Policy Manual sample

MDT Home Health Care Agency, Inc. 71 JEJUNOSTOMY TUBE STABLIZATION AND DRESSING CHANGES PURPOSE: Jejunostomy tubes are stabilized to prevent erosion of the skin around the tube, to prevent tube migration or to prevent accidental removal. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: • Exam gloves • Skin prep if ordered • Bag for soiled dressing • Antiseptic cleanser as ordered by physician or • 4x4 gauze soap and water • Tape GENERAL CONSIDERATIONS: 1. There are a variety of jejunostomy tubes; some may be anchored internally. Tubes that are not have the greatest potential to migrate in or to fall out. Physicians may choose to anchor tubes by suturing them to the abdomen. Sutures may loosen and alter the skin integrity and comfort for the patient. 2. Jejunostomy stoma site care for new, infected or draining wounds or suture sites may require individualized wound care protocol according to physician’s orders. Healed stomas can be cleansed with soap and water. PATIENT AND FAMILY EDUCATION: Education of the patient and caregivers should include tube stabilization procedures, purpose, potential problems or anchoring issues and s/s to report to agency nurse and/or physician. PROCEDURES: 1. Wash hands. Gather equipment. 2. Remove old dressing and discard. Inspect tube site for redness, swelling or drainage. 3. Cleanse around tube: • With a new stoma, site care protocol as ordered by the physician. • With a healed site, cleanse with soap and water, rinse thoroughly and pat dry. 4. Place dry gauze around tube. May tape down in window frame fashion. This may not be needed on a well healed site. 5. Secure tube with tape. Apply skin prep as ordered. •Place the piece of tape approximately 4 inches from stoma, perpendicular to tube, or • Place the piece of tape underneath tube, adhesive side up, approximately 4 inches From stoma. Then cross each end of tape over top of tube and adhere it to patient's abdomen, forming V shape with base of V pointing away from stoma. 6. Store equipment. 7. Remove gloves. Wash hands.