Definition
Pin site care to be carried out of the site of pain insertion for patients on skeletal traction at intervals to detect and prevent infection.it involves placing a pin wire or screw in the fractured bone and most commonly used to treat fracture of femur.
Article
- Sterile dressing tray
- Normal saline solution.
- Hydrogen peroxide
- Sterile glove
- Clean glove
- Povidone-iodine solution.
- Sterile cotton balls and gauze pieces.
- K-basin.
Procedure
| Nursing action | Rationale | |
| 1 | Before procedure Explain the procedure to the patient | It helps to gain cooperation during the procedure |
| 2 | Wash hands or sanitize as per agency policy | Prevet cross infection |
| 3 | Position the patient as required | It ensures accessibility of the affected side |
| 4 | Place mackintosh and draw sheet under the arm/leg. | It prevents the bed from getting contaminated due to spilling of solution or soiled dressing |
| 5 | During procedure Wash hands and don clean gloves | Reduce transmission of infection |
| 6 | Remove soiled dressing. Pour normal saline over the dressing site if required and remove the soiled dressing. | Pouring normal saline helps loosen any crust and helps to remove the dressing easily |
| 7 | Remove the soiled gloves and dispose. Wash hands or sanitize. | To prevent cross infection. |
| 8 | Open the sterile dressing set using aseptic technique without touching the inside of the sterile field using a Cheatle forceps or sponge holding forceps. | Aseptic technique reduces transmission of infection. |
| 9 | Pour normal saline and hydrogen peroxide in 1:1 dilution in one bowl and povidone –iodine in another bowl. | |
| 10 | Wear the sterile gloves. | Prevent transmission of infection. |
| 11 | Assess pin site for deviation from healthy healing i.e. any discharge pus inflammation, in case of wound discharge, collect sample as required according to hospital policy. | It ensures prompt management of infection at the site. |
| 12 | Clean the skin around pins and the pin from inside out in circular motion with cotton swab dipped in hydrogen peroxide and normal saline. Use one swab for each circular wipe. | Use of normal saline removes crust from pin site. |
| 13 | Begin by cleaning pins on one side of extremity and then repeat the same on the other side. | Prevent cross contamination. |
| 14 | Push the skin away from each pin using cotton swab and clean pins. | Ensure proper cleaning of the site and prevents contamination. |
| 15 | Soak sterile gauze in povidone -iodine solution, squeeze and wrap around each pin site or dry gauze dressing according to need. Either bolster dressing or signal strip of gauze piece rotated over the site can be used as per practice. | Ensure proper cleaning of the site and prevents contamination reduce bacterial growth. |
| 16 | Ensure that all the pin sites are covered. | |
| 17 | Position patient in comfortable position. | Promotes rest and sleep. |
| 18 | Dispose off waste and leave the patient’s unit clean. | |
| 19 | Clean and replace articles. | Make them available for future use in good condition. |
| 20 | After procedure Remove gloves and wash hands | |
| 21 | Record the condition of pin site, any discharge or bleeding if present look for any induration Record type of solution used and patient’s compliance. | Provide data for evaluating wound healing. |
Special consideration
- Pain medications should be administrated as ordered 30 minutes to 1 hour prior to dressing.
- Assess and report physicians for signs of nerve damage, circulatory impairment and infection i.e. burning sensation,tingling,numbness,redness of skin, prolonged or purulent drainage from pin site, elevated body temperature, bowing or bending of pins.
- Colour,warmth,sensation,digital movement, oedema, capillary refill and pulse of the extremity should be compared with that of the unaffected extremity and reported for any deviations.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
Stories are the threads that bind us; through them, we understand each other, grow, and heal.
JOHN NOORD
Connect with “Nurses Lab Editorial Team”
I hope you found this information helpful. Do you have any questions or comments? Kindly write in comments section. Subscribe the Blog with your email so you can stay updated on upcoming events and the latest articles.
