#Four principles of asepsis skin

Opening packages (Q-tips, gauze, gels, and creams) with gloves on.Re-use of syringes, cannulas, and bottles of saline for irrigation.No space to put supplies or position well (big problem in home care in the home of hoarders).Nothing to secure opened dressing packages (plastic baggies).Insufficient or inappropriate bedside storage in facilities.

Bags, rather than appropriately sized boxes, for supply storage in home care.

No access to a clean field to work from or one that is impermeable to moisture.

What are the pitfalls and problems that may lead to a wound dressing procedure that is, questionably, a clean one? To list a few: Pitfalls And Problems of Clean Dressing Technique Comparing outcomes of one technique with the other is of interest, but what about the actual technique and how well is it actually practiced? Some issues are obviously not acceptable if using a 'clean technique ' there should not be cut pieces of foam dressings floating about in the supplies box, Xeroform dressings cut in half with the foil wrapper folded over, bits floating in the bottle of saline, and grubby, yellow-topped gel dressing tubes with no alcohol wipes in sight. What about re-using syringes and cannula? For how long? A gauze loaf once open cannot be considered sterile, and, although cleaning with it may be acceptable, is it okay to use as a primary dressing filler? Looking at the technique in detail has been lacking. 1 This short definition is simple and essentially covers the bases but raises some questions, particularly for home health care. as involving the use of a clean procedure field, clean gloves, with sterile supplies, and with avoidance of direct contamination of materials and supplies. Outlining exactly what is meant by clean dressing technique is worthwhile because it does not mean the 'five-second rule' applies it is not a sloppy version of a sterile techniques. Thank goodness for clean gloves (and may there be plenty of them). In this particular home, I had plenty of space and a reasonably sized area for open supplies, but that is not usually the case. Between the cats, dogs, birds, phones ringing, and neighbors dropping by, sterile technique has no place in home health care.

Believe me, sterile procedures are for situations where there is at least one other person present to ensure asepsis. Finishing the procedure with a clean pair of gloves on (though I really dislike gloves and sticky-backed dressings), I smoothed the dressing onto the wound and placed the reinforcement strips.

#Four principles of asepsis skin

After cleaning the wound and drying the surrounding skin, I used the skin barrier wipe and placed the second sterile towel between me and the patient's wound. Everything prepped and opened (which took a while), I opened the dressing pack (a very fancy, large Band-Aid) and went off to the bathroom to 'scrub up.' I returned, dried my hands with one paper towel, donned the sterile gloves connected the dressing to the sterile mini-suction device, and managed to discourage the patient's cat without contaminating anything. I found two sterile towels, a nail brush, and a pair of sterile gloves, and the patient told me it was so I could remain sterile. While getting out the supplies for the wound dressing, the patient told me the doctor had discussed the dressing with her and provided a few things. I arrived and did the patient's assessment. Case Report: Home Health Wound Dressing Change I was reminded of a visit to a patient to utilize a fancy new dressing that I had never used before. I particularly appreciated the comment that nurses need to decide which approach to have by using critical thinking skills. 1 There is insufficient evidence in the literature relating to chronic wound care. The conclusion of the paper essentially is that a clean technique for acute wound care does not affect the incidence of infection. Having read a recent article on clean versus sterile dressing technique, commenting again on this issue seems highly appropriate. The WoundSource Editors would like to congratulate Margaret on her award. It has received the most views of any blog posted on WoundSource within the last year.

Editor's note: This blog by Margaret Heale, RN, MSc, CWOCN, is the recipient of the 2019 Blog of the Year Award.