SKILL TEST 4- JACKSON-PRATT DRAIN NURSING CARE

JACKSON-PRATT DRAIN

Placing Jackson-Pratt drain

Image Important for Skill test

A Jackson-Pratt (J-P) or Grenade drain collects wound drainage in a bulblike device that is compressed to create gentle suction. It consists of perforated tubing connected to a portable vacuum unit.

Bulb part of Jackson-pratt drainage

 

After a surgical procedure, the surgeon places one end of the drain in or near the area to be drained. The other end passes through the skin via a separate incision.

 These drains are usually sutured in place. The site may be treated as an additional surgical wound, but often these sites are left open to air 24 hours after surgery. 

They are typically used with breast and abdominal surgery. As the drainage accumulates in the bulb, the bulb expands and suction is lost, requiring recompression. Typically, these drains are emptied every 4 to 8 hours, and when they are half full of drainage or air. 

Empty and Measured Drainage

EQUIPMENT

• Graduated container for measuring drainage

• Clean, disposable gloves

• Cleansing solution, usually sterile normal saline

• Sterile gauze pads

• Skin-protectant wipes

• Dressing materials for site dressing

ASSESSMENT

• Assess the situation to determine the need for wound cleaning, a dressing change, or emptying of the drain.

• Assess the patient’s level of comfort and the need for analgesics before wound care. Assess if the patient experienced any pain related to prior dressing changes and the effectiveness of interventions employed to minimize the patient’s pain.

• Assess the current dressing. Assess for the presence of excess drainage or bleeding or saturation of the dressing.

• Assess the patency of the Jackson-Pratt drain and the drain site. 

Note the characteristics of the drainage in the collection bag.

• Inspect the wound and the surrounding tissue. Assess the appearance of the incision for the approximation of wound edges, the color of the wound and surrounding area, and signs of dehiscence. 

Note the stage of the healing process and characteristics of any drainage. Also assess the surrounding skin for color, temperature, and edema, ecchymosis, or maceration.

DIAGNOSIS

• Risk for Infection

• Impaired Skin Integrity

• Disturbed Body Image

• Deficient Knowledge

PLANNING

• Drain is patent and intact.

• Drain care is accomplished without contaminating the wound area and without causing trauma to the wound.

• Patient does not experience pain or discomfort.

• Wound continues to show signs of progression of healing.

• Drainage amounts are measured accurately at the frequency required 

by facility policy and recorded as part of the intake and output record.

• Patient demonstrates an understanding of drain care.

IMPLEMENTATION

1. Review the medical orders for wound care.

2. Perform hand hygiene. 

3. Identify the patient.

4.  Provide privacy to patient.

5.  Assemble equipment on overbed table within reach.

6. Provide analgesic Medication & Allow enough time for the analgesic to achieve 

its effectiveness before beginning the procedure.

7. . Place a waste receptacle at a convenient location for use during the procedure.

8. Patient positioning and use of a bath blanket provide for comfort and warmth. Waterproof pad protects underlying surfaces.

9. Put on clean gloves & put on mask or face shield.

10. Place the graduated collection container under the drain outlet. 

Without contaminating the outlet valve, 

pull off the cap. The chamber will expand completely as it draws in air. 

Empty the chamber’s contents completely into the container. Use the gauze pad to clean the outlet. Fully compress the chamber with one hand and replace the cap with your other hand.

11. Check the patency of the equipment. Make sure the tubing is free from twists 

and kinks.

12. Secure the Jackson-Pratt drain to the patient’s gown below the wound with a 

safety pin, making sure that there is no tension on the tubing.

13. Carefully measure and record the character, color, and amount of the drainage. Discard the drainage 

according to hospital policy. 

Remove gloves.

14. Cleaning of the sutures with the gauze 

pad moistened with normal saline. Dry sutures with gauze before applying new 

dressing.

15. If the drain site is open to air, observe the sutures that secure the drain to the skin. Look for signs of pulling, tearing, swelling, or infection of the surrounding 

skin. 

16. Dry with a new gauze pad. Apply skin protectant to the surrounding skin.

17. Remove and discard gloves. 

Remove all remaining equipment; place the patient in a comfortable position, with 

side rails up and bed in the lowest position.

18.Perform hand hygiene.

19. Check drain status at least every 4 hours. Check all wound dressings every shift. 

20. Perform more frequent checks if the wound is more complex or dressings 

become saturated quickly.

EVALUATION

• Patient exhibits a patent and intact Jackson-Pratt drain with a wound 

area that is free of contamination and trauma.

• Patient verbalizes minimal to no pain or discomfort.

• Patient exhibits signs and symptoms of progressive wound healing, with drainage being measured accurately at the frequency required by facility policy, and amounts recorded as part of the intake and output record.

• Patient verbalizes an understanding of the rationale for and the technique for drain care.

DOCUMENTATION

1. Document the location of the wound and drain, the assessment of the wound and drain site, and patency of the drain. Note if sutures are intact. 

2. Document the presence and characteristics of drainage on the old dressing upon removal. Include the appearance of the surrounding skin. 

3. Document cleansing the drain site. Record any skin care and the dressing applied. Note that the drain was emptied and recompressed. Note pertinent patient and family education and any patient reaction to this procedure, including patient’s pain level and effectiveness of nonpharmacologic interventions or analgesic.

4. Document the amount and characteristics of drainage 

obtained on the appropriate intake and output record.

Cleaning the area arround the jackson-pratt wound drain?

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CLEANING FROM THE CENTER OUTWARD IN CIRCUL MOTION.