The charge nurse observes a new staff nurse who is changing a dressing on a surgical wound. After carefully washing her hands the nurse dons sterile gloves to remove the old dressing. After removing the dirty dressing, the nurse removes the gloves and dons a new pair of sterile gloves in preparation for cleaning and redressing the wound. The most appropriate action for the charge nurse is to:
A. Discuss dressing change technique with the nurse at a later date.
B. Congratulate the nurse on the use of good technique.
C. Interrupt the procedure to inform the nurse of the need to wash her hands after removal of the dirty dressing and gloves.
D. Interrupt the procedure to inform the staff nurse that sterile gloves are not needed to remove the old dressing.
Correct Answer: C. Interrupt the procedure to inform the nurse of the need to wash her hands after removal of the dirty dressing and gloves.
The staff nurse is doing two things incorrectly. Nonsterile gloves are adequate to remove the old dressing. The nurse should wash her hands after removing the soiled dressing and before donning sterile gloves to clean and dress the wound. Not doing this compromises client safety and should be brought to the immediate attention of the nurse.
Option A: Before discussion of dressing technique with the staff nurse, the charge nurse should ensure that the new nurse knows the proper infection control technique during dressing changes to prevent contaminating the client’s surgical wound.
Option B: Approval of an inappropriate technique would not lead to necessary changes. The new staff nurse needs further education on how to properly handle dressing changes for a surgical wound, especially the proper infection control techniques. If the new staff nurse demonstrates correct infection control technique and proper dressing changes, then the charge nurse may offer them praise for their work and diligence.
Option D: Nonsterile gloves are adequate to remove the old dressing. However, the use of sterile gloves does not put the client in danger so discussion of this can wait until later. Proper infection control technique is of utmost importance during dressing changes of a surgical wound to avoid complications.