Sterile Wound Dressing Change - Clinical Nursing Skills |

[@landa182000]

This was very good and encouraged me! Ty!

[@LevelUpRN]

Happy to hear!

[@Weasel0539]

I'm currently dressing a huge leg wound for my husband. I'm not a nurse. I was taught to wash hands, get all my packaged dressings to hand, wash hands, glove up, set out the sterile wound cleaning tray, remove dressings, remove gloves, wash hands, new gloves, dress wound

[@sarahwells141]

correct

[@MissCandySoFly]

Correct we use 3 pairs of gloves

[@JohnDoe-qp4li]

Should perform Hand hygiene first after removing the gloves and before touching the sterile items

[@ugonnauwazie-inechi6716]

Thanks for the video. Hand washing was missed throughout the procedure, and I think its very important to emphasize this for infection control.

[@LevelUpRN]

Absolutely! Between each glove change, hand hygiene would be performed.

[@shirleyanderson8441]

@@LevelUpRN I expressed that when I posted this to a fresh post-op. Also, part of the set-up is your drop basket. Pre cut tape.

[@blessingagbo592]

She mentioned it

[@Nurses-in-worship]

Your procedure is straight to the point and I enjoyed it.

[@LevelUpRN]

So glad it helped! Thank you for watching!

[@KevenLorenzo-f3f]

Nursing student here ! So scared but so excited to learn , keep up the great videos ❤

[@LevelUpRN]

Happy to be part of your journey! Thank you😊

[@dollyemerson2166]

Thank you for a wonderful demonstration of a patient wound change - I need to do this on my own and feel comfortable about doing this after your demonstration.

[@norbesumalnap9496]

Its helpful to me because im caregiver and i can apply it to my clients thank you so much.

[@SuzyQ77]

I'm watching this because every time I go to see the wound care Dr, every Monday for a wound on my foot, I'm watching the nurse and use is using the regular blue gloves & she is bringing in partially used items such as cotton & also guaze kerlix rolls, a partially used 4 pack of "sterile" guaze to directly wrap around the wound, and this last time she brought in used promogran prisma (pulled out of her pocket) & proceeded to dress the wound on my foot. I have kept my mouth shut these past 4 weeks & just redid the wound when I got home & I did it the STERILE way! But this time, seeing her pull out used prisma & getting ready to put it on my foot, I spoke up & said "You're not suppose to put an open package of prisma on my wound." It clearly pissed her off, she angrily said "FINE!" Then snatched up the used prisma, put it back in the open wrapper & slammed it on the table. But then she uses the SAME gloves to pull it out of her pocket, then toss it aside & open a new one & put it on the wound. She uses the SAME gloves to touch EVERYTHING before it's opened and after. On the second visit, this nurse dressed my wound for the 1st time & rubbed lotion on my foot around the wound & some got on/in the wound! And this small tube of lotion, SHE USES ON OTHER PATIENTS AS WELL!! I told her, "you just got lotion on the wound." So got an attitude and said, "ugh, fine... I'll wash the wound again!" So the next time I went, I told her not to apply any lotion on my foot. But this last time I went in, the wound was looking really good.... it was doing well for several weeks actually. But the next day I went to clean & dress it, I opened it & puss oozed out! I KNOW without a doubt it's because of her touching products used on other patients that she then uses on me, touching these items with the blue gloves & touching the wound with the same gloves! I'm so angry! Next time I go in, I plan to speak to someone in the hospital staff to report this. It took so long to get this wound in a good healing state and now this! I should have to tell a nurse how to use sterile techniques and not to use the same supplies & medicine on me that she's used on other patients! And I certainly shouldn't get an attitude on return. I use several pairs of gloves as I dress wounds myself, and I make sure all packages are open before I touch the sterile guaze, etc inside of it with clean gloves! This nurse opens packages & is getting supplies from the cabinets using the SAME pair of blue gloves as she used when touching my foot! What so I need to do at this point?! I wish I could say forget them & go to another wound care Dr but this is the ONLY wound care Dr that will accept triwest that is no further than 40min from my home. So I'm stuck with them! What do I do??

[@okekehonesty284]

First of all this note is too Long, is not everyone that will have the patience to read everything...but my suggestion is that u should probably continue dressing the wound urself since you can instead of going to a doctor and still redo it at home

[@shirleyanderson8441]

Good demo of how we are taught. I just posted this to a first-day post-op lumpectomy, positive for C-A.

[@shirleyanderson8441]

Hand washing with each step, drop basket for debris. Use double-lined waste basket so soiled is treated as a biohazard for family protection, etc.

[@tanishasmall2979]

Student nurse here from Jamaica thanks for this info I have an exam on wound dressing next week

[@LevelUpRN]

Good luck!!

[@ojimaojoatabo1745]

Thank you so much. I found the wound dressing procedure very helpful...especially the aspect of filling up the wound with gauze and preventing contamination... I'll like you to do a video on how to access pain. Thanks

[@cibeleanjos3051]

Thank you for video I'm student of nurse here in brazil , learning more with this class🇧🇷

[@LevelUpRN]

Happy to hear and you are welcome!

[@bonganimgoboli4565]

You're not using the feeding method, whereby the clean hand feeds the dirty hand to avoid going straight from the wound to the sterile area with one hand? Cause this introduces infection or bacteria that might come from the wound to your sterile area, and it therefore compromises the sterility.

[@zoyafatima295]

In... .

[@sarahwells141]

You are correct. She has contaminated her sterile area many times.

[@jamesmorrison2055]

It wouldn't matter because whatever bacteria that came from the wound is bacteria the patient already has to begin with. You wound't be contaminating the patient with any new organisms.

[@horacewilliams8785]

A good demonstration using the "wound field" concept. The sterile field becomes an extension of the wound. Using this technique the only fault I found was the lack of handwashing after taking of the dirty gloves.

[@cathepar]

I appreciate your skills videos please keep them coming they're much needed

[@LevelUpRN]

So happy to help!!

[@jeannec2936]

Hi, this was a really helpful video! Great to have something available on the go. Other than hand hygiene, I think it's important for you to note that whenever a thing touches the wound, it breaks sterility rather than going from middle to outside edge of the wound to address that information.

[@comicalcosmonaut959]

Wouldn't you in that case go from clean to dirty area? Or in this case, middle to center?

[@yasminkhatun6063]

First step of wound dressing is to unwrap the wound with clean gloves and put into a kidney tray ,, 2nd step -To wash hands and to unwrap the sterile tray ,to put betadine solution and NS solution in two bowl , 3rd step- Put on sterile gloves and then clean the wound with gauze one stroke and first clean the less infective area and then the main wound , 4th step- Apply betadine or other medication on wound and place the gauze piece on the wound , 5th step- put off the gloves and make the wound close with leukoplast .

[@yasminkhatun6063]

This is by Bsc Nursing student of Bardhaman Medical college

[@munangamuya2610]

Wow tommorow am having my osc examen this is very helpful.

[@somebody4244]

You do not need sterile gloves after a proper clinical hand wash.

[@jeseekar]

You clean from the inside to the outside not outside to inside

[@gentleoldmoviefan5680]

Very good. What does "NS" mean? (abbreviation used in 2nd step - of summary above) (Normal Saline? - I'd like to be sure of what you meant. ~ thanks.)

[@shielaventura6165]

You are not using the sterile hand and the procedure hand? It looks like you contaminated your sterile field the moment you used your right hand to clean the wound and the same right hand to get the 2nd gauze and dipped it in with the saline. Are you not supposed to be using your left hand to do the cleaning and your right hand for your sterile field instead? 🤷

[@HD-po7fb]

I agree she is using the same hand for everthing

[@natonyabryan182]

Was wondering myself

[@talashk615]

Yes claean and dirty hand technique, one swipe then drop the guaze in the dirty hand and then into the clinical bag,

[@tobyabah1156]

Just like you said, why is she using both hands? The both hands are contaminated

[@KirungijoyceayesigaKJA]

How is she supposed to do it?

[@tempissttaylor3009]

I work in Nursing Homes and nursed do not change gloves after removing the old dressing, SMH!

[@Alaaaxxxxxxxx]

wait, youre using your dirty hand to go into sterile field im confused

[@Sankalesterling]

i have a question ,, so is there no effects of that tape to the skin of the patient . i thought it could cause some ulcers and interefere with blood circulations

[@alexavazquez9629]

hello, i am a little confused. i know ati says to open sterile supplies then put on gloves i am not sure what they meant by this if they just meant the kit itself open or what but i see you put on the gloves first then opened things i know in other videos i have seen them put on gloves after pouring solution can you explain when what is used? is this when solution is not in the kit and can you explain what ati means by open sterile supplies then put on gloves

[@mrssteviebaby]

Great video!!!!

[@LevelUpRN]

Thank you so much! Appreciate you watching.

[@TrizaMalambo]

I'm really enjoying with your wound dressing procedure

[@LevelUpRN]

Thank you so much Triza.

[@maudahlijah]

So please do you use saline for surgical wounds?

[@elsiegreenwich1382]

The first 2 things that should have been mentioned were ensuring that your hair, even hair as long as yours, is secured back from the face. Then, hand hygiene.

[@LevelUpRN]

Hi Elsie - You are correct, however in an effort to keep these to videos to an easily consumable length we made the decision to not speak to that in every skill video. We actually have an entire video dedicated to hand hygiene alone. We know you are all very smart cable individuals that know those steps NEED to be addressed first. Thank you, for reminding us all on the chance that maybe someone wouldn't have assumed that. You got this!!

[@jovyphancy4444]

Do you use gloves while documenting?

[@fatimaghailan6728]

don't forget to wear a mask during semi-critical wound care guys.

[@tylerashleyh442]

Did not perform hand hygiene after switching from clean gloves/bandage removal to sterile gloves

[@kristinarobinson5277]

I have taken on the role of wound care at my facility, I have had some experience while working ortho, but no formal specific training just yet, im excited but nervous because I still have my regular job that has to be done weekly

[@LevelUpRN]

Wound care is a great path… If you end up liking the work, you should look into getting wound care certified!

[@maudahlijah]

No use of povidone/drez solution?

[@jesusvaldez-ramos9853]

Hi, shouldn’t you have you measured the depth and length of the wound?

[@cami0076]

I need to do this for my grandmother now and this video is very helpful. I hsvr a question though- Ive read moist gauze should be put for those types of wounds-soaked in saline...So is it dry or moist?

[@LevelUpRN]

Moist gauze is typically appropriate, but definitely follow your provider’s instructions.

[@cami0076]

@@LevelUpRN , thank you so much!!

[@amalomer7466]

Thanks for the details and mentioning we should start from inside and outer.. to prevent infection

[@LevelUpRN]

Yes! Always start from least to most contaminated.

[@SilivaVisavisawaqa]

I thought we start from the least contaminated area first,then go inside,im confused which one to do first

[@meleshadgu3230]

Thank You❤

[@LevelUpRN]

You're welcome 😊

[@uroojazam1035]

Didn't she break the sterile field when she raised the sterile drape above her head at 2:32? Anything above the head or below the waist is considered unsterile? Also, no hand hygiene was performed between removing old dressing and donning new gloves. *Not hating: Just things that we must be careful off to prevent infection transmission*

[@babykiko7359]

what if the gauze is sticking to the wound when i want to remove it from the wound? how to prevents it from sticking. the wound will be bleeding again after the gauze is removed

[@LevelUpRN]

With a real patient, you should moisten the gauze with normal saline to help prevent sticking. However if the provider has ordered a wet-to-dry dressing for a wound with necrotic tissue, you are SUPPOSED to peel it off dry to lift off that necrotic tissue (mechanical debridement). However, this can ALSO lift off healthy tissue and cause pain/bleeding. As a wound nurse, I can tell you that there are other products and techniques we can use to debride a wound that are more effective and less painful than a wet-to-dry dressing. -Cathy

[@ClaraCharles-u7g]

What if i leave the wound open, one side,

[@nomvulabete637]

I liked the idea of writing your name and the date on the dressing .Will share with others .thank you

[@LevelUpRN]

If possible, write your name on it while it's still on the packaging so you're not putting pressure onto the patient's wound! You can also write your name/date/time on a piece of tape and put that across the dressing. - Ellis

[@jeffreybowers1220]

@@LevelUpRN YES to this. i had a bedsore on my lower back that went badddddd and they would always change the dressing then write on it with sharpie once they had the new one on LOL my bedsore aint a desk hahah

[@sarasherley]

Every time you touched the wound, then used the same hand to get new gauze and saturate it, you contaminated your sterile field. Considering you're selling a set of products to teach nursing skills, you should probably use proper technique.

[@sweetlittleapple3882]

Yes agreed thats y it is required to have two persons do dressing one to pass the stuff and another to do the actual dressing

[@sarasherley]

@@sweetlittleapple3882I’ve never seen a would dressing done with 2 people. Generally there’s a dedicated “dirty” hand that touches the wound, then you pass supplies between your hands so one stays sterile

[@abdulaziz.4168]

No need for to persons just take a forceps to grasp each new gauze. Called sterile no touch technique

[@sarasherley]

@@abdulaziz.4168 sure, if you have access to sterile forceps. But that’s not something every hospital stocks, let alone home health.

[@betlogwiwi690]

You could use right hand to touch the wound and left hand to touch the sterile filled.

[@princessmcgee411]

My instructor said we should set up our sterile field before removing old dressing wound. would this be correct as well?

[@LevelUpRN]

I think either would be totally fine. I like to remove the old dressing first because if I'm missing something I didn't know I may need, I can pop out and get it before setting up my sterile field. - Ellis

[@sarahwells141]

Yes. You should have everything ready and organised before you do wound care dressing change. That way you won't have to leave your sterile area multiple times if you forget something

[@onlyonesonya]

very good and detailed explaination

[@LevelUpRN]

Thank you so much!

[@benzngetich4977]

You have actually contaminated the procedure mid way, you are suppose to pick the gauze from your non dominant hand as you drop to the dominant hand for swab/wipe. Using the same hand for wiping or whatever and picking the sterile with the same same hand makes the procedure null and void

[@talashk615]

Watching from UK..

[@jalenanderson3280]

Such a good video🙌🏽thank you

[@LevelUpRN]

Glad it was helpful!

[@sunandademel4655]

Thank you very much ! It was very helpful to me .🙏🙏🙏

[@LevelUpRN]

You are welcome!

[@schoolrules2057]

Yasssss Content!

[@LevelUpRN]

😊

[@tuoyotoju3639]

Nice one 😊

[@AyoniAdeyinka]

I'm sorry but i think you are suppose to use a swab with an artery forcep and a dissecting forceps to clean the wound

[@TheVictoriaBoland]

Excellent. Thanks so much. If there were medication for the wound ordered, how would you go about adding that to the sterile field? Thanks!

[@LevelUpRN]

It depends, I think. My ideal way would be for a second nurse to squeeze some onto a sterile applicator for me. I suppose I could deposit some but would, of course, have to change my gloves if I'm doing a "sterile change". However, for what it's worth, sterile dressing changes is mostly a thing in nursing school. Most facilities utilize clean technique. - Ellis

[@doremifasolatido-ro7zs]

can a nurse wear a face mask when doing wound care in the US?

[@Terranceon4k]

Absolutely

[@Lammer49]

You're supposed to use tongs to take out sterile tongs from the tray, and You're supposed to use sterile tongs to remove and discard of the fresh and soiled gauze.

[@stephenortiz7659]

Thank you for your help !

[@LevelUpRN]

You're welcome!

[@dadaymochi2298]

Great thanks!

[@Teresa-li2tk]

Great job sister

[@Matt-uf6df]

Thank you

[@LevelUpRN]

You're so welcome!

[@ShefaliNayyar]

nice video only thing i didn't see here is the measurement of the wound.

[@LevelUpRN]

Wound measurements don’t necessarily have to be taken with each dressing change. For example, at my hospital, they are taken at admission, every Wednesday (“wound Wednesday “), and at discharge.

[@ab2948]

why you use dry gauges instead of wet?

[@LevelUpRN]

Different wounds will call for different treatment. It is most common to use dry gauze but there may be times the practitioner asks for wet gauze. Always check your orders!

[@clarelovescats3299]

Are other nurses out there using medi-honey to treat wounds?

[@LevelUpRN]

I have heard of this, but don't have experience in it. I'll see if Cathy can weigh in as she's a WOCN. - Ellis

[@DM-mn8nr]

When would you clean sterile VS not sterile?

[@LevelUpRN]

In the real world, wound care is typically NOT done using sterile technique. However nursing schools still teach and test on sterile wound dressing changes.

[@togodolphine6833]

Your hand manipulation is not correct. keep nondominant hand sterile and stay sterile to pick up gauze from the sterile field into the wound. the dominant hand once it comes into contact with the wound you don't bring it back to the sterile field

[@jamesmorrison2055]

It doesn't really matter because whatever bacteria she picked up from that wound was already present on the patient to begin with. In this case, you are not introducing the patient to any new organisms that they don't already have.

[@bernittaosei1982]

It's been helpful. Thank you. Please after cleaning an abdominal wound with yellow drainage with normal saline, what is next? Do we apply a dry sterile dressing, place a transparent dressing, or cover the wound with a sterile non-adherent dressing? I am a bit confused. Thank you

[@LevelUpRN]

Bernitta, unfortunately it's not easy for me to answer that because I need a lot of information to make a decision on how to dress a wound. Different qualities of the wound and drainage would mean I'd use different dressings. Is the drainage serous? Is it purulent? How deep is the wound? Though, I find it unlikely I'd use a transparent dressing on an abdominal wound of any kind. - Ellis

[@rowenatalie29]

Thank u

[@LevelUpRN]

Very welcome!

[@robertbob3760]

How often do we change the dressing

[@aubade8783]

Good try but you have not transferred the clean swab from the clean hand, (in this case the right) to the dirty hand, (the left) which would then clean the wound. If your right hand is dominant you would be better on the other side of the patient then you don't cross over the sterile field.

[@Terranceon4k]

You were suppose to waste the saline once opened

[@nondescript4311]

Rich countries have so advanced healthcare facilities. We just have everything autoclaved here. None of the one time use packages

[@rubinaclarke3617]

Hand washing before opening dressing pack

[@rickiboateng3012]

New grad here. So so so helpful

[@LevelUpRN]

Thank you so much!

[@InaReivax]

I rather irrigation instead of cleaning the wound with gauzes because of the pain it's not causing.

[@Mike-gc2hm]

Yeah that's correct should never do any rub on a wound just rinse and gently dab with sterile gauze

[@swilliams4957]

Hair should be pinned up or in a ponytail away from the face.

[@amymalik5049]

Don your gloves and wash hands after removing old bandage and cleaning wound. And after dressing change.

[@kandicekostyniuk8256]

Doff I think you meant ;) don would be putting gloves on, and washing gloves in-between 🤔

[@kristanmarshall9664]

The hand you use to wipe the wound should not be touching the other hand

[@jamesmorrison2055]

It does not matter because the bacteria she picked up from that wound is already present on the patient anyway. You're not introducing the patient to any organisms that they don't already have.

[@horacewilliams8785]

She used the wound field concept

[@christinaf8076]

And then the patient poops and messes it all up.

[@sallyjibueze4849]

It helpful but not all clear to

[@MssxykttnNYC]

I though u were suppose to do it with ur sterile hand . And need 4 or them

[@Kris-869]

Alot of contamination seen here😢

[@medhat.moustafa]

U need to measure your wound especially 1st time

[@SamSung-bt2gv]

You forgot to assess the wound size and depth prior to dressing it.

[@LevelUpRN]

Some facilities only require wound measurements to be taken at admission, once a week, and at discharge. So there may be times where you just need to provide wound care, but do not need to take measurements. However, definitely follow your facility’s policy. :)

[@marizenleoncio7961]

@@LevelUpRN It's necessary to do this at every dressing change as this is part of wound care. I don't think this will depend on the facility policy, it's part of nursing care.

[@aaliyahmarkland7843]

Hand hygiene wasn't demonstrated but most important you broke sterile field

[@LevelUpRN]

Thanks for your feedback! We understand the importance of hand hygiene and maintaining a sterile field. Since this is a short video format, we focus on specific aspects and assume viewers are already familiar with the basics, as we've covered hand hygiene and sterile field in the following videos: kzbin.info/www/bejne/lWPIY3lslM5oh5I and kzbin.info/www/bejne/gau4fWSqnb-AbMk. Appreciate you watching! ☺

[@agape..sarasworldoffaithho975]

No handwash

[@ElizabethKahenga]

You aren't dressing it in a sterile manner

[@smiths548]

People take care of yourselves avoid hospital

[@abeerbakir4447]

👍🫶

[@sonialuthra133]

Awsome vidoe and love your tatto😍

[@LevelUpRN]

Thanks! That's one of my favorite tattoos. - Ellis

[@cocoreo89]

Wouldn’t you be in a gown, mask, and goggles since it’s a sterile procedure?

[@LevelUpRN]

That is not common practice. Think, too, of inserting a urinary catheter. That is considered a sterile procedure but does not call for PPE. Though, I do sometimes wear some PPE with wounds when concerned about splash back! - Ellis

[@sarahwells141]

No you don't have too. All wounds have some type of bacteria in them, they arent sterile at all. The only reason we do a sterile procedure is to prevent any contamination from the Environment or putting anymore added bacteria into the wound :)

[@sandrinepontre8845]

Very bad video. Handhygiene the most important step was not done. Very Poor

[@LevelUpRN]

We are assuming that nurses and nursing students know to wash hands prior to ANY patient procedure. However, if you have questions about how to wash your hands, we do have a hand hygiene video on our channel.

[@nathippo]

Terrible... 😢

[@caranasser3710]

But then your pen gets all gross from those gloves.🫤