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There are a variety of clinical skills that nurses perform as a part of their duties. This essay is focused to appraise the performance of basic wound care and dressing using the aseptic non-touch technique (ANTT). This procedure is undertaken in a wide variety of different environments (Clare & Rowley, 2017). This is a hospital-based scenario. The scene for safety has been analyzed and dynamic risk assessment has been undertaken. Also, balanced and constructive feedback has been provided here with the appropriate rationale.
It was noticed that the nurse confirmed the patient ID properly and also checked the patient for allergies including allergies to adhesives, latex, and plasters very efficiently. She impressively introduced herself to the patient and explained articulately about what she was doing and asked for the consent. She should have ensured that the patient had privacy by checking the curtains that should have been pulled closed. Additionally, she could address any issues around the hygiene and security of the clinical environment thereafter. She efficiently checked if the patient was feeling any pain and that he/she was comfortable before starting any procedure (“Does the Use of Clean or Sterile Dressing Technique Affect the Incidence of Wound Infection,” 2018).
Her bedside manner is highly appreciated as she ensured a visible inspection of the wound dressing sites including the bed linen. Also, she verbalized what she had seen and stated that these would not need to be changed. Before collecting the articles required for the dressing, she appreciably washed her hands using the seven-step hand washing technique. She could either ensure if the trolley had been cleaned in the last 24 hours with soap and water or ask the assessor to confirm that. Also, she should have worn an apron additionally to ensure extra protection from thee microorganisms. Although she wiped the surface of the trolley with the wipes, yet she could apply a pre-set technique of wiping down the trolley i.e., from the farthest point to the nearest point. After wiping down the trolley, she carefully disposed of her gloves and cleaned her hands again (Isaac et al., 2019).
She thoroughly checked the inventory of items and ensured that all the items were intact, not wet and there were no holes or tears. She could confirm the expiry date on any packaging before placing the items on the bottom shelf of the clean trolley. Also, she should check that there is no precipitate in the saline cleaning solution. She properly disposed of her gloves and cleaned her hands before taking the articles to the bedside. Moreover, she only touched the legs of the trolley, and not the shelf directly while taking the trolley (Jones, 2014).
It was noticed that the handwash bottle was in the aseptic area due to which she contaminated the area primarily with the bottom of that bottle. Instead, she should keep that bottle out of the aseptic area. While primary dressing, she accidentally touched the top of the bin while disposing which is highly unwanted. Also, it is prescribed that everything should be inside the aseptic sheet, at least 1 inch inside from the edge (Sonoiki et al., 2020).
One must never lean over a sterile field or mix the forceps. One forceps stay in the sterile field and the other remains outside to clean the wound. That's why all gauze must be prepared before taking one of the forceps out of the sterile field. Moreover, saline and island dressings should be opened away from the sterile field to avoid contamination on the outside packaging. Instead of using two forceps of similar colour use different coloured forceps to distinguish. For instance, the yellow forceps could be used for arranging the equipment and the blue forceps to place the sterile towel. Then, the blue forceps should be kept back to prepare the sterile gauze dry and wrung out wet gauze. One blue forceps then becomes the dirty one. Then, she could pass the clean gauze to the dirty one making sure they do not contact or leave their designated zones (e.g., Left blue forceps remains within the sterile and the right one remains outside the field). Also, gloves are not required beyond the dressing change as long as the aseptic 30-60s hand wash has been followed. In summary, she must strictly consider working within the sterile field only (Clare & Rowley, 2017).
It is hereby concluded that the bedside manner conducted by Lucy was good throughout and can be improved as stated above. She tried her best to ensure that the patient is comfortable and also explained that how can the patient reach in case of any problem encountered. However, she should highly take care of the cleanliness and must strictly work within the sterile fields only. Additionally, it is the best practice is to state that any documentation left would be completed and specify that ANTT is used extensively.
Clare, S., & Rowley, S. (2017). Implementing the Aseptic Non-Touch Technique (ANTT®) clinical practice framework for aseptic technique: a pragmatic evaluation using a mixed methods approach in two London hospitals. Journal of Infection Prevention, 19(1), 6– 15. https://doi.org/10.1177/1757177417720996
Does the Use of Clean or Sterile Dressing Technique Affect the Incidence of Wound Infection? (2018). Journal of Wound, Ostomy and Continence Nursing, 45(3), E1. https://doi.org/10.1097/won.0000000000000437
Isaac, R., Einion, A. B., & Griffiths, T. H. (2019). Paediatric nurses’ adoption of aseptic non- touch technique. British Journal of Nursing, 28(2), S16–S22. https://doi.org/10.12968/bjon.2019.28.2.s16
Jones, M. L. (2014). 2.5 Aseptic technique and aseptic non-touch technique. British Journal of Healthcare Assistants, 8(3), 113–115. https://doi.org/10.12968/bjha.2014.8.3.113
Rowley, S., & Clare, S. (2019). Standardizing the Critical Clinical Competency of Aseptic, Sterile, and Clean Techniques with a Single International Standard: Aseptic Non Touch Technique (ANTT®). Journal of the Association for Vascular Access, 24(4), 12–17. https://doi.org/10.2309/j.java.2019.004.003
Sonoiki, T., Young, J., & Alexis, O. (2020). Challenges faced by nurses in complying with aseptic non-touch technique principles during wound care: a review. British Journal of Nursing, 29(5), S28–S35. https://doi.org/10.12968/bjon.2020.29.5.s28
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