Which sequence correctly describes the steps of performing a sterile dressing change around a chest tube site?

• A. Hand hygiene, remove old dressing, donn sterile gloves, inspect the site, clean around insertion, apply new sterile dressing, secure properly.
• B. Sterile gloves, hand hygiene, remove old dressing, inspect the site, clean around insertion, apply new sterile dressing, secure properly.
• C. Hand hygiene, sterile gloves, remove old dressing carefully, inspect the site, clean around insertion, apply new sterile dressing, secure properly.
• D. Hand hygiene, sterile gloves, apply new dressing before removing old dressing, remove old dressing, inspect site, clean around insertion, secure properly.

Answer: (C)

Maintaining sterile technique during a chest tube dressing change is essential. Start with hand hygiene to reduce the risk of introducing bacteria. Put on sterile gloves so you can handle sterile supplies and the dressing without contaminating anything. Remove the old dressing while keeping the sterile field intact, then carefully inspect the insertion site for signs of infection, dislodgement, or drainage. Clean around the insertion site in a controlled manner, usually from the clean area outward to prevent dragging contaminants toward the wound. Once the area is clean and dry, apply a new sterile dressing, ensuring it fully covers the site and creates a proper seal. Secure the dressing to prevent movement or displacement of the chest tube. Dispose of supplies and perform hand hygiene again as required by protocol. This sequence best preserves sterility, allows immediate assessment of the site, and reduces the risk of infection or tube displacement.