Technology for performing a simple medical service "Landaging for purulent diseases of the skin and subcutaneous tissue"

The dressing technology for purulent diseases of the skin and subcutaneous tissue is included in TPMUHTP and has the code A15.01.002 according to [1].

The content of the requirements, execution conditions, implementation requirements and the technology implementation algorithm are given in Table 2.

Table 2 – TPMUHTP “Laging for purulent diseases of the skin and subcutaneous tissue”

Content requirements, conditions Implementation requirements, execution algorithm
1 Requirements for specialists and support staff 1.1 List of specialties / who is involved in the performance of the service 1.2 Additional or special requirements for specialists and support staff 1) A specialist with a standard diploma of graduation from a secondary vocational medical educational institution in the specialties: “General Medicine”, “Nursing, Obstetrics” 2) A specialist with a standard diploma of graduation from a higher educational institution in the specialties: “ General Medicine”, “Nursing (Bachelor)” Have the skills to perform this simple medical service
2 Requirements for ensuring the safety of medical personnel 2.1 Requirements for labor safety when performing a service Before and after the procedure, carry out hygienic treatment of hands Mandatory use of gloves during the procedure.
Continuation of table 2
Content requirements, conditions Implementation requirements, execution algorithm
3 Conditions for performing a simple medical service Stationary. outpatient clinics
4 Functional purpose of a simple medical service Treatment of diseases
5 Material resources 5.1 Instruments, instruments, medical products 5.2 Reagents 5.3 Immunobiological preparations and reagents 5.4 Blood products 5.5 Medicines 5.6 Other consumables Clamp. The tweezers are non-sterile. The tweezers are sterile. Bubble probe. Surgical scissors with one sharp end. Richter scissors. Grooved probe. Clamp Mosquito. Scalpel. Drainage tube. Waterproof bag/container for Class B waste disposal. None. None. None. Hydrogen peroxide 3%. Alcoholic iodine solution 5%. Brilliant green solution. Octenisept. Hypertonic sodium chloride solution 10%. Ethyl alcohol 70%. Medicines prescribed by a doctor. Cleo. Hand sanitizer Bandages. Sterile cotton balls. Sterile gauze pads in various sizes. Patch. Sterile gloves Non-sterile gloves Oilcloth (disposable moisture-resistant diaper). Oilcloth (disposable plastic) apron. Glasses
6 Characteristics of the methodology for performing a simple medical service 6.1 Bandaging algorithm for purulent diseases of the skin and subcutaneous tissue 6.1 Bandaging algorithm for purulent diseases of the skin and subcutaneous tissue 6.1 Bandaging algorithm for purulent diseases of the skin and subcutaneous tissue I Preparation for the procedure: 1) Identify the patient, introduce yourself, explain the course and purpose of the procedure. Make sure that the patient has voluntary informed consent to the upcoming procedure for administering the drug and its tolerability. In the absence of such, check with your doctor for further actions. 2) Treat hands in a hygienic way, dry. 3) Put on non-sterile gloves. 4) Prepare everything you need for dressing. 5) Help the patient to undress and ask him to take a comfortable position on the dressing table or on a chair. 6) Place an oilcloth under the dressing area. 7) Put on goggles, protective clothing (apron, mask). II Performing the procedure: 1) Remove the fixing bandage (plaster or cleol napkin, bandage) using Richter’s scissors. 2) Remove all layers of the bandage one by one in the direction from one edge of the wound to the other (traction across the wound increases its gaping and causes pain), the skin should be held with a gauze ball or tweezers when removing the bandage, not allowing it to reach for the bandage. A dried dressing should be peeled off with a ball dipped in a 3% hydrogen peroxide solution (sometimes dried dressings are best removed after soaking, if the condition of the wound allows a bath of a warm solution of potassium permanganate 1: 3000). 3) Place the used material in a disinfection container or waterproof bag/container for class B waste disposal. 4) Remove gloves and place them in a disinfection container or waterproof bag/container for class B waste disposal. 5) Treat hands with antiseptic, do not dry , wait until the antiseptic is completely dry. 6) Put on sterile gloves, take sterile tweezers. 7) Examine the wound and its surrounding area (smell, discharge, convergence of the edges of the wound, swelling, soreness). 8) Treat the skin around the wound with sterile gauze balls, changing them after each movement, and moving the swab from the least contaminated area to the most contaminated and from the center outward, first dry, then moistened with antiseptic solutions (ethyl alcohol 70%), the edges of the wound are lubricated with 5% iodine solution or 1% brilliant green solution. 9) Remove the accumulated exudate, if any, by blotting with sterile balls or by washing with a 3% hydrogen peroxide solution, then dry the wound with dry swabs. 10) As prescribed by the doctor, apply an ointment or other medicine to the wound with a sterile spatula. 11) Apply a new sterile dressing in three layers with tweezers. If the wound is drained, apply a panty-type napkin. 12) Fix the bandage with a plaster, adhesive bandage or bandage, depending on the location of the wound. III End of the procedure: 1) Place the used instruments in a disinfection container or waterproof bag/container for class B waste disposal. 2) Remove gloves and place them in a disinfection container or waterproof bag/container for class B waste disposal. 3) Remove glasses , protective clothing (apron or gown, mask) and discard in a container or laundry bag. 4) Treat hands in a hygienic way, dry. 5) Clarify the patient’s state of health, inform the patient about the condition of the wound, instruct him on further actions. 6) Make an appropriate record of the results of the implementation in the medical records
7 Additional information about the features of the implementation of the technique Dressings for purulent diseases of the skin and subcutaneous tissue are carried out daily. Depending on the condition of the wound, the amount of discharge from the wound, dressing may be indicated twice a day. Bandaging can be carried out not in the dressing room, but directly at the patient’s bedside, in the ward for medical reasons, subject to the rules of asepsis and antisepsis. If the wound is drained with a tubular drain, the drain is removed as directed by a physician. With abundant purulent discharge, it is necessary to drain the strip (according to the doctor’s instructions) using a probe
8 Results achieved and measured Cleansing the wound from microbial flora. Stopping the development of the purulent process. Wound healing by secondary intention, without the formation of keloid scars, skin necrosis, cosmetic defects
9 Features of the patient’s voluntary informed consent when performing the technique and additional information for the patient and his family members The patient or his parents (legal representatives) (for children under 15) must be informed about the upcoming treatment and medical procedures. Information about upcoming procedures is communicated by the doctor, nurse or feldsher and includes information about the purpose of the treatment, the desired results and possible complications. Written confirmation of the consent of the patient or his relatives (authorized persons) to conduct medical procedures is required, as they are potentially dangerous to the patient’s health

End of table 2
Content requirements, conditions Implementation requirements, execution algorithm
10 Parameters for assessing and monitoring the quality of the implementation of the methodology No complications during and after the procedure. There are no deviations from the measurement algorithm. The presence of a record of the results of the appointment in the medical records. Timeliness of the procedure (according to the time of appointment). Patient satisfaction with the quality of the medical service provided. Patient’s feeling of comfort after dressing
11 Cost characteristics of technologies for performing a simple medical service Nurse’s coefficient of weight loss – 2.0
12 Graphical, schematic and tabular presentation of technologies for performing a simple medical service Missing
13 Formulas, calculations, nomograms, forms and other documentation (if necessary) Missing



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