Tap water as alternative dressing solution
CHAN Wai Yee, LI Ka Kit, LI Man Kit, LI Yan Pui, LING Wai Hang and TAI Hoi Yee
Caritas Institute of Higher Education, Hong Kong
: J Nurs Patient Care
Abstract
Normal saline, Betadine and chlorhexidine are the common dressing solutions in Hong Kong healthcare field, which tap water (TW) is not considered as proper dressing solution because it contains bacteria and unknown substances. However, to review the guidelines, some overseas countries accept TW dressing. A fundamental study had already been performed in Hong Kong which the potential benefits may be discovered. This study is to review whether it is better to use TW as dressing solution compared to normal saline in a patient with the superficial wound when it comes to infection rate. To compare the water treatment in Hong Kong and the USA, the chemical materials including hydrated lime, chlorine, alum, powdered activated carbon are used in water purification system. In the USA, studies and application of tap water have already performed and found that TW does not induce more infection in both acute and chronic wound. The water quality in Hong Kong is similar to the USA that TW is safe as an alternative cleansing solution. It shows benefits using TW in dressing. There is not only easily accessible in the community, but also more cost-effective in a health-care facility. So it possesses the potential to be an alternative solution to sodium chloride. TW is recommended for superficial wound dressing because of less life-threatening and most common in use. As TW dressing is safe, it may introduce to nursing implication. Community nurse may perform TW dressing in homecare and may educate patients’ to do TW dressing by themselves. The community geriatric assessment team may educate old age home staffs to perform TW dressing. Advanced practice nurses (APNs) may act as leaders of the evidence-based practice team and help formulate guidelines. In addition, the APNs may develop a TW dressing committee for promoting TW dressing through nursing conferences. To kick off the nursing implications, some practice change plans should include, such as holding TW dressing workshop, developing TW dressing guidelines, and setting up a committee of TW dressing. Reference: 1 Fernandez R., Griffiths R. (2012). Water for wound cleansing. Cochrane Database of Systematic Reviews. (2): 1-30. 2. Weiss EA, Oldham G, Lin M, Foster T, Quinn JV. (2013) Water is a safe and effective alternative to sterile normal saline for wound irrigation prior to suturing: a prospective, double-blind, randomised, controlled clinical trial. BMJ Open, (3): 1-7. 3. Zamani M, Panah FS, Esmailian M, Azizkhani R., Yoosefian Z, Soltani M. (2015). Effects of irrigation with different solution on Incidence of Wound Infection. Iranian Journal of Emergency Medicine. (2):64-69. 4. Chan MC, Cheung K, Leung P. (2016). Tap Water Versus Sterile Normal Saline in Wound Swabbing: A Double-Blind Randomized Controlled Trial. Journal of Wound, Ostomy and Continence Nursing. 43 (2):140-147.
Biography
LI Ka Kit, LI Man Kit, LI Yan Pui, LING Wai Hang and TAI Hoi Yee are Year 4 students of Bachelor of Nursing (Honours) Programme, Caritas Institute of Higher Education. Dr. Chan Wai Yee is their tutor to guide the study. cchan@cihe.edu.hk
