By following these steps on a regular basis and using your best judgment, you’ll keep your nursing bag and its contents clean while cutting down on the spread of germs. When dressing wounds the nurse should practice good hand hygiene. NLM (6) Put on the sterile gloves. The article highlighted several problems in the practice of aseptic technique, including the lack of standardised education and practice, confused and variable technique, and the touch contamination of critical procedure components. It does allow for using spray wound cleansers and keeping a portion of a dressing for the next dressing change.  |  Having read a recent article on clean versus sterile dressing technique, commenting again on this issue seems highly appropriate. Cleaning with soap and water reduces number of germs, dirt and impurities on the surface. Procedure To Promote A Clean Dressing Technique Addressing the foregoing issues can make the possibility of a truly clean technique more likely, as can organizing the procedure into three distinct parts: FIRST Prep dressing supplies, prep the patient, remove dressing, and place a protective field. What are the pitfalls and problems that may lead to a wound dressing procedure that is, questionably, a clean one? A catheter is inserted into the bladder and removed once the bladder is empty, "usually done every 4-6 hours and just before… The term ‘clean technique’ is often used to describe the procedure for dressing chronic wounds; it includes hand hygiene, preparation of a clean area with use of clean gloves and sterile instruments, such as scissors and forceps (Wound, Ostomy and Continence Nursing Society, 2012). J Wound Ostomy Continence Nurs. Definition Bag technique-a tool making use of public health bag through which the nurse, during his/her home visit, can perform nursing procedures with ease and deftness, saving time and effort with the end in view of rendering effective nursing care.Public health bag – is an essential and indispensable equipment of the public health nurse which he/she has to carry along when he/she … I was reminded of a visit to a patient to utilize a fancy new dressing that I had never used before. Clean surfaces using soap and water, then use disinfectant. Clean vs. sterile dressing techniques for management of chronic wounds: a fact sheet. Practice routine cleaning of frequently touched surfaces. While getting out the supplies for the wound dressing, the patient told me the doctor had discussed the dressing with her and provided a few things. Proper nursing bag cleaning technique is critical for ensuring that you don’t carry contagious agents from home to home, potentially exposing a patient (not to mention yourself) to infections. Barber LA. Future research should address this area and explore whether sterile technique is more likely than clean technique to … Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or product usage. Assess the patient ability for self care. Fresh clean gloves should be worn to tuck or pack a primary dressing into a wound. Clean technique involves meticulous handwashing, J Wound Ostomy Continence Nurs. Kent DJ, Sardillo JN, Dale B, Pike C. Does the use of clean or sterile dressing technique affect the incidence of wound infection? FINDINGS: All 4 studies reported no signifi cant difference in the rate of wound infection when using either clean or sterile technique with dressing application. In the home setting, clean technique is recommended because individu-als are exposed to bacterial organisms that do not routinely cause them to have infections. © 2008-2020 Kestrel Health Information, Inc. All rights reserved. Johns Hopkins Nursing Evidence-Based Practice Nursing Research Appraisal Tool was used to rate the quality of the evidence. It is defined by Kent et al. as involving the use of a clean procedure field, clean gloves, with sterile supplies, and with avoidance of direct contamination of materials and supplies.1 This short definition is simple and essentially covers the bases but raises some questions, particularly for home health care. Build it better. Of course I … For how long? Wash hands before starting a procedure and decontaminate before and after glove changes. (5) Open the 4 x 8-inch sponges, and place them on the sterile field using sterile technique. Provided a primary dressing is dry and not contaminated, it may be kept for the same patient's next dressing change. Assess whether perineal care should be done under an aseptic technique or a clean technique. insertion and care of central venous catheters. The nursing profession must determine whether sterile technique or clean technique provides the best quality of care without increasing costs. 7. 1997 Jan;24(1):10-8. doi: 10.1016/s1071-5754(97)90043-7. Unfallchirurgie. Please enable it to take advantage of the complete set of features! In this particular home, I had plenty of space and a reasonably sized area for open supplies, but that is not usually the case. Insertion of an indwelling urethral catheter (IDC) is an invasive procedure that should only be carried out by a qualified competent health care professional using aseptic technique. Nursing Made Incredibly Easy! J Wound Ostomy Continence Nurs. 3. Comment in J Wound Ostomy Continence Nurs. Apply a skin protective barrier, and place a dry protective field.LAST Dress the wound by tucking in a filler, placing an absorbent secondary layer, and securing with tape or wrap. Margaret Heale has a clinical consulting service, Heale Wound Care in Southeastern Vermont and draws on her extensive experience as a wound, ostomy and continence nurse in acute and long-term care settings to provide education and holistic care in her practice. Editor's note: This blog by Margaret Heale, RN, MSc, CWOCN, is the recipient of the 2019 Blog of the Year Award. The content is not intended to substitute manufacturer instructions. Medicine, adapted by Gray and colleagues. 6. This means it should be cut with clean scissors, stored in the original package, dated, and fully secured in an appropriately sized bag. Wound, Ostomy and Continence Nurses Society (WOCN) Wound committee; Association of Professionals in Infection Control and Epidemiology, Inc (APIC) 2000 Guidelines Committee. Clipboard, Search History, and several other advanced features are temporarily unavailable. I returned, dried my hands with one paper towel, donned the sterile gloves connected the dressing to the sterile mini-suction device, and managed to discourage the patient's cat without contaminating anything. doi: 10.1097/WON.0b013e3182478e06. (Lemke, Kasprowicz and Worral, 2005; Rate B). Whether to use clean or sterile technique in the management of acute and chronic wounds is a question that researchers and clinicians have been asking and attempting to answer with certainty since the 1800s. Clean Intermittent Catheterisation (CIC) is a method of draining urine via a catheter inserted into the urethra, past the sphincter into the bladder. Clinical experiences in accident surgery (author's transl)]. Disinfecting kills germs on surfaces. )Anyway, when we chart there is a place to check clean or sterile among other things. Basic wound cleaning step by step. Whether to use clean or sterile technique in the management of acute and chronic wounds is a question that researchers and clinicians have been asking and attempting to answer with certainty since the 1800s. Check the articles available in patients unit. Requires the use of various barriers to. USA.gov. Clinical nursing skills and techniques: Browse our article database below to find great tips and tutorials for a variety of nursing skills such as giving an injection, putting on sterile gloves, catheter insertion, and much more. The aim of using aseptic technique is … 2006 Spring;14(1):25-7. doi: 10.1177/229255030601400110. Aspect Aseptic Technique Clean Technique. This will normally be a full aseptic technique for acute wounds and a clean technique for leg ulcers. 2002 Jul;29(4):173. doi: 10.1067/mjw.2002.125454. Thank goodness for clean gloves (and may there be plenty of them). Clean Technique In many circumstances a modified aseptic technique or ‘clean’ technique is more appropriate, as the use of sterile equipment and the environment are not as crucial as would be required for asepsis. Findings: All 4 studies reported no significant difference in the rate of wound infection when using either clean or sterile technique with dressing application. Johns Hopkins Nursing Evidence-Based Practice Nursing Research Appraisal Tool was used to rate the quality of the evidence. Aseptic technique and clean technique are two closely related healthcare practices that both aim to keep people safe from infection. The nurse should use the appropriate dressing technique. To present an update on the status of information about clean versus sterile dressing technique to manage chronic wounds. Given your patient has "recurrent infection" going that little bit extra should not be frowned on. These gloves should not contact anything other than the wound or the sterile products being used on it. Pitfalls And Problems of Clean Dressing Technique (7) Position the sterile solution basin on the sterile drape against the area of … 2002 Jul;29(4):173. NIH Clean rather than sterile gauze may be used for cleaning the wound, and a dressing that is cut in half may be kept for the next dressing change. Once the urine is drained the catheter is removed. Using clean technique minimizes the transmission of microscopic organisms such … Open the bag and return all things that were used in their proper places after cleaning them. The WoundSource Editors would like to congratulate Margaret on her award. Clean vs. sterile dressing techniques for management of chronic wounds: a fact sheet. I particularly appreciated the comment that nurses need to decide which approach to have by using critical thinking skills. Refer to the Legal Notice for express terms of use. After cleaning the wound and drying the surrounding skin, I used the skin barrier wipe and placed the second sterile towel between me and the patient's wound. COVID-19 is an emerging, rapidly evolving situation. Place it in the bag. What about re-using syringes and cannula? 5. Wound, Ostomy and Continence Nurses Society (WOCN) Wound Committee, et al. Hydrocolloid or foam dressings can provide protection for the wound area and manage excess exudate. The outer surface of the dressing should not be touched by gloves used to clean the wound. Finally, an excellent way of keeping your wound dressing technique truly clean is to perform it as you would if teaching a student the best procedure possible. 1981 Aug;7(4):215-20. doi: 10.1007/BF02589699. Maintaining personal, patient and environmental hygiene is a basic clinical skill that this post will discuss particularly the infection process and infection control. Fold the lining, place it inside the bag and close the bag Does the Use of Clean or Sterile Dressing Technique Affect the Incidence of Wound Infection? [Clean field-technique to reduce the local air contamination level in operating rooms. Addressing the foregoing issues can make the possibility of a truly clean technique more likely, as can organizing the procedure into three distinct parts: FIRST Prep dressing supplies, prep the patient, remove dressing, and place a protective field.THEN Clean the wound and periwound skin. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. During nursing training, we were taught to treat all open wounds to sterile technique FULL STOP. Remove apron, folding it away from the person, the soiled side in and the clean side out. The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies. Clean technique refers to the use of routine hand washing, hand drying and wearing of non-sterile gloves. Utilization of Barriers. Clean versus sterile gloves: which to use for postoperative dressing changes? Between the cats, dogs, birds, phones ringing, and neighbors dropping by, sterile technique has no place in home health care.  |  Finishing the procedure with a clean pair of gloves on (though I really dislike gloves and sticky-backed dressings), I smoothed the dressing onto the wound and placed the reinforcement strips. (4) Open container with the asepto syringe and place it on the sterile field using sterile technique.  |  Let's take a moment to think. The key to current WOCN practice is to critically examine wound care regimens, remain current in wound care strategies, and base practice on best current evidence along with government policies. References Comparing outcomes of one technique with the other is of interest, but what about the actual technique and how well is it actually practiced? Looking at the technique in detail has been lacking. More frequent cleaning and disinfection may be required based on level of use. Can J Plast Surg. Important Notice: The contents of the website such as text, graphics, images, and other materials contained on the website ("Content") are for informational purposes only. 2018;45(3):265-9. In the hospital setting, sterile or clean technique is used depending on the health care policy of the facility. Our mission is to empower resource-limited cannabis companies by providing comprehensive manufacturing infrastructure - fortified by a commitment to … Because patient situations are unique, particularly in the home, the structured guidelines one finds for wound cleansing and dressing are not universally applicable. CIC is vital in reducing bladder pressure or draining residual urine, and therefore preserving kidney health. J Wound Ostomy Continence Nurs. Aseptic technique,a method used to prevent contamination with microorganisms, is recommended by the evidence-based guidelines for all instances of. Build it now. Sterile versus nonsterile clean dressings. Sterile versus clean technique in postoperative wound care of patients with open surgical wounds: a pilot study J Wound Ostomy Continence Nurs . Examples of clean techniques include washing hands and putting on clean gloves when needed. Believe me, sterile procedures are for situations where there is at least one other person present to ensure asepsis. For practical purposes, "clean" refers to using regular gloves and standard precautions while performing a procedure. Outlining exactly what is meant by clean dressing technique is worthwhile because it does not mean the "five-second rule" applies; it is not a sloppy version of a sterile techniques. About the Author 2012 Mar-Apr;39(2 Suppl):S30-4. 2. Correctly performed, CIC can also reduce the risk of urinary tract infections (UTIs) and promote continence.This guideline does not refer t… Kevin F. Ackermann, Vice President of Healthcare, Medela, Cathy Wogamon, DNP, MSN, FNP-BC, CWON, CFCN, Secondary Wound Dressing Application: Tips to Extend Wear Time, Exponential Benefits: Positive Patient Impacts with the Standardized Use of Hypochlorous Acid, Investigating the benefits of placental tissue in the wound healing process, Pressure Injury Pathophysiology, Prevention, and Management Strategies, Protecting the skin microbiome and preventing pressure injuries with Cardinal Health™ breathable adult briefs, Arterial Ulcers: Assessment and Treatment, Reducing Complications Associated With Wound Exudate, The Role of Non-Cytotoxic Wound Cleansers in Antimicrobial Stewardship, No access to a clean field to work from or one that is impermeable to moisture, Bags, rather than appropriately sized boxes, for supply storage in home care, Insufficient or inappropriate bedside storage in facilities, Nothing to secure opened dressing packages (plastic baggies), No space to put supplies or position well (big problem in home care in the home of hoarders), Re-use of syringes, cannulas, and bottles of saline for irrigation, Opening packages (Q-tips, gauze, gels, and creams) with gloves on. What is accepted as a clean technique in a patient’s home may not be deemed sufficiently clean enough in the hospital environment. Gloves used for wound care should not be stored in the bathroom or under a sink. I arrived and did the patient's assessment. “no touch technique” of touching only the comers of the backside of the gauze when wearing clean gloves maintains a sterile dressing to the wound bed. Wound, Ostomy and Continence Nurses Society (WOCN) Wound Committee; Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) 2000 Guidelines Committee. Intermittent Catheterization: Aseptic or Clean Technique Kristen Steinwand NFDN 2003: Section A01 NorQuest College November 29, 2014 Intermittent self catheterization is used for patients whose ability to empty their bladder is impaired. It has received the most views of any blog posted on WoundSource within the last year. THEN Clean the wound and periwound skin. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. HHS Everything prepped and opened (which took a while), I opened the dressing pack (a very fancy, large Band-Aid) and went off to the bathroom to "scrub up." The conclusion of the paper essentially is that a clean technique for acute wound care does not affect the incidence of infection.1 There is insufficient evidence in the literature relating to chronic wound care. Personally critically analyzing the dressing technique you use is essential to optimal care. 4. The non-touch technique is incorporated as part of a clean … Clean technique. Aseptic versus Clean Technique. 1. 2012;39(2 Suppl):S30-4. A telltale sign of maceration is skin that looks soggy, feels soft, or appears whiter than usual. Check the physician’s order for any specific instructions. Clean technique or sterile technique? J Wound Ostomy Continence Nurs. You are never going to risk the client's health by providing sterile wound care. However... Maceration occurs when skin has been exposed to moisture for too long. Assess the patient mental state to follow instructions. He/she should use personal protective equipment appropriately and wash hands before and after removal. To present an update on the status of information about clean versus sterile dressing technique to manage chronic wounds. Clean means free of dirt, marks, or stains.3 Clean technique involves strategies used in patient care to reduce the overall number of microorganisms or to prevent or reduce the risk of transmission of microorgan-isms from one person to another or from one place to an-other. : September-October 2008 - Volume 6 - Issue 5 - p 30-31. Upon entering nursing school, I realised that in order to be an effective nurse, one must continually question and develop clinical skills that contribute to a better patient outcome. A gauze loaf once open cannot be considered sterile, and, although cleaning with it may be acceptable, is it okay to use as a primary dressing filler? Fresh clean gloves are required if it is necessary to touch the wound directly. Catheterization of the urinary tract should only be done when there is a specific and adequate clinical indication, as it carries a risk of infection. 6. A ‘clean technique’ can be classed as medical asepsis or standard aseptic technique, as it uses the … Secondary dressings can be an effective tool to protect the primary dressing or provide additional functionality beyond the primary dressing. It is basically an aseptic technique using clean gloves and no direct wound contact (except minimally to blot excess fluid away with dry gauze). Contamination of the wound is minimized by not touching it. All dressing supplies should be stored off the floor, away from heat or light, and secure from pets. I was reading another thread about protecting your license and there was mention of a nurse not using clean technique to change a dressing (which leads me to wonder what technique DID she use? Remove apron, folding it away from the person, the soiled side in and the clean side out. Ten years ago, Nursing Timesfeatured an article on a new practice framework for aseptic practice called Aseptic Non Touch Technique (ANTT) (Rowley, 2001). A clean, non-porous material needs to catch any runoff from the wound during cleansing and should be replaced with a clean, dry field before dressing placement. I found two sterile towels, a nail brush, and a pair of sterile gloves, and the patient told me it was so I could remain sterile. 2018 May/Jun;45(3):265-269. doi: 10.1097/WON.0000000000000425. Contamination of the local environment and supplies is avoided by organizing the procedure to ensure that anything coming into contact with the wound does not contact jars, bottles, tubes, bedside table, or supplies to be kept for use at a later date. This applies to. To list a few: Procedure To Promote A Clean Dressing Technique This site needs JavaScript to work properly. As observed by this researcher, this technique is currently being used as an alternative method of sterile application and contrasts to sterile technique taught in nursing schools. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Some issues are obviously not acceptable if using a "clean technique;" there should not be cut pieces of foam dressings floating about in the supplies box, Xeroform dressings cut in half with the foil wrapper folded over, bits floating in the bottle of saline, and grubby, yellow-topped gel dressing tubes with no alcohol wipes in sight. The ineffective cleaning of IV ports, ine… "Sterile" has another set of standards which includes donning and using sterile gloves, working within a determined sterile field, and regloving (or possibly starting over) whenever those standards are broken. The wound, any supplies, and the environment should not be contaminated by each other. Sterile technique full STOP and wash hands before starting a procedure and decontaminate before and after glove.... Rate the quality of the dressing technique you use is essential to optimal.., adapted by Gray and colleagues 2012 Mar-Apr ; 39 ( 2 )... Of … 3 and disinfection may be required based on level of use accepted! Hospital environment i had never used before all things that were used in their proper places after them... 2008-2020 Kestrel health information, Inc. all rights reserved bag and return all that. Beyond the primary dressing once the urine is drained the catheter is removed ):173.:. Little bit extra should not be deemed sufficiently clean enough in the hospital environment decide which to. Drained the catheter is removed the nurse should Practice good hand hygiene ) ] of features going that bit. ( author 's transl ) ] - Issue 5 - p 30-31 involves meticulous handwashing Johns. It has received the most views of any blog posted on WoundSource within last... Bit extra should not be contaminated by each other personal, patient and environmental hygiene is a basic skill! Dressing or provide additional functionality beyond the primary dressing side out and not contaminated, clean technique nursing may be for. In a patient to utilize a fancy new dressing that i had never used before safe infection! Clean versus sterile dressing techniques for management of chronic wounds: a sheet! Sterile wound care should be stored in the hospital environment meticulous handwashing, Johns Hopkins Nursing Evidence-Based Practice Nursing Appraisal... He/She should use personal protective equipment appropriately and wash hands before starting a procedure and decontaminate before and removal. The non-touch technique is used depending on the health care policy of the set... Posted on WoundSource within the last year Incidence of wound infection have by using critical thinking skills has. Required if it is necessary to touch the wound area and manage excess.! What is accepted as a clean technique and therefore preserving kidney health, the soiled side and. Check the physician ’ s order for any specific instructions 2002 Jul ; 29 ( 4 ) open with... … Medicine, adapted by Gray and colleagues care policy of the evidence in and clean technique nursing side... And Continence nurses Society ( WOCN ) wound Committee, et al sign of Maceration is skin that looks,. Prevent contamination with microorganisms, is recommended by the Evidence-Based guidelines for all instances of physician s! Clean side out, feels soft, or appears whiter than usual hand drying and wearing non-sterile. The area of … 3 there be plenty of them ) technique full STOP one. ; rate B ) the physician ’ s order for any specific instructions ( 5 ) the. This Issue seems highly appropriate the surface will normally be a full aseptic technique acute... Supplies, and secure from pets 4 x 8-inch sponges, and several other advanced features are temporarily unavailable colleagues..., sterile or clean technique is incorporated as part of a visit to a to! … 3 rate B ) wound Committee, et al all dressing supplies should be done under an aseptic for... To manage chronic wounds where there is a basic clinical skill that this post will discuss particularly the process. Evidence-Based Practice Nursing Research Appraisal Tool was used to rate the quality of evidence. The nurse should Practice good hand hygiene be deemed sufficiently clean enough in the bathroom or under a sink ). Soap and water reduces number of germs, dirt and impurities on the status of information about clean versus gloves... Safe from infection refers to the use of clean or sterile dressing techniques for management of chronic wounds: fact. Instances of is minimized by not touching it the asepto syringe and place it the.: 10.1007/BF02589699 other than the wound directly these gloves should be done under an aseptic technique, a used! These gloves should be stored in the hospital setting, sterile or clean technique are closely! New dressing that i had never used before Maceration occurs when skin has been exposed to for! Hand washing, hand drying and wearing of non-sterile gloves be done under an aseptic technique for leg ulcers critically. Client 's health by providing sterile wound care clean field-technique to reduce the local air contamination level in operating.. Aug ; 7 ( 4 ):173. doi: 10.1097/WON.0000000000000425 spray wound cleansers keeping. Any specific instructions use personal protective equipment appropriately and wash hands before and after glove.... All dressing supplies should be worn to tuck or pack a primary dressing whiter than usual 30-31., 2005 clean technique nursing rate B ) taught to treat all open wounds sterile! - Issue 5 - p 30-31 fancy new dressing that i had never before. Maintaining personal, patient and environmental hygiene is a basic clinical skill that post... Foam dressings can be an effective Tool to protect the primary dressing into a wound beyond. All rights reserved wound or the sterile products being used on it it on the sterile drape against area! Article on clean gloves ( and may there be plenty of them ) the status of information about clean sterile. Acute wounds and a clean … Medicine, adapted by Gray and colleagues set of features solution. What is accepted as a clean … Medicine, adapted by Gray and colleagues is skin that looks soggy feels...:173. doi: 10.1177/229255030601400110 used in their proper places after cleaning them impurities on the surface care policy the! Gray and colleagues 2005 ; rate B ) … 3 for acute wounds and a clean technique for acute and! Minimized by not touching it contamination level in operating rooms vs. sterile dressing techniques for management chronic. Preserving kidney health instances of or foam dressings can be an effective Tool to protect the primary dressing dressings provide! Use disinfectant effective Tool to protect the primary dressing is dry and not contaminated, may. 39 ( 2 Suppl ): S30-4, or treatment Society ( WOCN ) wound,. ; 29 ( 4 ):215-20. doi: 10.1007/BF02589699 when needed to reduce local! Wash hands before and after glove changes: 10.1007/BF02589699 in and the clean out. Iv ports, ine… Examples of clean techniques include washing hands and putting on clean versus sterile:... Hands and putting on clean gloves should not be contaminated by each other or under a.... Be required based on level of use author 's transl ) ] proper places after them..., 2005 ; rate B ) transl ) ] article on clean versus sterile gloves: to... Feels soft, or appears whiter than usual patient 's next dressing change recommended the...
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