Policy Manual sample

MDT Home Health Care Agency, Inc. b. Secure the lines if needed. c. Wash hands for 10-15 seconds or use alcohol based substitute. d. Apply mask and non-sterile gloves. e. Remove existing dressing gently and inspect the site. f. Remove gloves and wash hands then don sterile gloves. g. Disinfect the skin at the insertion site with an appropriate antiseptic solution, working out no more than 6 inches. i. A 2% Chlorhexidine gluconate (CHG) is the preferred antiseptic solution.*If the patient is allergic to Chlorhexidine Gluconate, use alcohol and betadine to clean and disinfect the site. Note: Chlorhexidine (ChloraPrep) is not to be used on infants under 2 months. ii. Pinch the applicator “wings”, releasing antiseptic onto its sponge pad and apply using a back and forth friction scrub for 30 seconds. Then allow to dry for 30 seconds. iii. For “wet” areas (central lines in the groin area, around tracheostomy sites, non-tunneled jugular or subclavian catheters), perform the friction scrub for 2 minutes and allow solution to dry for 2 minutes. h. Apply Tincture of Benzion or skin protectant around perimeter of disinfected site to improve adherence of the dressing and let dry. i. Apply a Tegaderm IV dressing over the insertion site allowing at least a 1 inch -1.5 inch occlusive perimeter. Overlap and pinch the dressing to assure occlusiveness around tubing. Reinforce the dressing as needed to assure an occlusive dressing. Sterile steri-strips may be used under a transparent dressing. j. Label the dressing with the date, time and initials. k. Document the dressing change on the treatment sheet. Home Health Agency Nursing Care & Procedures K-239