Vіі. Методика проведения занятия и организационная структура занятия

Распределение баллов, которые может получить студент:

At mastering of theme № 1 a thematic module №1 for educational activity to the student the estimation for 4th is proposed to the traditional scale which is then converted in marks as follows:

Estimation	Balls
“5” (perfectly)	6
“4” (well)	4
“3” (satisfactorily)	2
“2” (unsatisfactorily)	0

Methodical pointing for work of students on practical employment

The thematic module 1

Introduction to surgery. Desmurgy. Aseptics and antiseptics.

Features of care of patients in the surgical department. Surgical operation.

Practical employment № 1

Theme: Introduction to surgery. Hygiene in surgical department. Work of nurse in surgical department.

Theoretical questions for the independent study and discussion on practical employment №1:

1. Life and activity of famous of home scientists-surgeons: M.I. Pyrogov, V.O.Karavayev, M.V.Sklifosovsjky, M.M. Volkovich, M.M. Amosov, A.A. Shalimov.

2. Structure and organization of surgical department.

3. Description of notions sanitary-gigienical and antiepidemic modes in the surgical departments.

4. Essence and basic positions of order №720.

5. The hygienical requirements produced to the clothes of medical personnel.

6. The hygienical requirements produced to the clothes of patients.

7. The hygienical requirements produced to bed linen of patients.

8. The hygienical requirements produced to the change of linen, at the care of patients and seriously sick.

9. Principles of diagnostics of nosocomial infection, warning of its distribution.

10. Moist cleaning up in the surgical department with the use of facilities of antiseptics.

11. Change of the linen worn next to the skin by a patient with the general and bed modes.

12. Change of bed linen by a patient with the general and bed modes.

13. To be able to execute medical manipulations: thermometry, injections.

Literature:

Basic:

1. Butyrsky A. General surgery. – Simferopol. 2004.

2. Shevchenko S.I. and others. Surgery. – Kharkov. 2004

Additional:

1. Kushnir R.Lectures of General surgery. – 2005.

2. Methodological recommendations on surgical patients care. – Vinnitsa National Pirogov Memorial medical university. 2006.

Distributing of marks which can be got by a student:

At mastering of theme № 1 a thematic module №1 for educational activity to the student the estimation for 4th is proposed to the traditional scale which is then converted in marks as follows:

Estimation	Balls
“5” (perfectly)	6
“4” (well)	4
“3” (satisfactorily)	2
“2” (unsatisfactorily)	0

Tests for verification of initial level of knowledges

That is the deposit of M. I. Pyrogov in surgical science?

а) first applied ether anesthesia;

б) it is the founder of antiseptics;

в) creation of topographical anatomy;

г) it is the founder of asepsis;

д) development of basic principles of the military field surgery.

What enters in the duty of the head nurse?

а) preparation to work of anesthesia apparatus;

б) control of work of the chamber trained nurses;

в) helping to the doctor-anaesthetist of;

г) control of work of doctor;

д) supervision after the sanitary state and economy of department.

What enters in the duty of the chamber trained nurse?

а) providing to the patient of urgent before-doctor help;

б) providing of department by the economic equipment;

в) realization of care of patients;

г) handing over in elimination of dirty linen;

д) helping to the doctor-anaesthetist of.

What enters in the duty of the operating trained nurse?

а) providing of sterility of all materials used for the operations;

б) conducting of change of the linen worn next to the skin;

в) realization of measures on the in-plant training of nurses;

г) participation in the operation;

д) realization of supervision and care of patients being found in a chamber.

Divide patients in the surgical departments on:

а) clean;

б) de bene esse clean;

в) festering;

г) blue pus patients;

д) sterile.

Nosocomial infections are divided on:

а) chamber;

б) operating;

в) hospital;

г) ambulatory;

д) mikrobic.

Who organizer and controls implementation of antiepidemic measures?

а) manager by the surgical department;

б) head nurse;

в) independent observers;

г) patients;

д) relatives of patients.

What elements are not included by the hygiene of medical personnel?

а) the personal hygiene of medical personnel;

б) hygiene of professional clothes and workplace;

в) change of the linen of sick worn next to the skin;

г) cleaning up of adjoining territory;

д) hygiene of conducting of medical manipulations.

That foresees the order №720?

а) obligatory bacteriological control of air;

б) rise of stability of patients to the unfavorable factors;

в) exposure of patients with pedikulosis;

г) exposure of patients with the festering-inflammatory diseases;

д) control of quality of sterilization.

What to do with the linen of patient, stained by a blood?

а) not to change to complete wound healing;

б) to change on clean;

в) to lay on a battery for drying;

г) to take in an oilskin sack in laundry;

д) to burn.

What is done with patients at the discovery at them of nosocomial infection?

а) transition in other department;

б) insulate in separate chambers;

в) bandaging is conducted above all things;

г) write for ambulatory medical treatment;

д) a separate medical personnel is selected.

What includes medical examination of employees of hospital?

а) digital rectal examination;

б) bicycle ergometry;

в) bacteriological research of strokes from a mucous membrane;

г) fiber-optic gastroscopy;

д) fluorography.

What measures are conducted in case of beginning of nosocomial infection?

а) setting by all patient of antibiotics;

б) registration with filling of the form 058-0;

в) epidemiology inspection with bringing of epidemiologist of sanitary-and-epidemiologic institution;

г) addition to medical treatment of patients of red wine;

д) discharge from work of main doctor.

What from transferred does not behave to the prophylaxis of air infection?

а) ultraviolet irradiation of air;

б) cleansing preparation of the operating field;

в) ventilation;

г) dispersion of freshen air;

д) inflow-outflow ventilation.

To the common measures of safety of medical personnel from infections belong:

а) rise of resistibility of organism to the infections;

б) timely exposure of bacteria carrier among a medical personnel;

в) washing of hands;

г) the use of protective facilities;

д) conducting of vaccination.

Situation tasks for verification of eventual level of knowledges

A sister-hostess in a manipulation cabinet for the hygienical washing of hands passed lump toilet soap. Is it correct she acted? What mean the hygienical washing of hands is conducted by?

At the practically healthy operating-room nurse at bacterial research of mucous nasopharynx pathogenic microflora was exposed. What measures it is needed to take with the purpose of warning of development of nosocomial infection? Who a medical staff from point of source of exciter of infection is considered?

In the surgical department during the flash of epidemic of flu to visit a patient his relative came and insists on the appointment. He can allow it? What measures for prevention to distribution of virus of flu must be conducted in the department?

A patient with a clean postoperative wound appeared on bandaging then, when bandaging to the patients with running sore are conducted. Is it possible to bandage him? How must the medical sister of bandaging act in this case?

A doctor-surgeon the last time passed fluorografy of a 2 year to that backwards. It is possible to admit him to work in the surgical department?

At sick D., 46 years, which 10 hours ago carried the operation concerning the intermuscular phlegmon of right thigh, bed and worn next to the skin linen made oneself dirty by excretions from a postoperative wound. How needed to act in this case?

The junior nurse of surgical department conducts the change of bed linen at patients in a chamber. She laid down muddy linen under a washstand on a sheet. What error was assumed by a junior nurse?

The junior nurse of surgical department changed linen at patients in a chamber, placed him in a sack from waterproof fabric. What must she do with the collected dirty linen farther?

The junior nurse of surgical department conducts the change of bed linen at patients in a chamber. She folds muddy linen under a washstand on a sheet. What error was assumed by the given junior nurse?

To the patient S., in 63, operative interference concerning the combined piles is planned. At a patient concomitant diagnosis – of high quality prostatic hyperplasia, that can provoke the sharp delay of urine in an early prostatic postoperative period. What the prophylaxis of nosocomial infection of urinary tracts will consists in?

A junior nurse is going to conduct the moist cleaning up in a chamber with the use of solution of chloramine B. How her to prepare necessary solution?

By a patient in the chamber of surgical department a junior nurse replaced the linen worn next to the skin. How after it must cleaning up in a chamber be executed?

At a patient with running sore at pressure in a wound the liquid fetid separated is selected with the bubbles of gas, an anaerobic infection is diagnosed. What features of care of such sick one? How to act with the used bandaging material?

A junior nurse conducted cleaning up in the chambers of surgical department by a moist method. What must she do with an inventory for cleaning up?

During the operation a hernioplasty surgeon by a chance unsealed the road clearance of bowel. On 3-and days after the operation in area of postoperative wound appeared excretions of intestinal content. What measures of prophylaxis of nosocomial infection need to be undertaken?