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StudentName____________________________________________________________________

COMPETENCY: CRITICAL ELEMENTS Wet to moist MET NOT MET

Removing the Soiled Dressing 1. Assesses for pain and medicates 30 minutes prior to procedure, if needed. 2. Places the patient in a comfortable position that provides easy access to the wound. 3. Washes hands and applies clean gloves. 4. Loosens the edges of the tape of the old dressing. Stabilizes the skin with the other hand while pulling the tape in the opposite direction. 5. Beginning with the top layer, lifts the dressing from the corner toward the center of the wound. If dressing sticks, moistens with 0.9% (normal) saline before completely removing it. 6. Continues to remove layers until the entire dressing is removed. 7. Assesses the type and amount of drainage present on the soiled dressing. 8. Disposes of soiled dressing and gloves in a biohazard bag. 9. Removes the cover of a tray of sterile 44 gauze; moistens the gauze with sterile saline. 10. Applies clean gloves. 11. Gently cleanses the wound with the saline-moistened gauze by lightly wiping a section of the wound from the center toward the wound edge. 12. Discards the gauze in a biohazard receptacle and repeats in the next section using a new piece of gauze with each wiping pass. 13. Discards gloves and soiled gauze into a biohazard bag. Procedural Steps for Applying Wet-to-Damp Dressing 14 Establishes a sterile field, using a sterile impermeable barrier. field barrier 14. 15. Opens sterile gauze packs and a surgipad onto the sterile field. The amount of gauze used will depend on the size of the wound. 16. Moistens sterile gauze with a sterile 0.9% saline solution for irrigation. 17. Applies clean gloves. 18. Wrings out excess moisture from the gauze before applying. 19. Applies a single layer of moist fine-mesh gauze to the wound, being careful to place gauze in all depressions or crevices of the wound. Uses sterile forceps or cotton applicator to ensure that deep depressions or sinus tracts are filled with gauze. 20. Applies a secondary moist layer over the first layer. Repeats this process until the wound is completely filled with moistened sterile gauze. 21. Does not pack the gauze tightly into the wound. 22. Does not extend the moist dressing onto the surrounding skin. 23. Covers the moistened gauze with a surgipad. 24. Secures the dressing with tape or Montgomery straps. 25. Disposes of gloves and sterile field materials in the biohazard waste.

EvaluatedBy:__________________ Comments: EvaluatedBy:__________________ Comments: [SE7/10/2012]

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