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Skill

Dressing Change: Dry & Moist

Prerequisite Skills

Universal precautions, asepsis, sterile technique.

Critical Element Criteria

Students must meet criteria of Critical Elements to safely perform the skill based on evidence-based practice. Score can be pass/fail, letter grade, or point assignment. Only acceptable score for Critical Elements is 100%

Critical Elements

  • Understanding of the importance of asepsis in the prevention of spreading health care associated infection (HCAI).
  • Handwashing.
  • Create appropriate physical environment.
  • Troubleshoot problems.

Procedure

Prior to Treatment: (Critical Thinking)

  • Assess patients need for treatment.
  • Confirm order.
  • Administer pain medication if needed.
  • Gather appropriate equipment: clean gloves, sterile gloves, appropriate sterile dressings, sterile saline.

Patient Interaction: (Safety)

  • Patient identifiers.
  • Provide for privacy.
  • Explain procedure.
  • Wash hands.
  • Educate patient about reporting discomfort.

Steps of the Procedure: (Patient Centered Care)

Dry Dressing Change

  1. Place patient in a comfortable positon.
  2. Apply clean gloves.
  3. Loosen edges of the tape of the old dressing, stabilizing skin while pulling the tape away.
  4. Begin at the edges, lifting the dressing toward the center of the wound.
  5. If the dressing sticks, moisten with sterile saline.
  6. Assess the drainage on the soiled dressing and the wound.
  7. Dispose of dressing in biohazard bag.
  8. Gently clean wound with saline-moistened gauze unless contraindicated.
  9. Remove gloves and wash hands.
  10. Open sterile gauze on a clean, dry surface.
  11. Apply clean gloves.
  12. Layer the dry dressing over the wound.
  13. Remove gloves and securely tape the dressing in place.

Moist Dressing Change

  1. Place patient in a comfortable positon.
  2. Apply clean gloves.
  3. Loosen edges of the tape of the old dressing, stabilizing skin while pulling the tape away.
  4. Begin at the edges, lifting the dressing toward the center of the wound.
  5. If the dressing sticks, moisten with sterile saline.
  6. Assess the drainage on the soiled dressing and the wound.
  7. Dispose of dressing in biohazard bag.
  8. Gently clean wound with saline-moistened gauze unless contraindicated.
  9. Remove gloves and wash hands.
  10. Open sterile gauze on a clean, dry surface.
  11. Moisten gauze with a sterile saline solution or water.
  12. Apply sterile gloves.
  13. Wring out excess moisture from gauze and apply in a single layer into wound.
  14. Cover with moisten gauze and surgical pad.
  15. Remove gloves and secure with tape.

After Procedure (Patient Centered Care)

  • Straighten room making patient comfortable, replace call light.
  • Wash hands before leaving room.

Document (Informatics, Communication)

  • Site assessment findings.
  • Patient"s response to procedure and results.