Final answer:
For patients with fragile skin, using a smaller gauge needle and avoiding paper tape are recommended practices. A 'time out' before skin incision is crucial for the medical team to review procedural details and ensure patient safety.
Step-by-step explanation:
The care of patients with fragile skin, such as elderly patients and Neonatal Intensive Care Unit (NICU) babies, requires special consideration to prevent skin damage. Of the options provided, the acceptable steps would be to use a 21 gauge or smaller numbered needle and avoid using paper tape. A smaller gauge needle causes less damage and is less painful, which is crucial for patients with delicate skin. Paper tape is avoided because it can cause tearing or strip away fragile skin upon removal. The use of a tourniquet should be carefully considered; if necessary, it should be applied with minimal pressure and for the shortest time possible. As for the question about needle change, it is unclear what 'no change is needle' implies, so additional context is needed to provide an appropriate answer there.
Before a skin incision in any procedure, it is essential for the medical team, which includes nurses, surgeons, and anesthesia professionals, to conduct a time out. During this time out, the nurse will review several items aloud with the team, such as the name of the procedure, the completeness of needle, sponge, and instrument counts, the correct labeling of any specimens including the patient's name, and any issues with equipment. This step is important to ensure patient safety and the success of the procedure.