Policy Manual sample

MDT Home Health Care Agency, Inc. 144 VAGINAL PACK REMOVAL PURPOSE: Safe removal of packing which has been inserted into the vaginal orifice for the purpose of administering medication, absorbing blood or applying pressure to the cervix and vaginal wall will be performed only upon specific physician's order and only when there is no risk of excessive bleeding. After removing the packing, the nurse should observe for signs of inflammation, infection and increased bleeding. Any unfavorable signs should be reported to the physician. The patient or caregiver should be instructed to report purulent discharge, pain or increased vaginal bleeding to medical personnel. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: • Kelley clamp (as needed) • Disposable gloves • Washcloth • Soap • Chux pad • Towel • Sanitary pad PROCEDURE: 1. Explain procedure to the patient. 2. Escort the patient to a private area and screen for privacy. 3. Wash hands. 4. Have the patient lie on her back with her knees flexed and the hips rotated laterally. 5 . Place Chux pad beneath patients hips. 6. Drape the patient. Expose perineum only. 7. Put on disposable gloves. 8. Grasp the end of the packing. Pull it gently, gradually and firmly forward out of the vagina. A Kelley clamp may be needed. 9. Inspect the package for the presence of drainage. Note amount, color and any other particularity. 10. Place packing in plastic bag for disposal. 11. Clean the perineum and apply sanitary pad if needed. 12. Remove gloves. Wash hands. DOCUMENTATION: Document that the packing was removed and describe the character and amount of drainage on tile Clinical Visit Note. Document any intervention that was initiated and any teaching that was performed. ____________________________________________________