ADVANCED SKILLS

Tissue Integrity & Elimination

Learning Objective-

  • Describe recommended techniques for medical & surgical asepsis.Discuss settings where surgical asepsis should be used.
  • Demonstrate ability to prepare a sterile field.
  • Demonstrate ability to perform a surgical hand scrub.
  • Demonstrate ability to don and removing sterile gloves.
  • Discuss the processes involved in wound care.
  • Describe factors that affect wound healing.
  • Demonstrate how to perform wound irrigation, sterile dry dressing change and wet-to-moist dressing change.
  • State the purpose of performing a wet-to-moist dressing change.
  • Identify the purpose of irrigating a wound.
  • Demonstrate the procedure for removing staples and sutures.
  • Describe the use and purpose of Montgomery straps.
  • Identify types of surgical drains and the procedure for the evacuation of each (Penrose, Jackson Pratt, Hemovac and T-tube).
  • Demonstrate care of a central line catheter including changing solution, tubing and dressing changes.
  • Identify factors to be assessed prior to catheterization.
  • Discuss nursing care of clients with indwelling catheters.
  • Describe differences in positioning male and female clients for catheterization.
  • Discuss types and sizes of catheters.
  • Discuss nursing considerations for catheter insertion of clients in all age groups.
  • Demonstrate sterile catheterization on both male and female manikins.
  • Compare and contrast condom catheter, straight catheter and indwelling catheter.

A. Sterile Glove & Sterile Field

Required Text and Resources:

Yoost & Crawford (2016).Fundamentals of Nursing, Chapter 26 and 37

Lewis (2014).Medical-Surgical Nursing (9th ed.), Chapter 19, p.p. 338-339

Mosby video series .Nursing Concepts Online.Advanced Skills, Tissue Integrity

Practicum:

Practice opening sterile packages, pouring a sterile solution, working in a sterile field and applying sterile gloves.

Have a peer review your ability to open a sterile package, work in a sterile field and apply and remove sterile gloves.

Have an instructor evaluate your ability to don sterile gloves, pour sterile solution, set up and work in sterile field, and remove sterile gloves.

B. Surgical Hand Scrub

Required Text and Resources:

Yoost & Crawford (2016) Fundamentals of Nursing, Chapter 37

Lewis (2014) Medical Surgical Nursing (9th Ed.), Chapter 19, p. 338

Practicum:

Have a peer review your ability to perform a surgical hand scrub.

C. Dressing Change

1. Sterile (Surgical) Dressings

a. Drains

b. Drain site care

c. Staple / Suture removal

d. Post-operative assessment

2. Central Line Dressings

3. Wound Care

a. Irrigation and dressing change

b. Traction care

Required Text and Resources:

Yoost & Crawford (2016).Fundamentals of Nursing, Chapter 29 and 37

Lewis (2014).Medical-Surgical Nursing (9th ed.), Chapters 12, p.p. 175, 177-186; Chapter20, p.p. 361-362 and Chapter 63, 1514-1515

Mosby video series .Nursing Concepts Online.Advanced Skills, Tissue Integrity

Practicum:

Practice Central Venous Catheter dressing, sterile dressing technique and open wound irrigation technique being certain to observe principles of surgical asepsis.

Practice drain tube and pin care with dressing change techniques being certain to observe principles of surgical asepsis.

Have two peers review your technique for performing sterile wet-to-moist dressing change and wound irrigation.

Have an instructor evaluate your technique for performing sterile dry or moist dressing change and wound irrigation in a group.

Document your procedure in EHR.

D. Urinary Catheterization

1. Foley Catheterization

2. Straight Catheterization

3. External Catheterization

Required Text and Resources:

Yoost & Crawford (2016.)Fundamentals of Nursing, Chapter 41

McKinney (2013).Maternal-Child Nursing (4th ed.), Pages 943-944

Lewis (2014). Medical-surgical Nursing (9thed.), Chapter 20, p.p. 360-361; Chapter 46, p.p. 1092-1094

Mosby video series .Nursing Concepts Online.Advanced Skills, Urinary Elimination

Practicum:

Practice insertion of straight and indwelling catheters and condom catheter.

Have a peer review your technique in performing straight catheterization and applying condom catheter.

Have two peers review your ability to insert an indwelling catheter.

Have an instructor evaluate your ability to insert an indwelling catheter in a group.

Document the catheterization procedure in EHR.

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