NUR1299 Appraising Performance of Basic Wound Dressing Assessment 2 Answer
A simple wound dressing is governed by an aseptic technique so as to avoid any introduction of infections into the wound (Denton and Hallam, 2020). Even if there is already an infection in the wound, an aseptic technique is mandatory to be used for its importance in no further development of any infections. Considering the clinical skills appraisal form for simple wound dressing, an analysis of the procedure followed by the nurse in the given video is presented to provide a constructive feedback to the person performing the skill.
A simple wound dressing should follow some of the important hygiene elements including good hand hygiene, appropriate and adequate usage of personal protective equipment (PPE), using sterile equipment and cleaning and sterilization of trolley along with ensuring a non-touch technique throughout the procedure (Denton, 2020).
Considering the first step of preparation and planning for the procedure it is quite clear that the nurse successfully ascertains indication for the procedure as well as the pain management requirements. She maintains a continuous conversation with the patient to make him comfortable about the procedure. Further, she gathers the required equipment and follow the procedure of sterile using ABHR to ensure a clean trolley before starting the procedure, which is an important step to reduce the number of viable pathogenic organisms (NHMRC, 2019). It was noticed that the nurse washed her hands properly and sanitized her hands and fingers before commencement of the procedure which is in line with the five moments of hand hygiene (HHA, 2019).
During the performance of the procedure, nurse is seen to be following proper protocol as discussed by Perry et al. (2018) of cleaning the trolley, placing the sterile dressing pack on top of the trolley, opening the pack with minimum contact and using the corners to open it and performing the procedure of cleaning the wound without any direct touch with hands. Further, during the performance of the procedure, it was noticed that the nurse did not used a clean disposable plastic apron and a face mask while performing the procedure. It is important to remind the nurse of using protective barrier between her clothing and any potential contaminants resulting from the procedure. In the next step she is seen using single-use gloves to remove the previous dressing.
However, after removal, she removed the gloves but forgets to perform hand hygiene using as indicated under 5 moments for hand hygiene and only used ABHR before wearing another set of gloves. Before redressing of the wound, it is necessary to perform further hand hygiene even when the gloves were used (Perry et al., 2018). She will be reminded of this step as hand hygiene is a necessary after any types of gloves is removed as gloves do not provider complete protection against hand contamination and there is a possibility of microorganisms getting into to hands through minor imperfections in gloves or by contamination of the hands while removing the gloves (HHA, 2019).
She efficiently meet all other steps in performing the procedure from explain it to the patient, obtaining consent, removing outer dressing, removing inner dressing, assessing and cleaning the wound and applying transparent wound barrier. However, priorities post procedure are not clear in the video and it is seen that after completing the procedure, nurse touches the patient’s blanket without removing the gloves and without following the hand hygiene procedure. She needs to be reminded and given proper training to dispose of the equipment, remove gloves and wash her hands immediately after the procedure, as health care-associated pathogens can be recovered from the wound and also from frequently colonized areas of normal, intact patient skin (Tollefson et al., 2019). Any defective hand cleaning can result in poor hand decontamination leading to microbial transfer and severe infections. A breach in asepsis by touching sheets, patients’ body or other equipment after the procedure poses a risk to the patient as well as the healthcare provider (Denton, 2020). This makes it important for healthcare provider like the nursing staff to be well trained and competent to manage the procedure as well as post procedure priorities.
The concerned nurse can be seen following a majority of procedures during the preparation andactual procedure of simple wound dressing. She is seen following the 5 moments hand hygiene at most of the instances as required but she miss the hygiene precautions at few instances between the cleaning of old wound and performing the new dressing. Also, she needs to reminded of the hand hygiene required after completing the procedure and use of apron and mask while performing the simple wound dressing. An efficient aseptic technique should be followed to avoid any further infection and avoid presence of pathogenic micro-organisms.