Policy Manual sample

MDT Home Health Care Agency, Inc. Standards and Practice Drainage Procedure – all of the equipment should be found in the dressing pack. • Ensure the patient is comfortable and fully informed about the procedure. • Wash hands. • Open dressing pack and drainage bottle. • Wearing disposable gloves, remove the dressing. • Wash hands • Put on sterile gloves • Clamp drainage bottle. • Remove cover from access tip on drainage bottle. • Remove catheter cap from catheter. • Using sterile alcohol swabs, wipe the end of the catheter. • Insert access tip into catheter until you hear and feel a click. • Release both clamps. • Drain slowly. It is recommended that you limit a single drainage to no more than 1000mls. • Drain fluid until it stops draining. If patient experiences pain, excessive coughing or becomes breathless, stop draining. Administer analgesia if required/ordered. • Clamp bottle. • Remove drainage line from catheter. • Place sterile cap on the end of the catheter (a new cap each time). • Position the pad around the catheter. • Wind the catheter around the pad. • Cover with gauze • Secure with vapour-permeable adhesive film. Do not apply film directly to the catheter. • Dispose of all equipment in the appropriate bag for clinical waste. Considerations: Indwelling pleural catheters are inserted to drain pleural fluid and relieve breathlessness, stop re- admission into hospital for repeated pleural aspirations and improve quality of life. Sutures are to be removed from incision site after 7 days post line insertion (if ordered). The sutures around the line itself should be removed 3 weeks post line insertion (ask for orders). Change in colour of pleural fluid: if the pleural fluid were to become cloudy then take a sample of fluid. (If ordered) Redness: If redness develops around the line then swab the area, check vital signs. If redness increases or patient feels unwell, contact patient’s MD, and the Agency. Drainage: Catheter to be drained 3 times weekly (for the first 3 weeks, ask for orders). Record fluid drained on the monitoring sheet. Generally : patients have their pleural catheter drained 3 times a week for the first 3 weeks, then twice weekly for a couple of weeks (ask for orders). If pleural fluid continues to diminish, drainage becomes weekly – fortnightly. If no fluid has been drained on 2 – 3 occasions, contact Patient’s Physician for Home Health Agency Nursing Care & Procedures K-208