Applying and Caring for a Patient Using a TENS Unit

Goal: The patient reports increased comfort and decreased pain; and is free from injury, skin irritation or breakdown.

1. Perform hand hygiene and put on PPE, if indicated.

2. Identify the patient.

3. Show the patient the device, and explain its function and the reason for its use.

4. Assess the patient’s pain, using an appropriate assessment tool and measurement scale. (See Fundamentals Review 10-1 through 10-6.)

5. Inspect the area where the electrodes are to be placed. Clean the patient’s skin, using skin cleanser and water. Dry the area thoroughly.

6. Remove the adhesive backing from the electrodes and apply them to the specified location. If the electrodes are not pregelled, apply a small amount of electrode gel to the bottom of each electrode. If the electrodes are not selfadhering, tape them in place.

7. Check the placement of the electrodes; leave at least a 2 (5 cm) space (about the width of one electrode) between them.

8. Check the controls on the TENS unit to make sure that they are off. Connect the wires to the electrodes (if not already attached) and plug them into the unit.

9. Turn on the unit and adjust the intensity setting to the lowest intensity and determine if the patient can feel a tingling, burning, or buzzing sensation. Then adjust the intensity to the prescribed amount or the setting most comfortable for the patient. Secure the unit to the patient.

10. Set the pulse width (duration of the each pulsation) as indicated or recommended.

11. Assess the patient’s pain level during therapy.
a. If intermittent use is ordered, turn the unit off after the specified duration of treatment and remove the electrodes. Provide skin care to the area.
b. If continuous therapy is ordered, periodically remove the electrodes from the skin (after turning the unit off) to inspect the area and clean the skin, according to
facility policy. Reapply the electrodes and continue therapy. Change the electrodes according to manufacturer’s directions.

12. When therapy is discontinued, turn the unit off and remove the electrodes. Clean the patient’s skin. Clean the unit and replace the batteries.

13. Remove PPE, if used. Perform hand hygiene.