Methodological Instruction to Lesson No 2 for 3rd – year students of the medical faculty
THEME:
1. An antisepsis. A care of patients with a purulent pathology.
2. A bandaging material and operational linen sterilization. The organization of work in operational block. A surgical treatment of the surgeon’s hands and a surgery field.
3. The organization of work in sterilization room. Preparation and sterilization cutting, optical and surgical instruments. Sterilization of a suture material.
AIM: To acquire modern principles of prophylaxis of an intrahospital infection. To learn the basic kinds of antisepsis and methods of their use. To determine indications to application of the basic substances of antisepsis. To be able to diagnose cases of hospital infection.
PROFESSIONAL MOTIVATION: Antisepsis belongs to potent and wide-spread enough methods of prophylaxis and treatment of local infectious diseases and a sepsis. Daily according to the World Organization of public health Services in the world dies from infectious diseases over 50 thousand and annually more as 17 million people. 35-40 % of patients of a surgical structure are made by patients with pyoinflammatory processes, postoperative purulent complications arise in 30 % of patients. In the general frame of a lethality in a surgical hospital the mortality in connection with infectious complications reaches(achieves) 42-60 %.
Using modern methods of antisepsis and preparations it is possible not only to suppress growth of a pathological microflora but also to stimulate a immune-biological condition of an organism on struggle against a surgical infection.
BASIC LEVEL:
STUDENTS’ INDEPENDENT STUDY PROGRAM
I. Objectives for Students’ Independent Studies
You should prepare for the practical class using the existing textbooks and lectures. Special attention should be paid to the following:
Theme 1. An antisepsis. A care of patients with a purulent pathology.
1. To know the basic groups of substances chemical antiseptics and indications to their application.
2. To know features of a care of patients with a purulent pathology.
3. To know features of dressings for patients with anaerobic infection.
Theme 2. A bandaging material and operational linen sterilization. The organization of work in operational block. A surgical treatment of the surgeon’s hands and a surgery field.
1. To familiarize with a technique of manufacturing of napkins, tampons, globules.
2. To know methods of preparation of the surgeon’s hand and to be able to be prepared for operation.
3. To acquire the basic methods of transportation of patients in operational room. Rules of clothing of operational linen.
Theme 3. The organization of work in sterilization room. Preparation and sterilization cutting, optical and surgical instruments. Sterilization of a suture material.
1. Features of preparation of instruments to operation. Preparation of washing and disinfectant substances.
2. To carry out tests on quality before-sterilization processings of instruments.
4. A technique of sterilization of cutting, optical and surgical instruments.
II. Tests and Assignments for Self – assessment
Multiple Choices.
Choose the correct answer/statement:
1. The founder of antisepsis was:
A. I.Mechnikov;
B. N.Pirogov;
C. E.Bergman;
D. J.Lister;
E. J.Pringl.
2. An antisepsis is a complex of the actions directed on destruction or decrease of microorganisms in:
A. A dressing material;
B. Instruments;
C. A suture material;
D. A wound;
E. Operation room.
3. What preparation of antisepsis belong to haloids
A. Spirt solution of iodine
B. Iodonatum
C. Ethil alcohol
D. Furacillin
E. Rokkal
4. Choose a preparation of group of oxidizers
A. Jodopiron
B. A potassium permanganate
C. Rivanolum
D. Dimexidum
E. A corrosive sublimate
Real-life situations to be solved:
5. During examination of otorhinolaryngologist at the nurse of surgical department, they discover a chronic tonsillitis. During bacteriological examination of mucous from the throat they discover a patogenic staphylococcus. Your actions as a chief of department.
6. A patient N., 48 years old, entered to traumatological department with cute-lacerated wound at the region of external condylus of the right femur, after 24 hours from the moment of trauma. A primary surgical cleansing was carried out, during which a tendon of digitorum flexor muscle was sewed. A primary sutures were put on the wound. During examination, after 3 days, they noticed a dropsy of surrounding tissues hyperemia, purulent discharges from the wound. What have developed? What is the reason of it?
III. Answers to the Self-Assessment:
1. C;
2. D;
3. A;
4. B;
5. For some days move aside from the work and carry out a sanitation of oral cavity. If results are negative, during inoculation, the admittance to the work is possible.
6. Complication is developed – suppuration of the wound in consequence of incorrect actions of the surgeon. Primary surgical cleansing of the wound after 24 hours iot aloud.
IV. References:
I. Essential reading:
1. Gostishchev V.K. General surgery /The manual. – M.: GEOTAR-MED, 2003. – 220p.
2. Lectures prof. B.I. Dmitriev from
3. Surgery: Text-book for English medium medical students / S.I. Shevchenko, O.A. Tonkoglas, I.M. Lodyana, R.S. Shevchenko. – Kharkiv: KSMU, 2001. – 344p.
4. Kushnir R. Ya. General surgery /Lectures.- Ternopil, Ukrmedknyha, 2005.- 308 p.
5. Butyrsky A. General surgery /The manual.- Simpheropol: publishers CGMU, 2004.- 478 p.
6. L.Ya. Kovalchuk et al. Doctor (student) – patient models of communication. Ternopil, TSMU, “Ukrmedknyha 2009, 39 p.
Further reading:
1.
2. Polskaya L.V. Nursing procedures in therapeutic practice.- Simpheropol, Universum, 2004.- 192 p.
3. Clinical Nursing Skills and Techniques: basic, intermediate and advanced. The C.V. Mosby Company, 1986.- 1296 p.
V. 5. Students’ Practical Activities:
9.00 – 12.00
Theme 1. An antisepsis. A care of patients with a purulent pathology.
Work 1. Students independently will carry out a care of patients with a purulent pathology, get acquainted with the organization of work in a purulent dressing room.
Work 2. Students take part in a care patient’s care with anaerobic infection, realizations of a dressing help the dressing-room nurse in time of bandaging.
Work 3. Students get acquainted with modern agents of antisepsis and apply them during dressings.
Theme 2. A bandaging material and operational linen sterilization. The organization of work in operational block. A surgical treatment of the surgeon’s hands and a surgery field.
Work 4. Students preparing the napkins, tampons, globules, take part in preparation of operational linen and a dressing material for operation, acquire a technique of stacking of linen in drums.
Work 5. Students process arms before operation, get acquainted with processing a surgery field.
Work 6. Students get acquainted with a structure of a surgery block, help to transport patients in- and from operational block.
Theme 3. The organization of work in sterilization room. Preparation and sterilization cutting, optical and surgical instruments. Sterilization of a suture material.
Work 7. Students take part in preparation of instruments for sterilization. Carry out tests on quality before-sterilization processings of instruments.
Work 8. Students take part at sterilization surgical, optical and cutting instruments.
Work 9. Students get acquainted with a technique of sterilization of a suture material.
Communicative skills: a. Physical methods of surgical patients examination;
VI. Seminar Discussion Of Theoretical Questions And Practical Work:
12.30 – 14.00
VII. The initial level of knowledge and skills is checked by the decision of situational problems (tasks) from each theme, answers to tests such as “Step”, constructive questions etc.
14.15 – 15.00
Students must know:
· a history of development of antisepsis;
· kinds of antisepsis;
· classification and the characteristic of the basic preparations of antisepsis, the indication to their application;
· substantive provisions of normative documents on struggle with hospital infection;
· definition of an intrahospital infection;
· the basic sources of an intrahospital infection;
· rules and principles of prophylaxis of an intrahospital infection.
Students should be able to:
· To determine indications to application of the basic substances of antisepsis;
· To process correctly hands before operation;
· To process a surgery field;
· To carry out a patient’s care with a purulent pathology;
· To carry out tests on quality of before-sterilization processings of the instruments;
· To be able to sterilize of surgical instruments;
· To make the program of struggle against an intrahospital infection;
· To determine preventive actions for struggle against an intrahospital infection in surgicaldepartment and a surgery block.
Prepared by docent Kushnir R.
Adopted at the Chair Sitting
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Minutes No_____________
