Clinic

1. Organization of the work of
the nurse of the treatment
room
Lecturer: Orynbassar S.A.

2. Basic principles of the organization
of the treatment room
The treatment room is an integral part of any
medical and prophylactic institution. Here, the
procedural nurse performs medical
appointments, carries out therapeutic and
diagnostic manipulations as part of her
functional duties. Equipping the treatment
room, maintaining it in proper sanitary and
hygienic condition, as well as the qualifications
of the nurse of the treatment room, play an
important role in ensuring the quality of medical
care for the patient and preventing the spread of
nosocomial infections.

3. Functions of the room
In the treatment room,
everything should be
provided for various
medical manipulations:
performing injections -
subcutaneous,
intramuscular,
intravenous; taking
blood from a vein for
laboratory tests;
punctures, etc.

4. Principles of organization of the
treatment room
In the process of organizing a treatment room in a
medical institution, you should rely on
"Sanitary and epidemiological requirements for
organizations engaged in medical activities"
In the treatment room, everything should be at a
minimum, since everything that is in the treatment
room must be disinfected.
The treatment room should be placed in a separate
room with an area of at least 12 square meters. m.
In departments with two ward blocks, at least two
procedural rooms are provided.
In infectious disease wards consisting of boxes,
treatment rooms should have an external exit and a
gateway at the entrance from the corridor.

5. Room requirement
 Walls should be lined with
glazed tiles up to the ceiling
or covered with moisture-
resistant matte paint.
 The ceiling should also be
covered with moisture-
resistant paint. It is allowed to
use suspended ceilings,
provided that structures and
materials are used that
ensure tightness, smoothness
of the surface and the
possibility of wet cleaning and
disinfection.

6. Room requirement
 To cover the floors,
moisture-proof materials
(linoleum, tiles, and other
materials) should be used.
When using linoleum
coatings, the edges of the
linoleum at the walls should
be tightly fixed between the
wall and the floor, brought
under the baseboards. The
seams of the sheets of
linoleum adjacent to each
other should be carefully
soldered.

7. The treatment room should be
equipped with:
 2 sectional sinks with hot and
cold water connection (for
hands, for tools);
 crane with elbow mixer;
dispensers (elbow) with liquid
(antiseptic) soap and antiseptic
solution;
 paper towel dispenser;
 mirror;
 containers for waste disposal in
accordance with the
requirements of biological
safety;

8. The treatment room should be
equipped with::
 supply and exhaust ventilation
with mechanical stimulation and
natural ventilation through
vents, frames, etc., equipped
with a fixation system;
 a fume hood (when using, for
example, cytostatics)
 air conditioning system.

9. Room requirement
 The surfaces of heating
appliances must have a
smooth surface.
 Heating devices should be
placed near the external
walls under the windows,
without fences.
 Cosmetic repairs of the
treatment room are carried
out annually.
 The elimination of current
defects must be carried out
immediately.

10. Room requirement
 The room of the treatment
room should have natural,
general and local artificial
lighting with fluorescent lamps.
 General lighting fixtures of the
cabinet should be with
continuous (closed) diffusers.
 The treatment room should be
equipped with closed, open or
combined lamps of ultraviolet
bactericidal radiation.

11. Standard equipment of the
treatment room
The furniture of the office is
represented by a medical couch, a
nurse's desk and a cabinet for
storing documentation. All dressing
materials and reusable instruments
are stored in bixes, ultraviolet
cameras, ensuring their sterility.
To soak used tools and
perform primary disinfectant
manipulations in the treatment
room, it is necessary to have
containers with disinfectant
solutions.

12. Standard equipment of the
treatment room
 Nurse's desk - 1;
 Nurse's chair - 1;
 Screw chair - 1;
 Medical cabinet for sterile solutions and medicines - 1;
Instrumental table - 2;
 Bedside table - 1-2;
 Refrigerator - 1;
 Medical couch - 1;
 Procedural table - 1;
 Cabinet for emergency and post-syndromic therapy
medicines - 1;
 Containers for waste disposal ("A", "B", etc.).

13. Cleaning equipment:
 galvanized (plastic) bucket for floor cleaning - 1;
 bucket for washing walls - 1;
 mop for washing floors - 1;
 Set for general cleaning - 1;
 containers for rags (processing of furnishings,
surfaces) - 1;
 disinfectants;
 Detergents.
All cleaning equipment should be clearly marked
indicating the premises and types of work.

14. Standardization of workplaces

15. Organization of TREATMENT
ROOM
In the Treatment Room, an aseptic,
working or economic zone are
distinguished and the intersection of
clean and "dirty" flows is excluded.
Working (aseptic) zone:
-couch,
-refrigerator,
-work and 2nd manipulation table. -
cabinets for storage of medicines and
medical products
-table (chair) for blood sampling
sterile bix

16. Organization of TREATMENT
ROOM
Economic zone:
 sink,
 table with drawers for
registration and documents,
 chairs for nurses, patients and
patients' belongings or hanger,
 Equipped place for disinfection
of instruments
 bedside table for storage
(disinfectants), detergents for
using for cleaning

17. Equipping with soft equipment:
 3 bathrobes (one for
working in the office, the
second for leaving the office
and the third additional),
 2 caps (one working, the
other additional),
 masks, shields, safety
glasses,
 towels or disposable
napkins,
 rollers and tourniquets for
intravenous injection.

18. Workplace
The treatment room is
the nurse's main workplace
Proper organization of the
workplace:
-rational use of working time,
- competent and accurate
execution of manipulations,
- high-quality sanitary and anti-
epidemic measures
- ensuring a high level of the
medical and diagnostic process
in the department.

19. Aesthetic design of the treatment
room
 The treatment room should
look neat and contain the
most necessary for work.
 There should be no bright
stickers, pictures, "sloppy"
instructions and memos
fixed with a band-aid. Glass
openings must be clean.

20. Aesthetic design of the
treatment room
On the walls there are only the necessary
instructions in minimal quantities in laminated form:
-higher single and daily doses of drugs;
-table of antidotes; the main stages of disinfection of
instruments, syringes, needles, systems and medical
waste of class "B";
-disinfection modes; memo to a medical professional on
the prevention of occupational infection;
-anaphylactic shock (nurse's tactics)

21. Aesthetic design of the treatment
room
Before entering the office, there must
be information:
- schedule for opening hours to cleaning
and quartz as a memo for patients
-The nurse should inform the patient
where the container is located for
spent cotton balls

22. Preparing the office for work
 wash your hands,
Check availability of:
-antiseptics and liquid soap;
-one-time towels or paper napkins for
hands;
-gloves;
-disinfectants;
-the required number of packages of
sterile material;
-the required number of packages of
syringes, peripheral catheters,
infusion systems, blood sampling
systems;

23. Preparing the office for work
-the required amount of drugs;
-bags for waste of classes "A" and "B";
-complete set of first-aid kit for emergency
situations;
-complete set of anti-shock kit;
-test tubes for blood samples for research;
-serums (zoliclons) to determine the blood group;
-replenish all missing items;
-check the temperature in the room and
refrigerator and fix the indicators in the logs;

24. Preparing the office for work
 prepare in the containers a solution of disinfectant "For disinfection
of instruments, syringes, for disinfection of surfaces" in the
concentration, necessary for the work, provided for the
inactivation of hemocontact hepatitis viruses;
 note in the journal or on the tags the name and concentration of
the solution, the date of its preparation; Period of use;
 wear gloves;
 take a large gauze cloth (clean rags);
 Moisten with the necessary amount of disinfectant from the
container for "Disinfection of surfaces" or dispenser with a ready-
to-use form of disinfectant:
 wipe all working horizontal surfaces; throw the napkin in the Class
A Waste bag;
 remove gloves, throw them in a package "Waste class A";
 Turn on the irradiator.

25. WORK PLAN OF THE PROCEDURAL NURSE
(regulations)
Things to do Time to do them
The working day of the procedure nurse begins with the
reception of the office:
-Accept the treatment room with all property, medicines
and documentation;
-Check the safe, the correctness of filling in the logs;
-Assess the sanitary condition of the office.
7.45 – 8.00
Morning Conference
The main purpose of the conferences should be to
familiarize medical and nursing personnel:
-with the work of the department over the past day,
-newly admitted patients, with temperature,
-severe and postoperative patients, with prepared
patients for operations and research.
8.00 -8.15

26. WORK PLAN OF THE PROCEDURAL
NURSE (regulations)
Preliminary current cleaning of the office
8.15 – 8.35
Quartz cabinet
8.35 – 9.35
Ventilation of the office
9.35 – 9.50
Delivery of spent syringes to the Central Sterilization
Department, checking the bookmark and sending the bix to the
autoclave
8.35 – 9.00
Workplace preparation:
9.00 – 9.50
obtaining medicines, solutions, alcohol from the head nurse;
verification of compliance with the expiration dates of drugs
and solutions;
filling in the documentation of the treatment room;

27. WORK PLAN OF THE PROCEDURAL
NURSE (regulations)
delivery of applications for blood, blood substitutes,
etc.;
9.00 – 9.50
delivery of tests to the laboratory;
select assignment worksheets.
Covering the sterile table (tray), preparing the
workplace
9.50 – 10.00
Conducting nursing manipulations (fulfilling
doctors' prescriptions)
10.00 – 12.30
Current cleaning of the office: disinfection of
working surfaces of the manipulation table,
change of sterile diaper, disinfection of
syringes, needles, systems for intravenous
infusions, etc.)
12.30 – 12.40

28. Documentation
 General cleaning journal.
 Journal of sterilization of instruments,
accounting for the quality of pre-sterilization
treatment.
 Journal of accounting of occupational injuries.
 Journal of accounting of medical instruments.
 Journal of accounting of medicines.
 Medical (sanitary) book.
 Journal of accounting for the receipt of
vaccines.

29. Documentation
 Acts of destruction of unsuitable (expired
vaccines).
 Refrigerator temperature log. Journal of
registration of preventive vaccinations.
 Journal of general cleaning of the office.
Journal of accounting of hyperegic reactions
MANTOUX.
 Journal from BCG.

30. Documentation
 Notebook quartz cabinet.
 Notebook of accounting for azopyramic and
phenolphthalein samples.
 Journal of appointments of the treatment room.
 Notebook of accounting for intravenous blood
sampling for biochemical analysis, HbSAg, rh factor
blood group.
 Notebook of accounting for intravenous blood
sampling on RW.
 Notebook of accounting for intravenous blood
sampling for HIV infection.
 Hepatitis vaccination register.

31. Standards and Standard Operating
Procedures :
 Standard equipment of the treatment room;
 SOP for the management of class B, B, D medical
waste;
 Antibiotic breeding standard;
 SOPS of intravenous, subcutaneous and
intramuscular injections;
 SOP laying vaccines in thermal containers for
transportation;
 SOP On catheterization of cubital and other
peripheral veins;
 SOP on the use of medicines and medical devices in
the treatment room;
 Standard for setting a sterile table;
 SOP for the preparation of bix for sterilization.

32. Quality of medical care
is determined, first of all, by the system of health
care organization as a whole and each of its
branches separately and by the correct
organization of a specific office or specialist