Procedure And Incidents During Placement

Procedure And Incidents During PlacementThis reflective piece get out be about a mental process that took place whilst on status and will look at infection control whilst doing an infertile non-touch technique (ANTT). victimization Atkins and Murphys 1993 model of reflection (Rolfe, G et al 2001). I pee apply this model as it helped me become aw argon of my actual thoughts and feelings regarding the situation, and more focussed when analyzing it.DescriptionI visited a lady who had bilateral leg wounds that involve to be dressed daily, the leg book bindings that had been put on the day to begin with were heavily exudated, the lady who I am going to call Jane to hold dear her identity as per NMC 2004 was adamant that she had kept her legs raised. The take for that I was functional with said that she would dress the legs this time and when I visited again I would do the dressings. The restrain opened the sterile packaging of gloves and placed it on the floor, this was to be her sterile plain stitch. The dressings and bandages that she required were opened and placed onto the sterile field and the go down on placed an apron over her uniform. The sterile gloves were put on and she proceeded to channelise the dressings that were on Janes legs, once the dressing had been removed these were placed into the waste bag.The nurse then proceeded to assess the wound and then redress it without changing her gloves, by non changing her gloves which were originally sterile these will now have become choked by handling the soiled dressing and would contaminate the new dressings and the wound.Stage OneWhilst watching the nurse change the dressing this made me question what I had been taught in University about ANTT. The procedure that we were taught in university is from The Royal Marsden 2008. This made me feel uncomfortable and question that the unhurried would be at risk of infection from health tutorship associated infections (HCAI).Stage TwoThe reason for unimaginative technique is to maintain asepsis and helps to protect the patient from HCAI it overly protects the nurse from any(prenominal) of the patients physical structure fluids and toxic substances (Department of Health (DOH) 2005). Elderly people are more at risk of infection which is caused by organisms that invade the immunologic defence mechanisms as there immune systems are less in effect(p) ( Calandra 2000) ANTT is used to ensure that when a healthcare professional handles sterile equipment solo the part of the equipment that will not contact the wound is handled (Preston 2005). When doing the ANTT procedure this involves ensuring that live with has been gained from the patient and they are aware of what the procedure will be, the environment and the equipment is prepared, hand-washing takes place, personalised protective equipment is used and a sterile field is maintain. In a Primary Care lay one of the biggest problems is infection that enters the body with a tear in the skin, this whitethorn be through a leg ulcer. A small number of microbes are sufficient nice for an infection to be caused, this may then be difficult to speak with antibiotics and what may have been a trivial problem may culmination up becoming a significant problem (DOH 2007). Nurses should assess the risk of transmission of infections from one person to other and plan their nursing care accordingly before they commence any form of action (Chalmers Straub 2006). paw washing prior to ANTT has been found to be the approximately important procedure for pr dismantleting infections, hands can be the biggest route of transmission of infection if not washed correctly (Akyol et al 2006). There have been recent studies that exhibit that hand washing is rarely carried out in a passable manner and 89% of staff misses some part of their hand out-of-doors during hand washing (Mcardle et al 2006). Handwashing should be through prior any procedure, this can be achieved by three different methods-Soap and weewee this is stiff in removing physical dirt or any dirtying and micro-organisms liquid soap is more efficient than a soap seal off (Ehrenkrantz, 1992).Anti-microbial detergent which is effective in removing physical dirt and is more effective than soap in removing micro-organisms (Ehrenkrantz, 1992).Alcohol base hand rubs, these are not as effective as the above in removing dirt or soil but are more effective in destroying pass(a) bacteria (Storr, J, Clayton-Kent, S, 2004).An aseptic procedure should be done in a clean environment and any equipment used should be sterile and spendable or decontaminated after each use and the nurse should ensure that the equipment is lax from dust and any other soilage (DOH 2003). Whilst the nurse does ANTT procedure it is essential that her hands, even though they have been washed, do not contaminate the sterile field or the patient, this is achieved by the nurse using sterile gloves she needs to be aware however that gloves can be damaged during use and may no longer be sterile (Kelsall et al 2006).The aim of eating away sterile gloves is to stiffen the risk of cross-infection from nursing staff to patients and to also reduce the transient contamination of the hands by micro-organisms from one patient to another (infection control Nurses Association (ICNA) 2002). The ICNA recommend that before a patient is inured a comprehensive risk assessment is taken to determine the most appropriate glove type for the task to be undertaken. Its been suggested that sterile gloves are only necessary if the nurses hands come into contact with the patients sterile body area, they argue that non-sterile gloves provide adequate infection control if hands decontamination has been done effectively (Hollinworth and Kingston 1998). Factors that need to be considered when making the choice in the midst of aseptic or clean technique for wound care is the setting where the dressing is to be done, the imm une status of the patient, this is influenced by age, medication, type of wound, pickle and depth of wound and the invasiveness of the procedure (APIC 2001).Hartley (2005) reports that aseptic technique is not universe carried out to a high standard and this could be related to the theory-practice dislocation or complacency in the professional field. Improving the skill based care needs to be the main focus on affix -registration education this includes which gloves to choose, maintaining a sterile field with the risk of non-touch technique and also developing assessment protocols (Preston 2005).Stage 3During my time on placement I cleaned and redressed a lot of wounds and I ensured that I used the antiseptic non touch Technique that was taught to me whilst at University. I ensured that I gained the consent of the patient prior to any procedure taking place and also maintained the clients privacy and dignity whilst carrying out the procedure.Whilst being on placement I have lea rnt that staff change the dressing on wounds using the aseptic non-touch technique differently to how I was taught in university but when questioning them why they do something a certain way they have a rationale for it. I will continue to clean and redress wound in the way I have been taught and believe that this is the way forward in fighting wound infections.