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Joint Aspiration (102.091)

Joint Aspiration (102.091) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Orthopedics and Movement

102.091

1
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: JOINT ASPIRATION

Effective Date: April, 2004 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed November 2007 June 2009 October 2011


PURPOSE: To provide guidelines for assisting with joint aspiration at UWMF Clinics.

DEFINITION: A joint aspiration is done to obtain a specimen of joint fluid for gross and microscopic
evaluation or to decrease pressure or pain on the joint capsule.

POLICY: The clinical staff will utilize the following guidelines to properly assist with joint aspiration of a
UWMF patient.

SUPPLIES: Sterile field & drape, 2 sterile gloves, mask(s), Sterile stretched gauze roll, clean gauze pads,
Lidocaine 1%-2 ampules, Chlorhexidine cleansing solution (3), Alcohol prep sticks (3) Band-
Aid, Kelly clamp, Ace wrap (potential), Pen, Syringes: 1 (30cc), 2 (50cc), & 1 (6-cc),
Sterile needles: 2/18-gauge (1½ inch) 2/20-gauge (1in), 25-gauge (5/8 in)
Lab tubes: 1-red top, 1-purple top, labels for tubes, lab requisitions
Provider’s order, Patient’s record

PROCEDURE:

1. Wash hands and gather equipment.

2. Check provider’s order and clarify any inconsistencies.

3. Review history with provider for contraindications to the procedure.

4. Introduce yourself and identify the patient. Include date of birth and verify allergies.

5. Explain procedure to the patient and answer any questions.

6. Assist patient onto exam table, then place underpad under affected joint.

7. Wash hands then gather equipment and set up sterile field.

8. Prepare areas for aspiration with chlorhexidine solution and gauze pads:
clean (x3) in circular motion from center of site to outside
clean in the same method and pattern (x3) with the alcohol prep sticks.

9. Assist provider as needed during aspiration.

10. Provide patient with support during the procedure.


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11. After the procedure, apply sterile gloves.

12. Apply pressure dressing (Stretched gauze roll) over aspiration site.
NOTE: Ace wrap may also be used to hold pressure dressing in place.

13. Remove gloves and wash hands.

14. Assist patient with getting dressed (if needed).

15. Label specimens with:
patient’s name & date of birth
medical record number
physician’s name
date, site and type of specimen
ordered test

16. Documentation (Progress Notes in HealthLink
Patient teaching
Amount of fluid aspirated, dressing applied
Lab test ordered and that specimen was sent to lab
How patient tolerated procedure
Discharge instructions and/or follow-up care

WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support

REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator

REVIEWED BY: Lynn Posick, NP, Ortho/Rehab - Foot/Ankle

REFERENCES:
1. Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams & Wilkins.
2. Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
3. Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby
Elsevier.

AUTHORIZATION:


Medical Director Date