OPENING STERILE PACKAGE
The next task or procedure is opening sterile package. The main equipment is sterile set. There are a few main steps involve such as perform medical and surgical hand washing, open the sterile package and arrange the equipment.
Firstly, the nurse should perform medical hand washing. After do the hand washing, dry your hand properly with clean tissue before open the first layer of the pack. Clean the trolley with swab before put the sterile pack on the trolley.
After that, perform first surgical hand washing. Open the first layer of the sterile pack. Then perform second hand washing and open the second layer of sterile package. Before that, check the expired date. If the set is expired, do not use it, change with another sterile set.
The next step is arranging the equipment after open the sterile pack. Make sure the nurse wear the sterile glove to maintain the sterility of the equipment. Take out all the galipot and forceps from the kidney dish. Arrange it at the free space but still in the sterile area. Put cotton ball and gauze in the galipot. Then pour normal saline into the galipot to make the cotton ball and gauze become wet and easy to clean the wound area. Before perform the dressing, squeeze the cotton ball and gauze to prevent from become too wet by using Bryant forceps.
As a conclusion, before doing the procedure, make sure the nurse do hand washing properly and prepare the right sterile set to perform the procedure to the patient.
Monday, May 11, 2009
EMPTY WOUND DRAINAGE BOTTLE
The next procedure is emptying wound drainage bottle. The equipment use in this procedure are meter container, alcohol swab, glove, wound tubing and hemovac. There are a few steps involve in this procedure such as clamp the drainage tubing, untied the bottle from the bed side, measure the fluid (cc) in chart and documentation.
Firstly, the nurse must clamp the drainage tubing to prevent bad flow and prevent bubble. If the drainage tubing is unclamped, the bubble will appear and will cause the blood from the wound non-stop flow.
Secondly, untied the bottle from the bed side. The purpose is easy to remove the drainage bottle and easy to empty it. Make sure do it properly.
The next step is measure the fluid (cc) in chart. Before that, drain the fluid in the meter container for easy to measure the amount of fluid. Make sure the nurse measure it accurately and record it.
The last step is documentation. Make sure the nurse write right time, date and reading in chart. The nurse also must check the name of patient before do the procedure to the patient. The purposes of empty wound drainage bottle are to preventing infection from the microorganism and to prevent overload of fluid from the patient’s wound. If not, the fluid will come out from the bottle and will make the patient feel uncomfortable.
As a conclusion, the nurse should carefully empty the wound drainage bottle and make sure exactly measure the fluid of wound with meter container.
The next procedure is emptying wound drainage bottle. The equipment use in this procedure are meter container, alcohol swab, glove, wound tubing and hemovac. There are a few steps involve in this procedure such as clamp the drainage tubing, untied the bottle from the bed side, measure the fluid (cc) in chart and documentation.
Firstly, the nurse must clamp the drainage tubing to prevent bad flow and prevent bubble. If the drainage tubing is unclamped, the bubble will appear and will cause the blood from the wound non-stop flow.
Secondly, untied the bottle from the bed side. The purpose is easy to remove the drainage bottle and easy to empty it. Make sure do it properly.
The next step is measure the fluid (cc) in chart. Before that, drain the fluid in the meter container for easy to measure the amount of fluid. Make sure the nurse measure it accurately and record it.
The last step is documentation. Make sure the nurse write right time, date and reading in chart. The nurse also must check the name of patient before do the procedure to the patient. The purposes of empty wound drainage bottle are to preventing infection from the microorganism and to prevent overload of fluid from the patient’s wound. If not, the fluid will come out from the bottle and will make the patient feel uncomfortable.
As a conclusion, the nurse should carefully empty the wound drainage bottle and make sure exactly measure the fluid of wound with meter container.
REMOVAL OF STITCHES
Stitches are removing when the wound already heal. This equipment in this procedure is same as wound dressing but add equipment which is sterile stitch scissor. There are a few main steps involve such as open sterile pack, use sterile stitch scissor, and documentation.
Firstly, open sterile pack. Before open it, perform surgical hand washing. As usual, arrange the equipment with pick up forceps. Put cotton ball and pour normal saline into the galipot. Then put sterile stitch scissor on the sterile set.
After that, use pick up forceps, remove the dressing. Before that, clean the stitches by use dapping method. Dap between the stitches part from upper to lower. Then, get tooth forceps and sterile stitch scissor. Get end die of stitches. You should cut it alternately. This is to make sure the wound is really healed. If the wound is already heal, can cut it all. After that, spray antibiotic which is water proof to prevent the patient from feel pain. It is also to cool the wound part. If the patient wants cover, get extra gauze and cover the area.
Last step is documentation. The nurse must document how many stitches remove. The nurse must make sure the wound heal before remove the stitches to prevent the complication such as dehiscence, which is the separation of wound edges.
As a conclusion, the nurse must be careful when do the procedures because of the sharp instrument to prevent the patient from have other injury due to our own mistake.
Firstly, open sterile pack. Before open it, perform surgical hand washing. As usual, arrange the equipment with pick up forceps. Put cotton ball and pour normal saline into the galipot. Then put sterile stitch scissor on the sterile set.
After that, use pick up forceps, remove the dressing. Before that, clean the stitches by use dapping method. Dap between the stitches part from upper to lower. Then, get tooth forceps and sterile stitch scissor. Get end die of stitches. You should cut it alternately. This is to make sure the wound is really healed. If the wound is already heal, can cut it all. After that, spray antibiotic which is water proof to prevent the patient from feel pain. It is also to cool the wound part. If the patient wants cover, get extra gauze and cover the area.
Last step is documentation. The nurse must document how many stitches remove. The nurse must make sure the wound heal before remove the stitches to prevent the complication such as dehiscence, which is the separation of wound edges.
As a conclusion, the nurse must be careful when do the procedures because of the sharp instrument to prevent the patient from have other injury due to our own mistake.
Sunday, April 26, 2009
C&S SWABBING
C&S is the short form from the culture & sensitivity.This procedure is done by taking the specimen from the patient and send it to the laboratory to be test to find the upcoming probability appear from the disease.There a few main steps from this procedure such as check the doctor's order,remove the dressing to expose the wound area and use the sterile c&s swab to take the specimen.
Firstly,the nurse must check the doctor's order.The nurse cannot do the procedure if there is no doctor's order.This is to make sure right patient with the right procedure.
Then,remove the dressing to expose the wound area,also make sure put sterile protector to protect the wound area.You also need to make sure the sterile protector is put properly under the patient's wound area to prevent it from move when do dressing.
Before use sterile c&s swab to take specimen,perform surgical handwashing and wear sterile glove to maintain the sterility of the swab.
After take the specimen,open the mouth of the tube,put the c&s swab and close it properly.For reminder,make sure before put c&s swab int the tube,prevent the swab from touch the side of the tube because it will effect the sterility of the tube.Then,put in the specimen container,and write right name of patient,time,date and other details.
As a conclusion,make sure the nurse before do the procedure,check the doctor's order and right patient.
Firstly,the nurse must check the doctor's order.The nurse cannot do the procedure if there is no doctor's order.This is to make sure right patient with the right procedure.
Then,remove the dressing to expose the wound area,also make sure put sterile protector to protect the wound area.You also need to make sure the sterile protector is put properly under the patient's wound area to prevent it from move when do dressing.
Before use sterile c&s swab to take specimen,perform surgical handwashing and wear sterile glove to maintain the sterility of the swab.
After take the specimen,open the mouth of the tube,put the c&s swab and close it properly.For reminder,make sure before put c&s swab int the tube,prevent the swab from touch the side of the tube because it will effect the sterility of the tube.Then,put in the specimen container,and write right name of patient,time,date and other details.
As a conclusion,make sure the nurse before do the procedure,check the doctor's order and right patient.
WOUND IRRIGATION
Another procedure that also done in the hospital is wound irrigation.It is also same procedure as wound dressing,but add another step.There are a few steps apply in this procedure such as put sterile kidney dish,20cc syringe,c&s swab and documentation.
Firstly,before opening the sterile pack,make sure perform surgical handwashing,to prevent from infection.Then,remove the old dressing.After remove the old dressing,put sterile protector.In addition,open second layer of sterile kidney dish and put under the patient's wound on sterile protector.
Secondly,get 20cc syringe and get 20ml of normal saline,put into the wound by irrigate it.Make sure the nurse irrigate at the whole part of the wound.
Then,take c&s swab and take the specimen of the wound,put it into the tube.Open the tube,close and put later in the container.For reminder,before put c&s swab into the tube,prevent the swab from touch the side of the tube,because only inside the tube that is sterile.Write right name of patient,tim,date,and other details before send it to the laboratory.
After that,continue clean the wound with wet method.Before that,remove the kidney dish to easy clean the wound area.The purpose of the dressing is to clean the wound to make sure the patient comfortable,and to less infection.Last step is docementation.Observe the patient's condition after done the procedure.
As a conclusion,make sure do the right procedure to the right patient.
Firstly,before opening the sterile pack,make sure perform surgical handwashing,to prevent from infection.Then,remove the old dressing.After remove the old dressing,put sterile protector.In addition,open second layer of sterile kidney dish and put under the patient's wound on sterile protector.
Secondly,get 20cc syringe and get 20ml of normal saline,put into the wound by irrigate it.Make sure the nurse irrigate at the whole part of the wound.
Then,take c&s swab and take the specimen of the wound,put it into the tube.Open the tube,close and put later in the container.For reminder,before put c&s swab into the tube,prevent the swab from touch the side of the tube,because only inside the tube that is sterile.Write right name of patient,tim,date,and other details before send it to the laboratory.
After that,continue clean the wound with wet method.Before that,remove the kidney dish to easy clean the wound area.The purpose of the dressing is to clean the wound to make sure the patient comfortable,and to less infection.Last step is docementation.Observe the patient's condition after done the procedure.
As a conclusion,make sure do the right procedure to the right patient.
Sunday, April 19, 2009
CVP INSERTION
CVP or Central Venous Pressure is rare procedure that only done by the doctor.It is done to the patient that have failure or disfunctioning of the heart.A catheter is passed via the subclavian vein or jugular vein into the superior vena cava to determine the venous return and intravascular volume of the right atrium.There are a few steps involve such as assess where there is a sight of CVP,position the patient,expose the CVP side and documentation.
First,assess where there is a sight of CVP.Easy for the doctor to insert the CVP connecting.The position must right to prevent the complication such as Carotid Artery Puncture due to wrong way of insertion.
The important step is position the patient.Doctor usually refer to the trendelenberg position.If not,put pillow under the patient’s leg.Then ask patient to look opposite from the CVP side to dilate the blood vessels.
The nurses must expose the CVP side by remove the gown of the patient to easy the doctor to connect the CVP.
Last step is documentation.Document on the tape IV site write date and time at the side,also at the subclavian side and the IV solution.The purpose of the CVP is to serve as a guide of fluid balance in critically ill patients, to determine the function of the right side of the heart,to estimate the circulating blood volume and to assist in monitoring circulating of the heart.
As a conclusion,make sure the nurse check the doctor’s order for the right patient to do the CVP insertion.
First,assess where there is a sight of CVP.Easy for the doctor to insert the CVP connecting.The position must right to prevent the complication such as Carotid Artery Puncture due to wrong way of insertion.
The important step is position the patient.Doctor usually refer to the trendelenberg position.If not,put pillow under the patient’s leg.Then ask patient to look opposite from the CVP side to dilate the blood vessels.
The nurses must expose the CVP side by remove the gown of the patient to easy the doctor to connect the CVP.
Last step is documentation.Document on the tape IV site write date and time at the side,also at the subclavian side and the IV solution.The purpose of the CVP is to serve as a guide of fluid balance in critically ill patients, to determine the function of the right side of the heart,to estimate the circulating blood volume and to assist in monitoring circulating of the heart.
As a conclusion,make sure the nurse check the doctor’s order for the right patient to do the CVP insertion.
HANDWASHING
Hygiene is important for the nurses because they deal with the patients.They come with different kind of disease.In the hospital they always apply the effective hand disinfection technique especially for the nurses to maintain the hygiene.So to maintain the hygiene the nurses must do handwashing to prevent cross infection.They are a few steps involve such as packs of fingers to opposing palms with finger interlocked,rotational rubbing backwards and forwards with clasped fingers of right hand in left palm and vice versa and rotational rubbing of right wrist and vice versa.Rise and dry thoroughly.
Pack of fingers to opposing palms with fingers interlocked.Scrub and friction can clean and less the amount the microorganisms.For every step,scrub for 10 times.This to maintain and make sure the surrounding of the hand are all protect from the external infection.
The next step is rotational rubbing backwards and forwards with clasped finger of right hand in left palm and vice versa.This is to maintain the whole part that involve and also to make sure the soap are spread out.
Then the next step is rotational rubbing of right wrist and vice versa.Rise and dry thoroughly .When want to wash the hand use elbow to open the pipe.This is final step of the procedure.Make sure before do handwashing,all the jewellery is remove from hand and wrist.This procedure is done within 1-2 minutes.
As a conclusion,make sure do handwashing before do one procedure to maintain hygiene and to prevent from the infection to the patient and yourself.
Pack of fingers to opposing palms with fingers interlocked.Scrub and friction can clean and less the amount the microorganisms.For every step,scrub for 10 times.This to maintain and make sure the surrounding of the hand are all protect from the external infection.
The next step is rotational rubbing backwards and forwards with clasped finger of right hand in left palm and vice versa.This is to maintain the whole part that involve and also to make sure the soap are spread out.
Then the next step is rotational rubbing of right wrist and vice versa.Rise and dry thoroughly .When want to wash the hand use elbow to open the pipe.This is final step of the procedure.Make sure before do handwashing,all the jewellery is remove from hand and wrist.This procedure is done within 1-2 minutes.
As a conclusion,make sure do handwashing before do one procedure to maintain hygiene and to prevent from the infection to the patient and yourself.
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