What is the first step in an exit-site dressing change?

• A. Wash hands
• B. Remove old dressing
• C. Inspect the exit site
• D. Apply new dressing

Answer: (A)

Hand hygiene is the first step because it directly prevents introducing bacteria to the exit site during the rest of the dressing change. When you touch the exit site, the dressing, or surrounding skin, clean hands reduce the risk of infection that can lead to exit-site infections or peritonitis, which PD patients are especially vulnerable to. After washing, you would then remove the old dressing, inspect the exit site for signs of redness, swelling, drainage, or pain, clean the area with the appropriate antiseptic if required, dry it, and apply the new dressing. Keeping a clean baseline before touching anything related to the exit site is essential for safe PD care.