Initiating a packing dressing
I am a Registered Practical Nurse (RPN) and provide care to elderly clients in their home. During one of my visits, I noticed my client had a deep wound on the sacral area. The client has wound care supplies in their home from when I treated a previous wound. As an RPN, do I have the authority to initiate a packing dressing?
An RPN has the authority to independently initiate wound care below the dermis (including debriding, packing and dressing) for this client.
RNs and RPNs with the knowledge, skill and judgement, are independently permitted to initiate specific controlled acts in some settings. While nurses have access to initiate controlled acts, they may not apply to certain practice settings because of other legislation or employer policies. Nurses who consider initiating an activity are advised to clarify the scope of their role and responsibilities within the health care team and with their employers.
In each situation, the nurse would need to determine if initiating an activity is the best course of action for the client.
A nurse must
- Assess the client and identify the problem
- Consider all options to address the problem
- Address the risks and benefits of each option
- Decide on a course of action
- Anticipate the management of the outcomes
- Accept responsibility for deciding that a particular activity is required
- Ensure the management of the outcomes
- Document the initiation and outcome of the activity in the client’s chart
- Follow up with the most responsible provider as necessary, or as per employer policies.
Nurses are accountable for any activity that they initiate. The requirements needed to achieve the competence to safely perform a particular activity is specific to each nurse and includes education, training, and experience. Nurses are expected to communicate with their employer if they require additional learning or professional development to provide safe client care.
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