2012;39(2 Suppl):S30-4. Wound, Ostomy and Continence Nurses Society (WOCN) Wound committee; Association of Professionals in Infection Control and Epidemiology, Inc (APIC) 2000 Guidelines Committee. 1997 Jan;24(1):10-8. doi: 10.1016/s1071-5754(97)90043-7. The content is not intended to substitute manufacturer instructions. Practice routine cleaning of frequently touched surfaces. 2002 Jul;29(4):173. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. 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? Using clean technique minimizes the transmission of microscopic organisms such … Wash hands before starting a procedure and decontaminate before and after glove changes. J Wound Ostomy Continence Nurs. Believe me, sterile procedures are for situations where there is at least one other person present to ensure asepsis. (4) Open container with the asepto syringe and place it on the sterile field using sterile technique. Build it now. Clipboard, Search History, and several other advanced features are temporarily unavailable. Place it in the bag. THEN Clean the wound and periwound skin. In the hospital setting, sterile or clean technique is used depending on the health care policy of the facility. 6. 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. 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. Clean Intermittent Catheterisation (CIC) is a method of draining urine via a catheter inserted into the urethra, past the sphincter into the bladder. 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. COVID-19 is an emerging, rapidly evolving situation. For practical purposes, "clean" refers to using regular gloves and standard precautions while performing a procedure. Kent DJ, Sardillo JN, Dale B, Pike C. Does the use of clean or sterile dressing technique affect the incidence of wound infection? 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. J Wound Ostomy Continence Nurs. Assess the patient mental state to follow instructions. More frequent cleaning and disinfection may be required based on level of use. It is basically an aseptic technique using clean gloves and no direct wound contact (except minimally to blot excess fluid away with dry gauze). 2018 May/Jun;45(3):265-269. doi: 10.1097/WON.0000000000000425. Thank goodness for clean gloves (and may there be plenty of them). Maintaining personal, patient and environmental hygiene is a basic clinical skill that this post will discuss particularly the infection process and infection control. 7. Of course I … 6. 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. [Clean field-technique to reduce the local air contamination level in operating rooms. 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. To list a few: Procedure To Promote A Clean Dressing Technique All dressing supplies should be stored off the floor, away from heat or light, and secure from pets. Our mission is to empower resource-limited cannabis companies by providing comprehensive manufacturing infrastructure - fortified by a commitment to … Johns Hopkins Nursing Evidence-Based Practice Nursing Research Appraisal Tool was used to rate the quality of the evidence. The non-touch technique is incorporated as part of a clean … Clean vs. sterile dressing techniques for management of chronic wounds: a fact sheet. Check the physician’s order for any specific instructions. 2018;45(3):265-9. 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. "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 ineffective cleaning of IV ports, ine… Comparing outcomes of one technique with the other is of interest, but what about the actual technique and how well is it actually practiced? 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. 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. What is accepted as a clean technique in a patient’s home may not be deemed sufficiently clean enough in the hospital environment. 3. Comment in J Wound Ostomy Continence Nurs. About the Author Refer to the Legal Notice for express terms of use. insertion and care of central venous catheters. 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. 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. Pitfalls And Problems of Clean Dressing Technique Remove apron, folding it away from the person, the soiled side in and the clean side out. Aseptic versus Clean Technique. I was reminded of a visit to a patient to utilize a fancy new dressing that I had never used before. 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.  |  Because patient situations are unique, particularly in the home, the structured guidelines one finds for wound cleansing and dressing are not universally applicable. 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. Barber LA. References Between the cats, dogs, birds, phones ringing, and neighbors dropping by, sterile technique has no place in home health care. Check the articles available in patients unit. 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 will normally be a full aseptic technique for acute wounds and a clean technique for leg ulcers. Wound, Ostomy and Continence Nurses Society (WOCN) Wound Committee, et al. 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. It has received the most views of any blog posted on WoundSource within the last year. 1. NLM The outer surface of the dressing should not be touched by gloves used to clean the wound. The wound, any supplies, and the environment should not be contaminated by each other. Can J Plast Surg. HHS Once the urine is drained the catheter is removed. A ‘clean technique’ can be classed as medical asepsis or standard aseptic technique, as it uses the … Future research should address this area and explore whether sterile technique is more likely than clean technique to … Medicine, adapted by Gray and colleagues. Sterile versus clean technique in postoperative wound care of patients with open surgical wounds: a pilot study J Wound Ostomy Continence Nurs . Clean surfaces using soap and water, then use disinfectant. Utilization of Barriers. : September-October 2008 - Volume 6 - Issue 5 - p 30-31. Correctly performed, CIC can also reduce the risk of urinary tract infections (UTIs) and promote continence.This guideline does not refer t… Unfallchirurgie. 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. Examples of clean techniques include washing hands and putting on clean gloves when needed. 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. 2. I particularly appreciated the comment that nurses need to decide which approach to have by using critical thinking skills. 2002 Jul;29(4):173. doi: 10.1067/mjw.2002.125454. Please enable it to take advantage of the complete set of features! Secondary dressings can be an effective tool to protect the primary dressing or provide additional functionality beyond the primary dressing. J Wound Ostomy Continence Nurs. He/she should use personal protective equipment appropriately and wash hands before and after removal. 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. Fresh clean gloves should be worn to tuck or pack a primary dressing into a wound. Provided a primary dressing is dry and not contaminated, it may be kept for the same patient's next dressing change. 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? © 2008-2020 Kestrel Health Information, Inc. All rights reserved. Does the Use of Clean or Sterile Dressing Technique Affect the Incidence of Wound Infection? J Wound Ostomy Continence Nurs. Gloves used for wound care should not be stored in the bathroom or under a sink. Hydrocolloid or foam dressings can provide protection for the wound area and manage excess exudate. The nurse should use the appropriate dressing technique. 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 … Remove apron, folding it away from the person, the soiled side in and the clean side out. Aspect Aseptic Technique Clean 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. Fold the lining, place it inside the bag and close the bag 4. 5. 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. It does allow for using spray wound cleansers and keeping a portion of a dressing for the next dressing change. 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). To present an update on the status of information about clean versus sterile dressing technique to manage chronic wounds. The nursing profession must determine whether sterile technique or clean technique provides the best quality of care without increasing costs. 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. (7) Position the sterile solution basin on the sterile drape against the area of … Fresh clean gloves are required if it is necessary to touch the wound directly. 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. Having read a recent article on clean versus sterile dressing technique, commenting again on this issue seems highly appropriate. Findings: All 4 studies reported no significant difference in the rate of wound infection when using either clean or sterile technique with dressing application. Basic wound cleaning step by step. Personally critically analyzing the dressing technique you use is essential to optimal care. It is defined by Kent et al. Disinfecting kills germs on surfaces. You are never going to risk the client's health by providing sterile wound care. Wound, Ostomy and Continence Nurses Society (WOCN) Wound Committee; Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) 2000 Guidelines Committee. Clinical experiences in accident surgery (author's transl)]. 2006 Spring;14(1):25-7. doi: 10.1177/229255030601400110. Clean versus sterile gloves: which to use for postoperative dressing changes? 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. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 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. 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. This means it should be cut with clean scissors, stored in the original package, dated, and fully secured in an appropriately sized bag. Ten years ago, Nursing Timesfeatured an article on a new practice framework for aseptic practice called Aseptic Non Touch Technique (ANTT) (Rowley, 2001). Clean technique. 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. 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. These gloves should not contact anything other than the wound or the sterile products being used on it. Contamination of the wound is minimized by not touching it. 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. Johns Hopkins Nursing Evidence-Based Practice Nursing Research Appraisal Tool was used to rate the quality of the evidence. Assess whether perineal care should be done under an aseptic technique or a clean technique. NIH Nursing Made Incredibly Easy! Looking at the technique in detail has been lacking. This site needs JavaScript to work properly. 2012 Mar-Apr;39(2 Suppl):S30-4.  |  Requires the use of various barriers to. This applies to. The aim of using aseptic technique is … 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. 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. 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. 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. When dressing wounds the nurse should practice good hand hygiene. 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