to air without cap past 2 days is now flat--toss)

4. Have trash bag at end of supply area to discard removed dressings---do not cross over supply area.

5. Follow wound care orders as written by doctor.

Notify doctor if no improvement in a week, calls for reassessment of treatment regimen. If doctor not listening to your nursing advice and need re-eval wound care regimen, follow chain of command: notify wound care nurse &/or nursing supervisor up to medical director if indicated.

6. Sterile technique for post op wound care in hospital/ SNF setting unless protocol dictates otherwise. Homecare: use clean technique.

7. Adequate lighting to see wound bed---even if need to grip penlight

between teeth.

8. Assess allergies and irritation to tape/wound care products. Use right size tape to decrease shearing forces on skin.

9. Emaciated or irritated skin: re-eval how much solution used with "wet to dry" ---dressings should be damp, not dripping wet. Use moisture barrier cream or skin prep to protect surrounding skin.

10. Discard old dressings into red receptacles in facilities; double bag for homecare then dispose in trach can.

11. Wash hands upon completion of procedure!

Let others add their comments

[CaLLaCoDe, BSN, RN]

Sterile technique is not appropriate and is overkill.

Overkill?...ok then playing it safe, pseudomonas is a crafty little bug to introduce to your client's dirty wound..lol

[GingerSue]

and then who is paying for the iv antibiotics?

[jimthorp]

and then who is paying for the iv antibiotics?

Is this question directed at me?