Wound Care: Sterile Dressing Changes Essay

Situation: Week 4 of skills lab: Today we were learning how to do sterile gloving and ungloving.

D daily inspection, date on the dressing, documentation this is a very important step not just for the nurse caring for the patient at the moment but other healthcare team members. Daily inspection of the site should be done to prevent damage or further damage if there was to be an issue with the site. Putting dates on the dressing is also important because the dressing should be changed every 7 days to prevent infection and break down of the dressing. Documentation is also key in insuring patient safety, what time the IV was inserted, the gauge, IV fluids and how the patient responded to the procedure.

NATA states that “woven and nonwoven gauze for clinically infected abrasions, avulsions, blisters, incisions, lacerations, or punctures. Woven, nonwoven, and impregnated gauze for puncture wounds that have cavities. Wound-closure strips with superficial, linear lacerations and postoperative incisions under minimal static and dynamic tension. Woven gauze with superficial to full-thickness abrasions, avulsions, blisters, incisions, and lacerations to achieve wet-to-moist debridement. Woven and non-woven gauze, non-adherent pads, and adhesive strips or patches for superficial to partial thickness abrasions, avulsions, and blisters and superficial-thickness incisions, lacerations, and punctures as a temporary dressing and on irregular body surfaces.” Once the dressing is completed, it is important to observe the wound for any signs of infection such as fever, foul-smelling wound drainage, swelling, redness, warmth and delayed wound healing. According to the NATA’s position statement, “the patient should be monitored for the development of adverse reactions stemming from the use of some cleansing solutions, topical antimicrobial agents, and non-occlusive and occlusive dressings. The individual must also be observed for rash, eczematous reaction, vesicles, white discoloration, tenderness, nodularity, burning, pruritus, or systemic reactions such as urticaria and anaphylaxis”. To

I showed the supernumerary nurse the proper way of preparing an NPWT using a non-touch sterile technique, started by slowly cleaning the surrounding skin prior to the application of the pressure dressing. Since it was the first time of the preceptee to perform a pressure dressing, I have provided my preceptee the principles of wound management so that it will reinforce the knowledge of the supervised nurse and skills on the management of wound using NPWT. I also provided the preceptee the protocols and the wound management chart to take note of the type of solutions to be used in managing a surgical wound. We also documented in the progress notes what we have performed, and informed the nurse in-charge on the frequency of dressing change in a week.

It is very important that when a patient needs a dressing changed that it is performed correctly and sterile. The first and foremost important step in any procedure is to perform proper hand hygiene. Next, obtain all necessary items on a Mayo stand. Most items involved in dressings are within a dressing packet that is enclosed until it needs to be used. The patient should be in a comfortable position while the procedure is being done with the area with the dressing on a supported area. The next most important step in any procedure for the medical assistant is to apply gloves. When removing a dressing, loosen the tape and pull from both sides toward the wound. Immediately, place the dirty, soiled dressing into a biohazard waste bag without touching

During my clinical simulation laboratory session 6: wound management, we all learnt about surgical wound dressing. However, what I found during the procedure was that maintaining sterile zone during surgical wound dressing is very challenging: there are complex procedure to ensure sterile zone and one simple mistake can result in restarting the whole process. Unfortunately, I made a mistake during the procedure and had to start again; it was very frustrating and time consuming process. However, there must be the reason behind this procedure so I decided to do some research and find out the consequences of poor surgical asepsis for wound management procedure.

Today, I went with wound care. The wound care nurses see a number of patients. First, they compile a list of patients for the day. Then, split the patients amongst themselves. The priority patients are new patients for wound care. Each patient is seen once a week unless there are complications. If I remember correctly, wound vac patients are seen three times a week: Monday, Wednesday, and Friday. Also, the wound care nurse will see those patients’ who’s wounds are little more complicated more often throughout the week.

In the emergency department where I currently work, we have quite a reasonable selection of wound care products, however, no protocols or up to date guidelines on wound specific dressings exist in our department. Our main resource is the wound care nurse specialist, but a consult must be made and they are only available Monday to Friday from 9am-4pm. Furthermore, they will mostly only come for larger and/or chronic wounds; a consult will rarely be done for ‘simpler wounds’. This means nurses are left to their own knowledge to decide on which type of dressing to use. Considering many nurses came to the department straight from school or from a floor that had minimal dressings, and only a handful of nurse have previous experience on a surgery floor or as a wound care nurse, the choice of dressing made is not necessarily the best choice. At times, this could result in more harm than good and impede in wound healing.

The necessary steps to changing a sterile dressing are first gather the supplies and hand hygiene. Also, when you handle supplies, touch only the outside wrappers with your bare hands. Explain it to the patient what you going to do why you have to do it. I would explain these steps to a patient who was nervous about having her sterile dressing changed by it won't get hurt and it will be over soon. Also I will explain to a patient if we don't change, it could get

* Wash your hands before and after any contact with the surgical site, even when changing the dressing.

One hundred percent of my students showed mastery of the following objectives; students will be able to identify was to prevent the spread of illness,

When a health care provider is designing an educational program to clearly articulate objectives to engage both patient as well as their families, the learning objective should be written in behavioral terms defining specific learning outcomes the participant is expected to accomplish at the completion of the learning activity. The learning objective should clearly state the purpose, the procedure, and the outcome (nhnurses, n.d). By providing the patient the purpose of the learning objective they will have a better understanding of why they are needing to fulfill the objectives that you proposed. It is important for the health care provider to state or demonstrate the step by step procedure because it guides the patient and their family on how to properly execute the activity.

I did a lot of going into the clinic on my breaks and observing a lot of different students for about 5 minutes each so I did see a variety of stages of patient education and oral hygiene instruction. Prior to the charting lecture I was wondering why they were putting Vaseline on teeth. Now it makes sense, to protect the restorations from the disclosing solution. Most of the time the students had their large teeth typodont and large toothbrush out. I saw one student demo a tooth brushing technique to a patient then she had the patient demo it back to make sure they understood. I thought that was a great idea.

Classroom training offers an opportunity for activity-based learning. Activity based learning includes information search, guided discussion, role, play, demonstrations, jigsaw design, training videos & DVDs, and games. Each of these activities is discussed below.

Understanding cognition and how we learn is essential in the developmental stages of children. Not all students learn in the same way, understanding the cognitive process will assist in the development of the students. By modifying my approach when giving instructions I have noticed growth in current students that I am working with. Using concrete materials and giving the opportunity for students to be involved in hands-on activities on a daily basis, is essential in making new material meaningful to learners.. The knowledge gained from this topic has increased my understanding and is benefiting the children I am currently