Fail this performance if any of the boxes below are checked.
0 pts
3 pts
4 pts
5 pts
K=Knock W=Wash hands I= Identify self & patient P=Privacy E= Explain S= Safety
PPE, wound care kit, sterile gloves to fit, NS, biohazard bag, other sterile supplies as needed per physician order
*Have pt rate pain. *Administer pain medication as needed prior to procedure. *Apply clean gloves *Remove old dressing using proper technique (dons gloves, remove layers one at a time, removes tape parallel to skin and toward drsg) *Properly disposes of old drsg in biohazard bag *Removes soiled gloves and performs hand hygiene.
Assessment of wound, size, color exudate, odor, and closure, palpate as necessary. Measure length, width, and depth. *Patient’s response, to procedure.
Old Dressing is removed per above criteria. *Preforms hand hygiene *Uses aseptic technique *Sterile wound kit used, sterile gloves used. *Cleanse wound and surrounding tissue *Apply moist drsg (remove excess solution) *Fill wound bed without touching surrounding skin. *Apply sterile gauze pad over wet gauze. *Cover the wound with sterile ABD pad. *Secure appropriately, initial & date. *Remove gloves and perform hand hygiene. *Dis
Old dressing is removed per above criteria. *Performs hand hygiene *Uses aseptic technique/sterile gloves *Cleanse wound and surrounding tissue using sterile applicators. *If drain is present, use split gauze to cover. Important to face drain to not drain on wound bed). *Apply a non stick dressing over suture/staple line. *Cover wound and drain site with sterile dressing. *Tape & label with time, date, and initials. *Remove gloves and perform han
Patient name, date, time, how patient tolerated procedure. Document assessment: size, color, edema, closures (staples/sutures intact/missing), exudate, odor.