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UNIT 4 Supporting Physiological Functioning
Procedure 32-10 ■ Applying Binders (continued)
Home Care ■ Teach the patient and/or caregiver how to apply the binder in the proper position, snugly but not too tightly. ■ Teach the family to inspect the site under the binder to be sure the skin is not pinched or with other points of pres- sure.This is especially crucial for older adults. ■ Clean binders in warm, soapy water when soiled. Use a mesh laundry bag to keep the Velcro straps from catching other clothing in the washer. Air-dry thoroughly. Patients should have two binders at home—a clean one to wear while the other is laundered. ■ Apply and remove binder to promote comfort and ensure good circulation.This also allows the patient and caregiver to inspect any incision or wound underneath. ■ Binders for children at home could be decorated with per- manent marking pens. ■ Allow children to help with applying and removing the binder.
Documentation Document the following information (many agencies use spe- cialized wound care flow sheets): ■ Appearance and location of the wound or incision under the binder, type and amount of exudates, and odor, if pres- ent, after cleansing ■ Pain level before and after the procedure. If the patient has been medicated for pain, document the drug and dose used, time given, and patient response. ■ Type of binder applied ■ Date and time the binder was applied and removed ■ Any change in the appearance of the wound or skin in con- tact with the binder ■ Education provided to the patient
Procedure 32-11 ■ Applying Bandages ➤ For steps to follow in all procedures, refer to the Universal Steps for All Procedures on the inside back cover.
■ Assess the condition of the wound (if one is present). Assess the wound for size (length, width, and depth in cen- timeters); location and depth of undermining or tunneling; amount, character, and odor of drainage; type and percent- age of tissue present in wound bed (granulation, slough, fibrin, necrotic); and periwound condition (intact, denuded, erythema, induration, or maceration). Wound dressings should be chosen based on the characteristics of the wound. ■ Assess for pain and check the circulation of the underlying body parts before and after applying the bandage. Look for cool, pale, or cyanotic skin; tingling; and numbness. Circulation to an extremity can be compromised if the bandage is too tight or the extremity swells after application. ■ Determine whether the patient or family has the skills to
Equipment ■ Appropriate bandage dressing ■ Clean nonsterile gloves (2 pairs) ■ Gauze sponges ■ Normal saline ■ Primary dressing (as prescribed) ■ Scissors ■ Tape or metal closures
Delegation This procedure may be delegated to a UAP who has the appropriate training. Assessment of the incision line or wound is a licensed professional’s responsibility and cannot be delegated. Preprocedure Assessment ■ Determine the body part or area to be bandaged. This allows you to choose the correct width of gauze or elastic ban- dage to use.
reapply the bandage when necessary. Teaching might be needed for home care.
➤ When performing the procedure, always identify your patient according to agency policy, using two identifiers, and be attentive to standard precautions, hand hygiene, patient safety and privacy, body mechanics, and documentation.
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