Dressing Checklists For Schools of Nursing NCJ (24219)

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DRESSING CHECKLISTS FOR SCHOOLS OF NURSING

ASEPTIC DRESSING

Student’s name: __________________________ Ward: __________________ Date: _______

BASIC PRINCIPLES 1 2 3 4 5 N/A


Maintain Basic Principles
Expose wound for a minimum time (5 minutes) (re-cover with sterile gauze)
Perform an efficient procedure (30 minutes for simple & 40 for large wound)
NURSE’S PREPARATION
Consult the care plan/Dressing order to determine the type of dressing required,
medication/solutions to be used, and frequency of change
Hair appropriately groomed (should be off the shoulders and tied)
Wash and dry hands thoroughly (using appropriate drying technique – inner
portion of paper towel)
An apron should be worn (lab coat for males). Additional personal protective
equipment may be necessary if indicated by the patient’s condition, (for
example a mask or gown)

PATIENT PREPARATION
Explain the procedure, to gain consent and co-operation.
Ensures privacy/prepare bed area (draw screen around bed, ensure adequate
lighting, clear bed area, position bed to working height, close window, turn off
fan)
Adjust bedclothes/patient’s clothing to permit easy access to the wound but
maintain warmth and dignity (prior to commencement of wound cleaning)
Assess the wound/dressing (do not leave uncovered during initially
assessment), check patient’s comfort
Make patient comfortable (Position, convenience, need for toilet and so on)
Administer analgesics as appropriate and allow time to take effect
PREPARING THE EQUIPMENT
Dressing trolleys or other suitable surfaces (upper and lower shelves)
Dressing packs, syringe (for irrigating the wound/pulling up solutions), gloves,
masks, cleansing solution, kidney dish, waste bin, topical drugs and new
dressing sets according to the care plan/local policy
Location of appropriate hand washing facilities
Clean surfaces and edges of dressing trolleys/or other suitable surfaces, remove
old tapes; place new tapes at an appropriate area of trolley.
Position trolley/s and waste bin/s appropriately for easy access
Check for sterility, sediments and expiry date of solutions, place at bottom of
trolley or other convenient area
CARRYING OUT THE PROCEDURE
Open outer wrapper, then remove dressing set from inner wrapper, ensuring
inner portion which is sterile is not touched (1/4 - 1 inch is allowed) (may also
open sterile glove, wash hand don gloves then open inner wrapper and
arrange equipment in dressing tray)
Open inner wrapper on sterile field ( touching 1/4-1inch only) arrange forceps,
gauze, swaps, tray/dishes (using a sterile arranging forceps or sterile gloves,
ensure hands do not touch sterile area), pour solutions, open sterile syringe,
dressing packs, gloves onto field (or on trolley), prepare tape, bandage (do not
place in sterile field) after arranging sterile field. Hands must always be
washed prior to donning sterile gloves or holding sterile forceps
Position patient, remove dressing using forceps if available or gloved hand ,
(unsterile or the now soiled glove that was sterile) then dispose in waste bin,
inspect wound, if not done before for colour, size, healing, type & amount of
exudates
Wash hands, don sterile gloves or pick up forceps ensuring hands do not touch
sterile field, identify clean and dirty hands ensuring they do not cross each other
(hands should not go below waist or above breast once you commence
dressing)
Transfer dressing material from clean to dirty hand; clean wound furthest way
first, clean from inner to outer for acute/surgical wound. For chronic wound
clean outer to inner. Ensure dirty hand does not touch sterile field
Ensure that hands remain between breast and navel; a hand that goes above the
breast or below the navel is considered unsterile
Use each gauze/cotton swab once in circular or vertical motions, pat dry around
wound if wet; apply topical medication if indicated
Apply dressing/bandage as indicated (dry to dry or wet to dry or as prescribed)
secure firmly with tape
Note patient’s response to procedure
Proper disposal of equipment and waste items; wash hands
Document that wound was dressed; also document findings
Rank Rank PRACTICE STANDARDS PROFESSIONAL STANDARDS
Score
Description

Exceptional 5  Proficient, coordinated, confident  Safe and accurate


 Does not expend unnecessary energy  Explicate/determines scientific
 Exceeds required objectives principles consistently
 Performs within an excellent time  Demonstrates critical thinking
period independently and very
quick/immediately
Good 4  Efficient, coordinated, confident  Safe and accurate
 Occasional expenditure of excess  Explicate/demonstrates scientific
energy principles frequently
 Performs within a reasonable time  Demonstrates critical thinking
 Meets objective of task independently after a reasonable time
Marginal 3  Frequently demonstrates desired skills  Safe and generally accurate
 Inefficient & uncoordinated  Intermittently explicates/demonstrates
 Expended excess energy scientific principles
 Performs within a delayed period of  Demonstrates critical thinking
time independently after an extended period
 Meets required objective with much
delay
Poor 2  Unskilled, inefficient  Safe if supervised performs alone at
 Considerable expenditure of excess risk
energy  Infrequently accurate
 Performs task within a prolonged time  Scantly explicates/demonstrates
period scientific principles
 Minimal demonstration of critical
thinking skills
Very poor 1  Unable to demonstrate procedure or  Performs at a dependent level requiring
behaviours appropriately examiner intervention
 Lacks confidence, coordination  Unsafe
 Does not demonstrate scientific
principles in care
 Demonstrates no evidence of critical
thinking

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