Policy Manual sample

MDT Home Health Care Agency, Inc. 149 FOR SILVER NITRATE STICKS: A) Prep the wound with cleanser or saline to moisten the wound. B) The silver nitrate stick is placed at the junction of granulation and scar tissue and applied around the wound at the wound edges to keep wound edges open. C) Silver nitrate may also be applied to hypergranulation tissue or proud flesh at the point where granulation has grown higher than the skin level. D) Normal reactions to silver nitrate is darkening of the skin and skin sloughing or the reduction of hypergranulation tissue to be level with skin surface. FOR WET TO DRY DRESSINGS, ENZYMATIC OINTMENTS, CHEMICAL SOLUTIONS OR OCCLUSIVE OR NON-OCCLUSIVE DRESSINGS: A) Crosshatching may be indicated with the initial dressing change. B) Prepare the supplies. C) Cleanse the wound as ordered by physician. D) Apply topical dressings as indicated by physician order and/or manufacturer directions. E) Frequency of the dressing change may be indicated by strike thru drainage, manufacturer directions or physician order. F) May need to protect the peri-wound with moisture barrier to prevent maceration of peri- wound and damage to surrounding skin. G) Silver nitrate sticks may need to be used to open wound edges as scar formation begins. 5) Perform procedures as ordered. 6) Dispose of equipment per policy. 7) Wash hands. DOCUMENTATION: Document the procedure, including description and measurement of the wound, amount of drainage, description of drainage, type of dressing and tolerance of the procedure on the Clinical visit note. Also document any teaching performed and the response by the patient or caregiver to the instruction. If further action is indicated, document follow-up/notification of clinical manager and/or physician. Wound photograph may be indicated ____________________________________________________