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Pre- and Post-Procedural Steps (SKWIPE and CLOWD)

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Pre- and Post-Procedural Steps (SKWIPE and CLOWD)

Key Points

  • Use SKWIPE before care to prevent missed preparation, identity errors, and privacy breaches.
  • Use CLOWD before leaving to confirm comfort, environmental safety, and follow-up communication.
  • Hand hygiene at entry and exit reduces pathogen transmission risk.

Equipment

  • Hand hygiene supplies (soap/water or alcohol-based hand rub)
  • Required care supplies prepared in advance
  • Identification resources per facility policy (ID band, photo, staff confirmation)

Procedure Steps

  1. Prepare Supplies needed for planned care to avoid leaving the resident during the procedure.
  2. Knock before entry, even if the door is open, to preserve dignity and respect.
  3. Wash hands upon entry using facility hand-hygiene standards.
  4. Introduce and Identify yourself and confirm resident identity using approved policy for the setting. In long-term care, use photo record or experienced-staff confirmation when residents cannot reliably self-identify.
  5. Provide Privacy by closing the door and pulling the curtain before personal care.
  6. Explain the planned care clearly and allow questions or refusal at that time.
  7. Complete care, then check Comfort and ask about immediate needs (for example, tissues or water).
  8. Set Light, Lock, and Low: call light within reach, bed brakes locked, bed in lowest position, alarms as ordered.
  9. Open door and curtain as appropriate for visibility and unit safety expectations.
  10. Wash hands again before leaving the room.
  11. Document or report declined care, abnormal findings, or any non-routine event per policy. Routine daily cares are not always charted unless declined or outside baseline, per agency policy.

Common Errors

  • Skipping entry or exit hand hygiene → increased cross-transmission risk
  • Leaving bed unlocked or elevated → increased self-transfer injury risk
  • Omitting identity check → wrong-person care risk

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