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CENTRAL VENOUS CATHETER DRESSING CHANGE
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| SUPPLIES | PROCEDURE |
| • ExSept Plus Solution • (1) Sterile package of 2x2 gauze pad • (2) Sterile 4x4 gauze pads (Two sterile 2x2 gauze pads can be substituted) • Chux sheet • (2) Sterile fields or sterile underpads • Sterile gloves • Non-sterile gloves • Dressing: occlusive or non occlusive according to clinic protocol • Staff face shield • Patient mask |
• Patient should don a face mask. Staff member should wash hands and use appropriate PPE. • Place under pad under the catheter. Open sterile field onto a newly cleaned surface or chux sheet. • Carefully open 2x2, 4x4 gauze pads and dressing onto sterile field. • Saturate gauze pads with ample amounts of ExSept Plus. (4x4: 8 - 12 ml; 2x2: 3 - 5 ml) • Staff should put on clean non-sterile gloves. • Carefully remove old dressing from the catheter site and discard. • Assess exit site according to clinic protocol. • Remove non-sterile gloves. • Staff should wash hands and put on sterile, or clean non-sterile gloves before cleaning exit site. • Take one of the ExSept Plus saturated 4x4 gauze pad and clean exit site starting at the center and move in a circular motion outwards to a radius of at least 2 inches from the exit site. • Repeat with the second ExSept Plus saturated 4x4 gauze pad. • Wait two minutes for site to dry. • Place sterile 2x2 gauze pad over the exit site, then place the dressing taking care not to kink the catheter. |
| PREPARATION OF GRAFT/FISTULA FOR CANNULATION | |
| SUPPLIES | PROCEDURE |
| • ExSept Plus Solution • (2) packages of sterile 2x2 gauze pads • Chux sheet • Non-sterile gloves • Staff face shield |
• Have the patient wash their access site prior to sitting in the dialysis chair. Staff member should wash hands and use appropriate PPE. • On a clean chux sheet or under pad carefully open both packages of sterile 2x2 gauze pads keeping pads on sterile wrappers. • Saturate both sets of 2x2 gauze pads with ample amounts of ExSept Plus (3 - 5 ml). • Put on clean non-sterile gloves. • Take one saturated ExSept Plus 2x2 gauze pad and clean the exit site starting at the center and moving in a continuous circular motion outwards to a radius of at least 2 inches covering the insertion site. • Take the second ExSept Plus saturated 2x2 gauze pad and clean the venous site starting at the center and moving in a circular motion outwards to a radius of at least 2 inches covering the insertion site. • Wait 2 minutes before cannulating. • Initiate dialysis treatment as per clinic protocol. |
| PERITONEAL DIALYSIS EXIT SITE DRESSING CHANGE | |
| SUPPLIES | PROCEDURE |
| • ExSept Plus Solution • Sterile 4x4 gauze pads • Sterile cotton swabs • Chux sheet • (2) Sterile fields or underpads • Sterile gloves • Non-sterile gloves • Dressing: occlusive or non occlusive according to clinic protocol • Staff mask • Patient mask • Tape |
• Patient should don a face mask. Staff member should wash hands and use appropriate PPE. • Staff should put on non-sterile gloves, and assist the patient with placing a sterile under pad beneath their catheter. • Open sterile field onto newly cleaned surface or chux sheet. • Carefully open 4x4 gauze pads, cotton swabs and dressing onto sterile field. • Saturate 4x4 gauze pads and cotton swabs with ample amounts of ExSept Plus (8 - 12 ml). • Assess exit site according to clinic protocol. • Remove non-sterile gloves, wash hands, and put on new sterile gloves. • Using sterile cotton swab, remove dried blood and exudates from the exit site. Discard old swab and use new swab to repeat until exit site is clean. • Take (1) one ExSept Plus saturated 4x4 gauze pad and clean the exit site starting at the center and moving in a circular motion outwards to a radius of at least 2 inches from the exit site. Repeat with a new ExSept Plus saturated 4x4 gauze pad until the site is clean. • ExSept Plus must remain on the skin for 2 minutes before applying dressing. • Carefully apply dressing according to clinic protocol. • Tape as needed. |
| Procedures for Use |
| CENTRAL VENOUS CATHETER DRESSING CHANGE |
| PREPARATION OF GRAFT/FISTULA FOR CANNULATION |
| PERITONEAL DIALYSIS EXIT SITE DRESSING CHANGE |
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