Nursing - IV Dressing Issues Term Paper

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However, when ad-hoc methods meant to maintain the former conflict with protocols necessary to ensure the latter, the consequences can be compounded by the anaerobic environment under the dressing that promotes more rapid bacterial infection instead of protecting the wound site from external bacterial contamination (Fitzpatrick 1997).

Protocol Compliance Issues in Antisepsis of Intravenous Dressings: Wound dressings are provided in sterile packages and when applied with proper care and adherence to antisepsis protocol, help ensure that wound sites are protected from bacterial infection. However, when protocols are violated, whether accidentally, through oversight, or negligently, wound dressings represent significant vulnerabilities to infection via external contamination. Sometimes, techniques and procedures that are meant to solve other problems introduce increased risks to the antiseptic integrity of the wound site. For example, it is common practice to increase the absorbency of sterile gauze pads by simply doubling them over in half. While this does increase absorbency, it does so at the expense of significantly increasing the potential exposure of the wound to bacterial contamination.

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Whereas placing a full size gauze pad over a wound is easily accomplished without touching the wound-side surface of the pad, doubling the pad over without touching the eventual wound-side surface is nearly impossible, especially in actual practice when the practitioner is doing several things at once. Notwithstanding the protection of sterile gloves, virtually all change-of-dressing procedures involve coming into contact with the patient's skin and bedding, such as while rolling up a sleeve or straightening a limb for access. Even experienced practitioners underestimate the danger posed by Staphylococcus Aureus and Gram-Negative Bacilli transmission via this mechanism, for which the epidermis provides fertile ground, and which account for as many as one-half of all catheter devices infections, for example (NursingLink 2007)......

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