Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [129], C).
2. 2.Show
   Wash hands with soap and water. Clean trolley or plastic tray following local guidelines for aseptic procedure.
   To minimize cross‐infection (NHS England and NHSI [122], C).
3. 3.Show
   Position the patient comfortably on their side or sitting forward so that the site is easily accessible without undue exposure of the patient.
   To maintain the patient's dignity and comfort (RCN [153], E).
4. 4.Show
   Prepare the trolley or tray with a sterile field and cleaning solution.
   To minimize the risk of infection and ensure the equipment is available (Preston [145], C).

Procedure

1. 5.Show
   Remove the old dressing and place it in a disposable bag.
   To prevent cross‐infection (Fraise and Bradley [61], E).
2. 6.Show
   Decontaminate hands with soap and water or with an alcohol‐based handrub. Put on gloves and apron.
   To minimize the risk of microbial contamination (NHS England and NHSI [122], C).
3. 7.Show
   Observe the site for any signs of infection, such as redness, swelling or purulent discharge.
   To ensure careful monitoring of the site to minimize the chance of infection (FPM [57], C).
4. 8.Show
   Clean the site with a skin‐cleaning agent (e.g. aseptic non‐touch technique with normal saline 0.9%).
   To minimize the risk of infection (Hebl [76], R).
5. 9.Show
   Apply transparent occlusive dressing over the whole area.
   To anchor the epidural or intrathecal catheter, minimize the risk of infection, and allow observation of the epidural or intrathecal site (FPM [57], E).
6. 10.Show
   Ensure that the patient is comfortable.
   To maintain patient comfort and dignity on completion of the procedure. P

Post‐procedure

1. 11.Show
   Remove gloves and apron and dispose of all material in the clinical waste bag. Decontaminate hands.
   To prevent environmental contamination (NHS England and NHSI [122], C).