Question

SKILLNAME Sterile Dressing change REVIEW MODULE CHAPTER Description of Skill Indications CONSIDERATIONS Nursing Interventions (pre, intra, post) Outcomes/Evaluation Client Education Potential Complications Nursing Interventions

Answer 1

Sterile dressing change:

Description of skill:

Sterile dressing change is done to prevent infection,to assess wound healing using aseptic Non Touch Technique.

Indications:

a) to prevent infection

b)dressing is due for change

c) for application of medications

d)to remove sutures

e)wound cleaning

Nursing interventions:

• Before changing a dressing, check for any any specific orders about the wound or dressing in
• Ask for help for changing a dressing on a restless or confused adult.Hand hygeine is to be performed.
• Assist the client to a comfortable position in which the wound can be readily exposed
• Remove and dispose of soiled dressings
• Use one swab for each stroke and discard each swab after use
• If a drain is present, clean it while taking care to avoid reaching across the cleaned incision. Clean the skin around the drain site by swabbing in circular motion from around the drain site outward, using separate swabs for each wipe.
• Always clean from least contaminated to most contaminated
• Record date, time, and initials on new tape or dressing.Assist the client to comfortable position and perform hand hygeine.

Evaluation:

• Record the amount of granulation tissue or degree of healing; amount of drainage and its colour, consistency, and odour; presence of inflammation; and degree of discomfort associated with the incision or drain site
• Report any deviations from the prescribed procedure to the doctor.

Client education:

a)Instruct the client to call doctor if there is any signs of infection such as fever,redness around the site,increasing pain,any discharge or blessing that has soaked the dressing.

b)Nutrition

Potiential complications:

a)Infection

b)Delayed wound healing

c)Skin stripping

d)Skin tears

e)Dermatitis

Interventions:

a)Ask the client for any adhesive allergy before starting the procedure.

b)Use appropriate adhesive as per client condition.Some adhesives can cause skin damage for at risk patients and it is important to understand the different types when selecting dressings for such clients.