Order Performing Irrigation of a Wound

Order Performing Irrigation of a Wound
Order Performing Irrigation of a Wound
1. Review the medical orders for wound care or the nursing
plan of care related to wound care.
2. Gather the necessary supplies and bring to the bedside
stand or overbed table.
3. Perform hand hygiene and put on PPE, if indicated.
4. Identify the patient.
5. Close curtains around bed and close door to room if possible. Explain what you are going to do and why you are
going to do it to the patient.
6. Assess the patient for possible need for nonpharmacologic
pain-reducing interventions or analgesic medication before
wound care and/or dressing change. Administer appropriate prescribed analgesic. Allow enough time for analgesic
to achieve its effectiveness before beginning procedure.
7. Place a waste receptacle or bag at a convenient location for
use during the procedure.
8. Adjust bed to comfortable working height, usually elbow
height of the caregiver (VISN 8, 2009).
9. Assist the patient to a comfortable position that provides
easy access to the wound area. Position the patient so the
irrigation solution will flow from the clean end of the
wound toward the dirtier end. Use the bath blanket to
cover any exposed area other than the wound. Place a
waterproof pad under the wound site.
Order Performing Irrigation of a Wound
10. Put on a gown, mask, and eye protection.
11. Put on clean gloves. Carefully and gently remove the
soiled dressings. If there is resistance, use a silicone-based
adhesive remover to help remove the tape. If any part
of the dressing sticks to the underlying skin, use small
amounts of sterile saline to help loosen and remove.
12. After removing the dressing, note the presence, amount,
type, color, and odor of any drainage on the dressings.
Place soiled dressings in the appropriate waste receptacle.
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