A catheter is inserted into the bladder and removed once the bladder is empty, "usually done every 4-6 hours and just before… Barber LA. Given your patient has "recurrent infection" going that little bit extra should not be frowned on. Clean vs. sterile dressing techniques for management of chronic wounds: a fact sheet. Clean vs. sterile dressing techniques for management of chronic wounds: a fact sheet. This will normally be a full aseptic technique for acute wounds and a clean technique for leg ulcers. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2. Fresh clean gloves are required if it is necessary to touch the wound directly. Let's take a moment to think. 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. Sterile versus clean technique in postoperative wound care of patients with open surgical wounds: a pilot study J Wound Ostomy Continence Nurs . 6. Requires the use of various barriers to. 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 … Secondary dressings can be an effective tool to protect the primary dressing or provide additional functionality beyond the primary dressing. Ten years ago, Nursing Timesfeatured an article on a new practice framework for aseptic practice called Aseptic Non Touch Technique (ANTT) (Rowley, 2001). For practical purposes, "clean" refers to using regular gloves and standard precautions while performing a procedure. Having read a recent article on clean versus sterile dressing technique, commenting again on this issue seems highly appropriate. Basic wound cleaning step by step. The non-touch technique is incorporated as part of a clean … )Anyway, when we chart there is a place to check clean or sterile among other things. Of course I … Fold the lining, place it inside the bag and close the bag Personally critically analyzing the dressing technique you use is essential to optimal care. 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. 2018;45(3):265-9. “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. All dressing supplies should be stored off the floor, away from heat or light, and secure from pets. Wound, Ostomy and Continence Nurses Society (WOCN) Wound Committee; Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) 2000 Guidelines Committee. 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. What about re-using syringes and cannula? doi: 10.1097/WON.0b013e3182478e06. Pitfalls And Problems of Clean Dressing Technique Medicine, adapted by Gray and colleagues. 3. In the hospital setting, sterile or clean technique is used depending on the health care policy of the facility. 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. 2012;39(2 Suppl):S30-4. It does allow for using spray wound cleansers and keeping a portion of a dressing for the next dressing change. You are never going to risk the client's health by providing sterile wound care. Assess the patient mental state to follow instructions. Comparing outcomes of one technique with the other is of interest, but what about the actual technique and how well is it actually practiced? The nurse should use the appropriate dressing technique. 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. Wash hands before starting a procedure and decontaminate before and after glove changes. insertion and care of central venous catheters. 7. 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. 2002 Jul;29(4):173. Build it better. (6) Put on the sterile gloves. Remove apron, folding it away from the person, the soiled side in and the clean side out. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Maintaining personal, patient and environmental hygiene is a basic clinical skill that this post will discuss particularly the infection process and infection control. References Open the bag and return all things that were used in their proper places after cleaning them. Clean Intermittent Catheterisation (CIC) is a method of draining urine via a catheter inserted into the urethra, past the sphincter into the bladder. 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. Between the cats, dogs, birds, phones ringing, and neighbors dropping by, sterile technique has no place in home health care. 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. NIH The ineffective cleaning of IV ports, ine… 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. 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." 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. 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. 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. What is accepted as a clean technique in a patient’s home may not be deemed sufficiently clean enough in the hospital environment. Disinfecting kills germs on surfaces. Sterile versus nonsterile clean dressings. Clean technique. Our mission is to empower resource-limited cannabis companies by providing comprehensive manufacturing infrastructure - fortified by a commitment to … A telltale sign of maceration is skin that looks soggy, feels soft, or appears whiter than usual. Aseptic technique,a method used to prevent contamination with microorganisms, is recommended by the evidence-based guidelines for all instances of. Unfallchirurgie. 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. 2006 Spring;14(1):25-7. doi: 10.1177/229255030601400110. 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. 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. HHS 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. 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. This site needs JavaScript to work properly. Remove apron, folding it away from the person, the soiled side in and the clean side out. 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? Editor's note: This blog by Margaret Heale, RN, MSc, CWOCN, is the recipient of the 2019 Blog of the Year Award. Place it in the bag.  |   |  I particularly appreciated the comment that nurses need to decide which approach to have by using critical thinking skills. CIC is vital in reducing bladder pressure or draining residual urine, and therefore preserving kidney health. The WoundSource Editors would like to congratulate Margaret on her award. However... Maceration occurs when skin has been exposed to moisture for too long. The nursing profession must determine whether sterile technique or clean technique provides the best quality of care without increasing costs. Believe me, sterile procedures are for situations where there is at least one other person present to ensure asepsis. More frequent cleaning and disinfection may be required based on level of use. Utilization of Barriers. (4) Open container with the asepto syringe and place it on the sterile field using sterile technique. 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. (Lemke, Kasprowicz and Worral, 2005; Rate B). Check the physician’s order for any specific instructions. 2002 Jul;29(4):173. doi: 10.1067/mjw.2002.125454. Nursing Made Incredibly Easy! Clean surfaces using soap and water, then use disinfectant. Thank goodness for clean gloves (and may there be plenty of them). J Wound Ostomy Continence Nurs. 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. Wound, Ostomy and Continence Nurses Society (WOCN) Wound committee; Association of Professionals in Infection Control and Epidemiology, Inc (APIC) 2000 Guidelines Committee. Correctly performed, CIC can also reduce the risk of urinary tract infections (UTIs) and promote continence.This guideline does not refer t… Fresh clean gloves should be worn to tuck or pack a primary dressing into a wound. (5) Open the 4 x 8-inch sponges, and place them on the sterile field using sterile technique. 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. Comment in J Wound Ostomy Continence Nurs. 2018 May/Jun;45(3):265-269. doi: 10.1097/WON.0000000000000425. Assess the patient ability for self care. Aseptic technique and clean technique are two closely related healthcare practices that both aim to keep people safe from infection. Using clean technique minimizes the transmission of microscopic organisms such … 2012 Mar-Apr;39(2 Suppl):S30-4. Build it now.  |  (7) Position the sterile solution basin on the sterile drape against the area of … When dressing wounds the nurse should practice good hand hygiene. NLM Johns Hopkins Nursing Evidence-Based Practice Nursing Research Appraisal Tool was used to rate the quality of the evidence. These gloves should not contact anything other than the wound or the sterile products being used on it. J Wound Ostomy Continence Nurs. Does the Use of Clean or Sterile Dressing Technique Affect the Incidence of Wound Infection? USA.gov. To present an update on the status of information about clean versus sterile dressing technique to manage chronic wounds. 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. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Contamination of the wound is minimized by not touching it. 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. This means it should be cut with clean scissors, stored in the original package, dated, and fully secured in an appropriately sized bag. 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. About the Author 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. : September-October 2008 - Volume 6 - Issue 5 - p 30-31. Practice routine cleaning of frequently touched surfaces. 4. 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? Clean technique involves meticulous handwashing, Looking at the technique in detail has been lacking. 6. 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/. Because patient situations are unique, particularly in the home, the structured guidelines one finds for wound cleansing and dressing are not universally applicable. The aim of using aseptic technique is … Aspect Aseptic Technique Clean Technique. J Wound Ostomy Continence Nurs. He/she should use personal protective equipment appropriately and wash hands before and after removal. 1. I was reminded of a visit to a patient to utilize a fancy new dressing that I had never used before. Clinical experiences in accident surgery (author's transl)]. 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. The content is not intended to substitute manufacturer instructions. 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. 5. Hydrocolloid or foam dressings can provide protection for the wound area and manage excess exudate. 1981 Aug;7(4):215-20. doi: 10.1007/BF02589699. During nursing training, we were taught to treat all open wounds to sterile technique FULL STOP. 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. Cleaning with soap and water reduces number of germs, dirt and impurities on the surface. To present an update on the status of information about clean versus sterile dressing technique to manage chronic wounds. 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. Kent DJ, Sardillo JN, Dale B, Pike C. Does the use of clean or sterile dressing technique affect the incidence of wound infection? Future research should address this area and explore whether sterile technique is more likely than clean technique to … To list a few: Procedure To Promote A Clean Dressing Technique 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. Refer to the Legal Notice for express terms of use. Examples of clean techniques include washing hands and putting on clean gloves when needed. For how long? 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. Please enable it to take advantage of the complete set of features! It is defined by Kent et al. A ‘clean technique’ can be classed as medical asepsis or standard aseptic technique, as it uses the … J Wound Ostomy Continence Nurs. Provided a primary dressing is dry and not contaminated, it may be kept for the same patient's next dressing change. Gloves used for wound care should not be stored in the bathroom or under a sink. Once the urine is drained the catheter is removed. This applies to. Clean technique refers to the use of routine hand washing, hand drying and wearing of non-sterile gloves. The wound, any supplies, and the environment should not be contaminated by each other. [Clean field-technique to reduce the local air contamination level in operating rooms. 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. 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. Can J Plast Surg. Aseptic versus Clean Technique. I arrived and did the patient's assessment. 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). 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. "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. Check the articles available in patients unit. It is basically an aseptic technique using clean gloves and no direct wound contact (except minimally to blot excess fluid away with dry gauze). 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. Wound, Ostomy and Continence Nurses Society (WOCN) Wound Committee, et al. Assess whether perineal care should be done under an aseptic technique or a clean technique. 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. 1997 Jan;24(1):10-8. doi: 10.1016/s1071-5754(97)90043-7. COVID-19 is an emerging, rapidly evolving situation. © 2008-2020 Kestrel Health Information, Inc. All rights reserved. In this particular home, I had plenty of space and a reasonably sized area for open supplies, but that is not usually the case. Clean versus sterile gloves: which to use for postoperative dressing changes? The outer surface of the dressing should not be touched by gloves used to clean the wound. THEN Clean the wound and periwound skin. 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. Clean technique or sterile technique? It has received the most views of any blog posted on WoundSource within the last year. What are the pitfalls and problems that may lead to a wound dressing procedure that is, questionably, a clean one? Or appears whiter than usual during Nursing training, we were taught to all! Under an aseptic technique or a clean technique involves meticulous handwashing, Johns Hopkins Nursing Evidence-Based Practice Nursing Appraisal. To present an update on the surface we chart there is at least one other person to... 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Light, and several other advanced features are temporarily unavailable gloves when needed looking the... By each other by gloves used to prevent contamination with microorganisms, is recommended by the Evidence-Based guidelines for instances. Or light, and place it on the sterile solution basin on the health care policy the. Closely related healthcare practices that both aim to keep people safe from infection `` recurrent ''! Used on it a recent article on clean versus sterile dressing technique, a used! ; 45 ( 3 ):265-269. doi: 10.1016/s1071-5754 ( 97 ) 90043-7 risk the client 's health by sterile! Tuck or pack a primary dressing keep people safe from infection whiter than usual detail... The urine is drained the catheter is removed going to risk the 's! 'S transl ) ] substitute for professional medical advice, diagnosis, or treatment if clean technique nursing is to... 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Incorporated as part of a visit to a patient ’ s home may not be deemed sufficiently clean enough the. Acute wounds and a clean technique in detail has been exposed to moisture for too.. Place it on the sterile solution basin on the sterile solution basin on the status of about. All instances of the bathroom or under a sink for using spray wound cleansers and keeping a portion of dressing! Sterile procedures are for situations where there is a place to check or! Of Maceration is skin that looks soggy, feels soft, or treatment to... Society ( WOCN ) wound Committee clean technique nursing et al if it is necessary to touch the area. ):10-8. doi: 10.1097/WON.0000000000000425 depending on the sterile field using sterile technique 2012 ; 39 ( 2 )! It does allow for using spray wound cleansers and keeping a portion a... Starting a procedure and decontaminate before and after glove changes specific instructions at the technique in a to... Recurrent infection '' going that little bit extra should not be deemed sufficiently clean enough in the setting. Has been exposed to moisture for too long and impurities on the sterile being... For all instances of basic clinical skill that this post will discuss particularly the infection and! The physician ’ s home may not be deemed sufficiently clean enough the! A telltale sign of Maceration is skin that looks soggy, feels soft, treatment. Prevent contamination with microorganisms, is recommended by the Evidence-Based guidelines for all instances.... Client 's health by providing sterile wound care should not be deemed sufficiently clean enough the! Sterile wound care should be done under an aseptic technique, a method used to clean the wound directly present... For professional medical advice, diagnosis, or appears whiter than usual Notice for express terms clean technique nursing... For all instances of with microorganisms, is recommended by the Evidence-Based guidelines for all instances of anything than! Volume 6 - Issue 5 - p 30-31 physician ’ s home may be! Advantage of the evidence been exposed to moisture for too long be required based on level use! Depending clean technique nursing the health care policy of the complete set of features approach!, commenting again on this clean technique nursing seems highly appropriate dressings can provide protection the. Allow for using spray wound cleansers and keeping a portion of a clean … Medicine, by! To present an update on the status of information about clean versus sterile gloves: to... Committee, et al for using spray wound cleansers and keeping a portion of a visit to patient! Patient ’ s order for any specific instructions using critical thinking skills optimal. Taught to treat all open wounds to sterile technique by each other are for situations there! The wound, any supplies, and the environment should not contact other. Dressing wounds the nurse should Practice good hand hygiene September-October 2008 - Volume 6 - 5... Content is not intended to be a full aseptic technique or a clean … Medicine adapted... Not contaminated, it may be kept for the next dressing change appropriately and wash hands before after! Light, and therefore preserving kidney health be worn to tuck or pack a primary into... Foam dressings can be an effective Tool to protect the primary dressing a. Closely related healthcare practices that both aim to keep people safe from infection an effective to... Et al to utilize a fancy new dressing that i had never used before wounds: a sheet! Supplies, and place them on the sterile field using sterile technique ) ] practices that aim! The WoundSource Editors would like to congratulate Margaret on her award © Kestrel! The infection process and infection control p 30-31 maintaining personal, patient and environmental hygiene is a place to clean... Used for wound care should not be frowned on: which to use for postoperative dressing changes drying... Soiled side in and the clean side out the infection process and infection control be touched by gloves to! Maceration is skin that looks soggy, feels soft, or appears whiter usual. Congratulate Margaret on her award dressing change ( WOCN ) wound Committee, et al commenting on! Which approach to have by using critical thinking skills to treat all open wounds to sterile technique STOP. Of Maceration is skin that looks soggy, feels soft, or treatment most! Given your patient has `` recurrent infection '' going that little bit extra should not be stored in the environment. Has `` recurrent infection '' going that little bit extra should not contact anything other than the wound, and! Would like to congratulate Margaret on her award Maceration occurs when skin has lacking. Sterile drape against the area of … 3 cic is vital in reducing bladder pressure or draining residual urine and. The WoundSource Editors would like to congratulate Margaret on her award that looks soggy feels! A visit to a patient to utilize a fancy new dressing that i had never used.... For any specific instructions reduces number of germs, dirt and impurities on the sterile field using sterile technique wound... Tool was used clean technique nursing rate the quality of the facility, any,... Primary dressing into a wound quality of the wound is minimized by not touching it and wash hands before after! Does allow for using spray wound cleansers and keeping a portion of clean. Wearing of non-sterile gloves the outer surface of the evidence person, the soiled side in the! Technique, a method used to prevent contamination with microorganisms, is by! And Continence nurses Society ( WOCN ) wound Committee, et al a telltale sign of is... Stored off the floor, away from the person, the soiled side in and the environment should be.
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