| Course | NR 224 Fundamentals: Skills |
|---|---|
| Week | 6 |
| Paper type | Wound care write-up |
| Length | About 1,100 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 224 Week 6
Wound Care Write-Up: A Sterile Dressing Change Over a Midline Incision and a Drain Site on the Third Day After Bowel Surgery
Student Name
College of Nursing, Chamberlain University
NR 224: Fundamentals: Skills
Instructor Name
Month Day, Year
Wound Care Write-Up: A Sterile Dressing Change Over a Midline Incision and a Drain Site on the Third Day After Bowel Surgery
The Patient and the Order
Mrs. A. is 61, on the third day after an open sigmoid colectomy. She has a 14-centimeter vertical midline incision closed with staples and, on her lower left abdomen, a surgical drain exiting through a separate small incision, connected to a bulb. The order is for a dry sterile dressing change to the incision and the drain site once a day and as needed. Her pain is 3 of 10 at rest; she had her oral pain medicine 40 minutes before I began. Details are composite.
The Centers for Disease Control and Prevention guideline on surgical site infection focuses mainly on what happens before and during surgery, but its purpose runs through the days after: a wound that was closed cleanly can still be contaminated at the bedside (Berríos-Torres et al., 2017). The dressing change is one of the few points after surgery where nursing hands meet the wound directly, which is why most of this write-up is about preparation.
Preparation, Most of the Work
Before opening anything, I gathered everything on the over-bed table, cleaned with a disinfectant wipe and dried: a sterile dressing kit with a drape and sterile gloves, sterile gauze squares, a split drain sponge, a sterile cup, sterile normal saline, tape suited to her skin, a pair of clean gloves, a measuring tape, and a small plastic bag. I taped the bag, open, to the far rail, opposite the table, so the old dressing would go in without crossing the sterile field and without a trip to the bin.
I raised the bed to my waist height, lowered the near rail, and positioned Mrs. A. flat on her back with a folded sheet over her chest and another over her legs, exposing only her abdomen. I placed the table on my dominant side, within reach without leaning over her body. The order of the setup is the order I will work in, so that my hands never have to cross the field to reach something.
Two Kinds of Gloves, Two Reasons
The old dressing came off with clean gloves. The reason is protection: the dressing carries her drainage, and the clean gloves protect my hands and keep her fluids off my skin. I loosened the tape by pulling toward the incision, not away from it, to avoid pulling the wound edges apart, and lifted the dressing off with the soiled side turned inward. Before it went into the bag, I looked at it: a 3 by 4 centimeter area of pale pink, thin drainage on the incision dressing, and a 2 by 2 centimeter area of the same on the drain dressing, both similar to yesterday's charted amount. The clean gloves and dressing went into the bag together.
The new dressing went on with sterile gloves. The reason is different: the sterile gloves protect her wound from my hands. I cleaned my hands, opened the kit on the table, and put on the sterile gloves following the technique of touching only the inside of the first glove with my bare hand and only the outside of the second glove with the gloved hand.
Between the two pairs of gloves, I washed my hands. That step is easy to skip because the clean gloves looked unsoiled when they came off, but the moment before a clean procedure is one of the points at which hand hygiene is required, and gloves do not fully protect the skin underneath them.
The Field Has Edges
The sterile field is the inside of the kit's wrapper and the drape laid on it. Its outer inch counts as not sterile, because it is where the wrapper met the table. I poured the saline into the sterile cup from a height without touching the rim, and dropped the gauze onto the field from its opened package without touching the package to the field. Once my sterile gloves were on, my hands stayed above waist level and in front of me, and I did not turn away from the field. When Mrs. A. coughed and reached toward her abdomen, I asked her to hold the rolled towel against her chest instead, so her hand would not cross the field.
Direction, Not Just Cleaning
The incision was cleaned from the least contaminated area to the most. With a saline-moistened gauze square, I cleaned from the top of the incision to the bottom in one stroke along the line of the staples, discarded the gauze, and repeated with a new square on each side, moving outward from the incision. I did not scrub back and forth, which would carry skin bacteria onto the incision line.
The drain site is more contaminated than the incision, because it is an open track to the inside of the abdomen with fluid moving through it. It was cleaned after the incision, never before, in circles moving outward from the drain, with a fresh gauze each time. A split sponge went around the drain tube, with a gauze square over it, and the incision was covered with dry gauze. The tape was placed so that the drain tubing was secured below the dressing, not pulling on it.
Describing What Was Seen
The charted description gives what a second nurse could compare tomorrow. Incision: 14 centimeters, edges approximated along its full length, all staples intact, a line of redness about 3 millimeters wide on each side of the staples, no swelling, no warmth to touch, no drainage from the incision line after cleaning. Drain site: skin intact around the tube, 2 millimeters of redness, a small amount of serous-pink drainage at the insertion point, suture holding the drain in place intact. Drain bulb: 45 milliliters of serous-pink fluid emptied since 0600, which I measured and recorded. Mrs. A. tolerated the change with pain of 4 during cleaning.
A narrow line of redness along the staples on the third day is expected. Redness spreading more than a centimeter or two beyond the incision, warmth, swelling, cloudy or foul drainage, or edges pulling apart would not be, and would be reported the same day. None was present, and the description is written so that tomorrow's nurse can tell at once whether that has changed.
References
Berríos-Torres, S. I., Umscheid, C. A., Bratzler, D. W., Leas, B., Stone, E. C., Kelz, R. R., Reinke, C. E., Morgan, S., Solomkin, J. S., Mazuski, J. E., Dellinger, E. P., Itani, K. M. F., Berbari, E. F., Segreti, J., Parvizi, J., Blanchard, J., Allen, G., Kluytmans, J. A. J. W., Donlan, R., & Schecter, W. P. (2017). Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surgery, 152(8), 784-791. https://doi.org/10.1001/jamasurg.2017.0904
Reading the NR 224 Week 6 instructions
For Week 6 you write up a wound care procedure, often a sterile or clean dressing change, with the rationale for each step and a description of the wound. Expect the instructions to want preparation, technique, the order of cleaning and documentation of the wound's appearance. Plan on several APA pages with the wound guideline or a scholarly article cited. The strongest papers explain where sterile technique can fail, such as the border of the field or reaching across it. Wounds should be described with measurements, colors and drainage rather than words like good or improving. Pain management and the patient's comfort during the procedure belong in the write-up as well.
Inside the NR 224 Week 6 example
The paper begins with the patient and the order, then cites Berrios-Torres et al. (2017) to explain why bedside care still matters for infection. Preparation takes a full section: the cleaned table, the supplies, the bag for the old dressing and the patient's position. A section on gloves explains two kinds and two reasons, with hand hygiene between them. The sterile field section defines its outer inch as not sterile and describes pouring saline from a height. Cleaning runs top to bottom along the staples, then outward from the drain. The final section charts the incision's length, a 3-millimeter line of redness and the drainage, and names what would be reported.
Where the points sit in the NR 224 Week 6 rubric
Wound care write-ups are commonly graded on preparation, sterile technique, cleaning method, wound assessment and documentation, rationale and APA. Sterile technique and its rationale carry the largest share, which is why the paper names the points where the field could break. Preparation earns credit when it is shown to prevent contamination, as with the placement of the bag for the old dressing. Cleaning method scores when the direction is argued, least contaminated area to most. Documentation is graded on measurable detail a colleague could compare. Naming the findings that would change the plan meets the assessment criterion. The CDC guideline supports the infection points with a recognized source.
NR 224 Week 6 help from the desk
The heaviest losses come from describing the sterile field so vaguely that nobody could tell whether it broke. Sterile technique written as a general promise, instead of at the two or three points where it fails, costs points. Wounds described with words like nasty or improving lose assessment marks. Changing gloves without a reason, handling the old dressing as clean and stating a cleaning direction with no argument all add up. Forgetting pain in a procedure that hurts is a frequent gap. If the field breaks partway through, say what you would do next. Send the dressing order and the wound you are describing, and a write-up can follow that pattern.
Get a NR 224 Week 6 example written to your instructions
Send the assignment instructions, the rubric and any wound documentation form your section uses, and a custom NR 224 wound care write-up is returned inside 24 to 48 hours, the first one free. Products and terminology vary by lab, so include the dressing type your classroom teaches and the example is written around that instead of a generic one.
More NR 224 papers and pre-licensure samples
- NR 224 Week 1: One Small Safety Action Post
- NR 224 Week 2: C. diff Contact Precautions Write-Up
- NR 224 Week 3: Urinary Catheter Procedure Rationale
- NR 224 Week 4: Vital Signs Write-Up
- NR 224 Week 5: Fall Safety Scenario Response
- NR 224 Week 7: Charting Exercise
- NR 224 Week 8: Skills Reflection
- NR 226 Week 6: Priority-setting Case
- NR 222 Week 6: Community Resource Brief
- NR 228 Week 6: Patient Teaching Handout
- NR 103 Week 6: Failed Check-Off Reflection
NR 224 Week 6 questions, answered
What if the field is broken partway through?
Say so, and say what you did about it. A write-up describing a contaminated glove noticed, stopped for and replaced scores better than one where nothing ever goes wrong, because the second is not credible. The recovery is examinable material, and some labs build the break into the scenario deliberately to see it handled.
How much detail does the wound description need?
Enough that somebody who has never seen it could recognize it at the next change. Size, depth where visible, the color of the bed, the state of the edges and the surrounding skin, and what was on the dressing that came off. Words like nasty or healing well are judgments with no evidence underneath.
Which dressing product should the example use?
The one your lab teaches, since products differ and the reasoning is attached to the product. A foam, a hydrocolloid and plain gauze are chosen for different reasons, so an example built on the wrong one carries reasoning that does not transfer. Include the name your classroom uses when you ask.
Where can I find a free NR 224 Week 6 sample paper?
The complete Week 6 wound care write-up for a midline incision and drain site, with preparation, glove changes and the charted wound description, is printed below.
Why is the drain site cleaned last in the NR 224 Week 6 example?
The drain is an open track into the abdomen with fluid moving through it, so it is more contaminated than the incision and is cleaned afterward, in circles moving outward.