Wound care is an essential aspect of nursing, and every nurse should be able to perform wound care in a proper manner (Blackburn, Ousey, & Stephenson, 2019). An aseptic technique should always be used when applying or changing a wound dressing. This is to ensure that infections or pathogen are not introduced into the wound. This technique should be followed even when the wound is already infected so that infections can be avoided further. The nurse has to ensure that a sterile field is maintained all through the process in order for the technique to be deemed functional. The procedure promotes healing and protects the wound from further harm. Therefore, one has to have acquired adequate nursing skills to be able to perform the aseptic technique as required. This essay will discuss the appraisal of the simple wound dressing skill using the case scenario provided.
In this case, the nurse did pretty good by informing the patient that she wanted to perform wound dressing. However, the nurse should introduce herself, then explain the procedure vividly to the patient. This prepares the patient both emotionally, psychologically and physically. The nurse also started by confirming the name of the patient, which is pretty good to ensure that procedure is being done on the right patient. The nurse did not check documentations, and this is important to update herself for any changes in the condition of the patient and also to counter check if the dressing is due to be changed. While preparing for the procedure, the nurse washed her hands which is important, but she did not follow the proper handwashing technique. It is vital to perform proper hand washing before and after performing any procedure on the patient (Ellingson et al. 2014). The nurse also did not clean the trolley appropriately. Cleaning of a trolley should always be done prior to gathering equipment. She also cleaned the top shelf and did not use single strokes hence spread of pathogens. Moreover, the nurse left the sanitizer on the sterile field, which should only hold sterile items. It is commendable that she opened the sterile dressing pack on top of the trolley and opened without touching them.
The nurse did not wash her hands before wearing the clean gloves removing the old dressing, which was wrong. Moreover, she had placed the gloves on the lower shelf exposed, yet she did not clean the lower shelf. This makes them dirty and increases the spread of infection. The nurse also failed to assess the wound status after removing the old dressing. This is important to note the progress of the wound and to know if it is infected or healing as expected (Dabiri, Damstetter, & Phillips, 2016). Although the nurse sanitized her hand before cleaning the wound, she did not wear sterile gloves. The nurse instead used clean gloves that were not sterile and even kept touching them as she wears. This may contribute to the wound being infected (Holloway, 2020). The nurse perfectly ensured that she cleaned the wound without re-introducing them to a clean area. However, she did not maintain an aseptic technique. She could have prepared the gauzes first so that the forceps do not keep touching they would and the sterile field. The nurse also has to clean the wound, starting from the inside part towards the outer part (Vowden, & Vowden, 2017). This is to prevent dirt and bacteria from being introduced from the surrounding skin into the wound but instead, get swept away from the wound. The nurse also kept engaging the patient throughout the procedure, and this was good because the patient will not feel left out during the process and relieve anxiety (Khalaila, 2014). The nurse will also be able to figure out changes in the patient and may know when the client is a pain.
In conclusion, the nurse used sterile equipment while dressing the patient; however, she failed to maintain sterility. This is not recommended since the wound will get infected, and this will prolong healing. Moreover, this may lead to further complications arising from infections. Every nurse should, therefore, be careful while performing an aseptic technique to prevent infections. Continuous medical education on aseptic technique should also be provided so that the nurses can continuously improve their skills and get to care for wounds properly. This will significantly improve the outcome of care and promote wound healing.
References
Blackburn, J., Ousey, K., & Stephenson, J. (2019). Nurses’ Education, Confidence, and Competence in Appropriate Dressing Choice. Advances in skin & wound care, 32(10), 470-476.
Dabiri, G., Damstetter, E., & Phillips, T. (2016). Choosing a wound dressing based on common wound characteristics. Advances in wound care, 5(1), 32-41. https://doi.org/10.1089/wound.2014.0586
Ellingson, K., Haas, J. P., Aiello, A. E., Kusek, L., Maragakis, L. L., Olmsted, R. N., ... & VanAmringe, M. (2014). Strategies to prevent healthcare-associated infections through hand hygiene. Infection Control & Hospital Epidemiology, 35(8), 937-960. https://doi.org/10.1086/677145
Holloway, S. (2020). Principles of Wound Interventions. Wound Care Nursing E-Book: A Person-Centred Approach, 37.
Khalaila, R. (2014). Simulation in nursing education: an evaluation of students' outcomes at their first clinical practice combined with simulations. Nurse education today, 34(2), 252-258. https://doi.org/10.1016/j.nedt.2013.08.015
Vowden, K., & Vowden, P. (2017). Wound dressings: principles and practice. Surgery (Oxford), 35(9), 489-494. https://doi.org/10.1016/j.mpsur.2017.06.005
