Many actual or potential health problems or issues may require the use of this skill as part of related interventions. An appropriate health problem or issue may include:

• Infection risk
• Altered body image perception
• Knowledge deficiency

The expected outcomes to achieve when performing care for a Hemovac drain are that the drain remains patent and intact, drain care is accomplished without contaminating the area and without causing trauma, and the patient does not experience pain or discomfort. Other outcomes that are appropriate may include the following: if there is a surgical wound, it shows signs of progressive healing without evidence of complications; the drainage amounts are measured accurately at the frequency required by facility policy and recorded as part of the intake and output record; and the patient demonstrates understanding of drain care.

The expected outcomes have been met when the drain has remained patent and intact, drain care was accomplished without contaminating the area and without causing trauma to the wound, the patient did not experience pain or discomfort, the drainage amounts were measured accurately at the frequency required by facility policy and recorded as part of the intake and output record, and the patient has demonstrated understanding of drain care.

Document the location of the drain, the assessment of the drain site, and patency of the drain. Note if sutures are intact. Document the presence and characteristics of drainage on the old dressing upon removal. Include the appearance of the surrounding skin. Document cleansing of the drain site. Record any skin care and any dressing applied. Note that the drain was emptied and recompressed. Note pertinent patient and family/caregiver education and any patient reaction to this procedure, including patient's pain level and effectiveness of nonpharmacologic interventions or analgesia, if administered. Document the amount and characteristics of drainage obtained on the appropriate intake and output record.

• Patient has a Hemovac drain placed in the left knee following surgery. The record indicates it has been draining serosanguineous secretions, 40 to 50 mL every shift. While performing your initial assessment, you note that the collection chamber is completely expanded. The nurse empties the device and compresses to resume suction. A short time later, the nurse observes that the chamber is completely expanded again: Inspect the tubing for kinks or obstruction. Inspect the device, looking for breaks in the integrity of the chamber. Make sure the cap is in place and closed. Assess the patient for changes in condition. Remove the dressing and assess the site. Make sure the drainage tubing has not advanced out of the wound, exposing any of the perforations in the tubing. If you are not successful in maintaining the suction, notify the health care team of the findings and interventions and document the event in the patient's record.

• A sterile dressing is usually maintained for 24 to 48 hours; the use of a dressing after this time depends on the site assessment and amount of drainage (Orth, 2018). The site may be treated as an additional surgical wound, but often these sites are left open to air 24 hours after surgery. Refer to facility policy and prescribed interventions regarding need for sterile approach to site care and use of dressing.
• When the patient with a drain is ready to ambulate, empty and compress the drain before activity. Secure the drain to the patient's gown below the wound, making sure there is no tension on the drainage tubing. This removes excess drainage, maintains maximum suction, and avoids strain on the drain's suture line.
• Appropriate nutritional support is critical in achieving successful wound healing and may be overlooked (Quain & Khardori, 2015). Collaborate with the registered dietician and dietary staff to develop an individualized nutrition intervention plan for the patient (Baranoski & Ayello, 2020).