SELF/Perioperative Nursing/Surgical Wound Dressing/Psychomotor Skills Practice Instructions

Surgical Wound Dressing – Perioperative Nursing (ECSACONM)

Overview

This page provides a psychomotor skills practice guide for performing a routine postoperative surgical wound dressing, developed for perioperative nursing training under ECSACONM (East, Central and Southern Africa College of Nursing). It is intended as a self-directed developer worksheet, outlining the sequential steps, associated learning objectives ("good skills"), common errors, and practical guidance for aseptic non-touch dressing technique.

During practice, non-sterile instruments, equipment, and supplies may be used. For the purposes of this simulation, treat every instrument, supply, and surface as though it were sterile. Maintain aseptic non-touch technique throughout the exercise and respond to any simulated contamination exactly as you would during an actual postoperative surgical wound dressing.

Perform every action as though patient safety depends on it: maintain continuous separation between the clean and dirty forceps, preserve the sterile field, assess the wound carefully before cleaning, use the two-forceps non-touch technique throughout wound cleansing and dressing application, and recognize when simulated findings require modification of the procedure or escalation to the surgeon. Consistent practice under realistic conditions will develop the technical skills, clinical judgment, and disciplined aseptic technique required to perform routine postoperative surgical wound dressing safely and effectively.

NB: This practice requires the low-cost surgical wound dressing simulator and one assistant. The assistant should support the exercise by performing the assistant actions described in the procedure.

Purpose

To guide nursing students and practitioners through a systematic, step-by-step process for performing a postoperative surgical wound dressing using aseptic non-touch technique, ensuring patient safety, infection control, correct two-forceps wound cleansing, and appropriate recognition and escalation of concerning wound findings.

Psychomotor Skills Practice Instructions

#	Step	Assistant	Instructions	Good Skills (Learning Objectives)	Common Errors	Guidance
1	Gather Supplies	Say aloud: "I would gather all supplies and equipment needed for the dressing change and check that they are complete, intact, and within their expiry dates before starting."
2	Perform Hand Hygiene and don clean gloves	Say aloud: "I would perform hand hygiene, allow my hands to dry, and put on clean gloves before handling the patient or removing the old dressing."
3	Consent and prepare patient	Articulate the patient has been consented.
4	Prepare Clean work area	-	Clean and dry the work surface. Place the waste bag within reach. Arrange unopened supplies so you can reach them without leaning over the patient or sterile field.	The work surface is visibly clean and dry. The waste bag is reachable without crossing over sterile supplies. Unopened items are arranged in the order they will be used. There is enough open space to create separate clean, sterile, and contaminated areas.	Placing supplies on a wet or visibly soiled surface can contaminate their packaging. Positioning the waste bag across the sterile area may cause used items to pass over sterile supplies. A crowded surface increases accidental contact between clean and contaminated items.	Before continuing, trace the route your hands will take from supplies to wound to waste. Rearrange the area if any movement must cross the sterile field.
5	Set Up Sterile Field and Equipment	Pours saline/ordered solutions into gallipots after field is set (non-sterile pour); assists with waste handling; stabilizes limb/site if needed.	Remove the old dressing using clean gloves or designated forceps. Moisten it with sterile saline if it adheres to the simulated wound. Discard it, remove the clean gloves, perform hand hygiene, and open the sterile field and equipment without touching sterile contents.	The old dressing lifts without pulling the simulated skin covering from the cylinder. If it adheres, it is moistened before removal. Used materials move directly to waste without passing over the sterile field. After removing the dressing, you remove the clean gloves and articulate hand hygiene before opening sterile supplies. The sterile barrier remains dry and intact. Package edges do not touch sterile contents. The two forceps and swabs remain within the sterile field. Sterile saline or prescribed wound cleansing solution is poured without the container touching the sterile receptacle.	Pulling off an adherent dressing can disturb healing tissue, cause pain, or provoke bleeding in a real wound. Opening sterile supplies before removing the old dressing exposes them to contamination. Touching sterile contents with bare hands or clean gloves contaminates them. Reaching across the field or allowing package edges to touch it contaminates the field.	Mark separate clean, sterile, and contaminated zones during early practice. Pause after opening the field and check that every sterile item lies fully inside the sterile boundary.
6	Wound Assessment	-	Inspect the simulated incision before cleaning. State aloud your findings for wound edges, drainage, surrounding skin, swelling, pain, and any finding that would require escalation to the surgeon.	You inspect the full incision and surrounding skin before touching the wound with a swab. You state whether the wound edges are approximated or separated. You describe the amount and character of simulated drainage. You identify visible redness, swelling, bruising, skin damage, or simulated tissue changes. You state whether the findings represent expected healing or require the procedure to stop and escalation to the surgeon.	Beginning cleaning before inspection can remove drainage or other evidence needed for assessment. Describing the wound only as "normal" or "abnormal" omits observable findings. Continuing after simulated uncontrolled bleeding, wound separation, purulent drainage, necrotic tissue, or another serious finding delays escalation to the surgeon.	Use the same assessment order each time: wound edges, drainage, incision appearance, surrounding skin, swelling, and pain. Point to each area as you describe it.
7	Cleaning the Wound	Maintains waste bag open/accessible; pours additional saline when requested; helps keep patient still/comfortable without entering sterile field.	Hold the clean forceps in your less dominant hand and the dirty forceps in your dominant hand. Use the clean forceps to pick up and moisten one swab, then transfer it without allowing the forceps to touch. Use the dirty forceps to clean the incision from the cleanest area toward the less clean area in one stroke. Discard the swab after one pass and repeat with a new swab until the simulated exudate is removed.	The clean forceps remain over the sterile field and handle only sterile supplies. The dirty forceps remain on the patient side and handle swabs that contact the simulated wound. The forceps tips do not touch each other. Each swab is damp but not dripping. Each pass moves in one direction from the centre or cleanest area outward. A new swab is used for every pass. Used swabs go directly to waste. At the end, no visible simulated exudate remains on the incision, and the surrounding surface is not flooded with solution.	Allowing the clean and dirty forceps to touch contaminates the clean forceps and sterile field. Returning the dirty forceps to the sterile supply area transfers contamination. Reusing a swab or moving it back and forth can carry material toward the incision. An oversaturated swab allows fluid to drip and spread contamination. Scrubbing the surface can injure healing tissue in a real wound.	Say "clean hand stays clean; dirty hand stays patient-side" while practicing. Move slowly until the hand roles remain separate without hesitation. Use coloured simulated exudate so you can see whether each pass removes material or spreads it.
8	Apply the sterile dressing	Opens outer packaging and presents inner sterile dressing (drop technique) without touching contents; prepares tape/secondary dressing if required.	Use the clean forceps to lift the sterile dressing by an edge. Transfer or position it without touching the wound-facing surface. Centre it over the incision so the entire incision is covered.	The wound-facing side of the dressing does not touch gloves, clothing, the work surface, or the simulator outside the prepared area. The dressing is centred over the incision. Every part of the incision is covered, with dressing material extending beyond each wound edge. The dressing lies flat without folds over the incision.	Touching the wound-facing surface contaminates the dressing. Allowing an edge to contact a non-sterile surface contaminates that edge. A dressing that is too small leaves part of the incision exposed. A folded or off-centre dressing may lift or leave uneven coverage.	Before lowering the dressing, pause above the simulator and align its centre with the marked incision. After placement, inspect all sides for complete coverage.
9	Secure Dressing	Cuts/prepares tape; supports limb/skin to avoid pulling; checks comfort after securing.	Apply tape or the ordered securement material from one side of the dressing to the other. Keep the dressing centred and remove visible gaps without pulling the tape tightly around the simulated limb.	The dressing remains centred while tape is applied. Tape extends onto intact simulated skin on both sides. All dressing edges lie against the surface without lifting. There are no wrinkles directly over the incision. The dressing does not slide when gently touched. The silicone or vinyl surface does not pucker under excessive tension.	Loose tape allows the dressing to move and exposes the wound edge. Excessive tension can restrict circulation on a real limb and is shown during practice by puckering or deep pressure marks on the simulator surface. Leaving an edge unsealed allows contamination or leakage. Failing to inspect the finished dressing may leave displacement unnoticed.	Apply one strip at a time and check the dressing position after each strip. Finish with a gentle touch test: the dressing should remain in place without visible puckering of the simulated skin.

References

Page data
Keywords	surgery, health
SDG	SDG03 Good health and well-being
Authors	Ian-laurel
License	CC-BY-SA-4.0
Organizations	SELF, ECSACONM
Language	English (en)
Related	0 subpages, 1 pages link here
Views	2 page views (analytics)
Created	July 29, 2026 by Ian-laurel-1
Last edit	July 29, 2026 by StandardWikitext bot
Cite as	Ian-laurel-1 (2026). "SELF/Perioperative Nursing/Surgical Wound Dressing/Psychomotor Skills Practice Instructions". Appropedia. Retrieved July 30, 2026.
API queries	basic, semantic, html, files, more