HHC Health & Home Care Clinical Policy And

More documents

Recommendations

Info

HHC HEALTH & HOME CARE Section: 7-10 Skin Care: Wound Irrigation __RN a. Reporting any changes in pain, drainage, temperature, or other signs and symptoms of infection. b. Techniques to change or reinforce dressing, if indicated. c. Diet to promote healing. d. Medications/disease processes that may be impeding healing. e. Activities permitted. 118
HHC HEALTH & HOME CARE Section: 7-11 Skin Care: Suture Removal __RN PURPOSE: To remove sutures after healing has occurred. CONSIDERATIONS: Although the physician orders the removal of nonabsorbable sutures, there are general guidelines for timing removal based on location: head and neck, 3 to 5 days; chest and abdomen, 5 to 7 days; lower extremities, 7 to 10 days after insertion. EQUIPMENT: Suture removal tray or sterilized pick-up forceps and suture scissors Alcohol or antimicrobial sponges Impervious trash bag Dressing and tape Butterfly strips Skin protectant (optional) Gloves PROCEDURE: 1. Adhere to Universal Precautions. 2. Explain procedure to patient. 3. Follow clean technique, remove all dressings, and discard in appropriate containers. 4. Examine the wound before removing sutures. 5. Observe the wound for gaping, drainage, signs of infection, or embedded sutures. Ensure that proper healing has taken place and it is time to remove the stitches. 6. Position the patient so that the suture area is without tension. 7. Assemble the necessary equipment at the bedside and open sterile instrument set. 8. Cleanse suture area thoroughly with antimicrobial sponges. 9. To remove interrupted sutures: a. With forceps, grasp the knot of suture with gentle upward pull to slightly expose a small segment of the suture that was below the skin. Cut exposed suture on the opposite side of the knot. No segment of the stitch that is above the skin's surface is to be drawn below or through the skin. b. Still holding the knot, pull the cut suture up and out. Discard suture. c. Remove every other suture along the incision line and observe for any gaping of the wound. If gaping occurs, do not remove any of the remaining sutures, approximate edges, apply butterfly strips, and notify the patient's physician. (See Butterfly Strips, No. 7.17.) If no gaping, continue removal until all sutures have been removed. 10. To remove plain, continuous sutures: a. Grasp the first suture and cut that suture on the opposite side of the knot. b. Cut the next suture in line on the same side. Pull the first suture out in the direction of the knot. Discard the suture. 11. After any suture removal: a. Cleanse the suture line with a sponge. b. For incision line support, prevention of a wide scar, or slight skin separation, butterfly strips may be used. Use skin protector to increase length of strips' adherence. Strips may be left in place 3-5 days. 12. Apply dry, sterile dressing secured with tape, if needed. 13. Discard soiled supplies in appropriate containers. AFTER CARE: 1. Document in patient's record: a. Procedure and observations. b. Patient's response to procedure. 2. Instruct patient/caregiver in care of healing incision line, including: a. Reporting redness, discharge, or other signs of infection. b. Changing the protective dressing. c. Showering or bathing, when permitted by physician. d. Protecting the incision line from direct sunlight for at least six months. 119
Page 1 and 2:
HHC Health & Home Care Clinical Pol
Page 3 and 4:
Title Procedure Page 4.06 Gastroint
Page 5 and 6:
Title Procedure Page 9.16 Infusion
Page 7 and 8:
Title Procedure Page 14.14 Emergenc
Page 9 and 10:
HHC HEALTH & HOME CARE SECTION: 1-2
Page 11 and 12:
Page 13 and 14:
HHC HEALTH & HOMECARE SECTION: 1-4
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
HHC HEALTH & HOME CARE Respiratory:
Page 43 and 44:
HHC HEALTH & HOME CARE Section: 3-1
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
HHC HEALTH & HOME CARE Cardiac Refe
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
HHC HEALTH HOME CARE Section: 4-5 G
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
HHC HEALTH & HOME CARE Gastrointest
Page 71 and 72:
HHC HEALTH & HOME CARE Section 5-2
Page 73 and 74: HHC HEALTH & HOME CARE Section 5-4
Page 75 and 76: HHC HEALTH & HOME CARE Section: 5-6
Page 95 and 96: HHC HEALTH & HOME CARE GenitoUrinar
Page 123: HHC HEALTH & HOME CARE Section: 7-1
Page 139 and 140: HHC HEALTH & HOME CARE Skin Care: R
Page 159 and 160: HHC HEALTH & HOME CARE Medications:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Infusion Therapy Section: 9-17 Infu
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
HHC HEALTH & HOME CARE Infusion The
Page 231 and 232:
HHC HEALTH & HOME CARE Section: 10-
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Name: Vitamin? Yes No Brand: Date P
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
HHC EHALTH & HOME CARE Section: 13-
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
Page 315 and 316:
Page 317 and 318:
Page 319 and 320:
Page 321 and 322:
Page 323 and 324:
Page 325 and 326:
Page 327 and 328:
Page 329 and 330:
Page 331 and 332:
Page 333 and 334:
Page 335 and 336:
Page 337 and 338:
Page 339 and 340:
Page 341 and 342:
Page 343 and 344:
Page 345 and 346:
Page 347 and 348:
Page 349 and 350:
Page 351:
HHC HEALTH & HOME CARE General Prac
show all

HHC Health & Home Care Clinical Policy And

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?