Nursing Skill Check: Chest Tube Dressing Change

Review the proper technique and procedure needed to change chest tube dressing here.

West Coast University students, you can find the Checklist and Reference Guide links below:
http://www.westand4health.com/blackboard/video_resources/Chest_Tube_2020.pdf
http://www.westand4health.com/blackboard/video_resources/CHEST_TUBE_SRG_2020.pdf
"Replacing a chest tube insertion site dressing - before beginning this procedure always perform the following steps to ensure patient safety. Perform hand hygiene, provide patient privacy, introduce yourself, use to patient identifiers, verify allergy status, perform environmental safety check, ensure proper body mechanics, gather all supplies, provide patient education, verify MD order, assess for procedure need and explain procedure, educate patient about the rationale of procedure and associated adverse reactions. Materials needed to replace a chest tube insertion site dressing - sterile drape, gloves, absorbent pad, biohazard bag, sterile gloves, chlorhexidine swab, xeroform, split sponge dressing, 4x4 gauze pads microphone tape, tape. Assemble supplies before entering patient's room. The Procedure - assess patients pain level, raised bed height, lower head of bed, assess close chest drainage system. Don gloves and mask, position patient on unaffected side,
place linen saber pad beneath patient, remove dressing. Note color, consistency and amount of
drainage on dressing, discard dressing and appropriate receptacle, observe chest tube insertion site for any abnormalities including redness, swelling, pain, subcutaneous emphysema and excessive or unusual drainage, remove gloves, perform hand hygiene, setup sterile field. Remember to maintain sterile technique throughout the procedure. Open still xeroform petrolatum dressing and place it next to the sterile field. Don sterile gloves. Clean around insertion site with antiseptic. Clean line with new antiseptic. Remember not to cross the sterile field when disposing items in the appropriate receptacle. Place sterile petrolatum gauze around the chest tube at insertion site. Place drain pad across chest tube. Place split gauze opposite of one another. Use gauze pads around chest tube to create even surface. Place tape against chest wall adjacent to chest tube. Place end of tape firmly against chest wall on opposite side of chest tube. Repeat until entire dressing is covered and sealed. Assess patient and provide comfort. Discard soiled materials."

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