Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

333

Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 15-7

Changing the Dressing and Flushing

Central Venous Access Devices

Goal:The dressing is changed and the CVAD flushed with the

patient remaining free of signs of infection. Comments

1. Verify the medical order and/or facility policy and
   procedure. Often, the procedure for CVAD flushing and
   dressing changes will be a standing protocol. Gather
   equipment and bring to bedside.


2. Perform hand hygiene and put on PPE, if indicated.


3. Identify the patient.


4. Close curtains around bed and close the door to the room,
   if possible. Explain what you are going to do and why you
   are going to do it to the patient. Ask the patient about
   allergies to tape and skin antiseptics.


5. Place a waste receptacle or bag at a convenient location for
   use during the procedure.


6. Adjust bed to comfortable working height, usually elbow
   height of the caregiver (VISN 8 Patient Safety Center,
   2009).


7. Assist the patient to a comfortable position that provides
   easy access to the CVAD insertion site and dressing. If the
   patient has a PICC, position the patient with the arm
   extended from the body below heart level. Use the bath
   blanket to cover any exposed area other than the site.


8. Apply a mask. Ask patient to turn head away from access
   site. Alternately, have the patient put on a mask. Move the
   overbed table to a convenient location within easy reach.
   Set up a sterile field on the table. Open dressing supplies
   and add to sterile field. If IV solution is infusing via CVAD,
   interrupt and place on hold during dressing change. Apply
   slide clamp on each lumen of the CVAD.


9. Put on clean gloves. Assess CVAD insertion site (for inflam-
   mation, redness, and so forth) through old dressing. Note
   the status of any sutures that may be present. Remove old
   dressing by lifting it distally and then working proximally,
   making sure to stabilize the catheter. Discard dressing in
   trash receptacle. Remove gloves and discard.

Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

ExcellentSatisfactoryNeeds Practice