STANDARDIZED PROCEDURE FOR SUTURING I.

Definition This procedure will take place when a percutaneous tube requires securing, or when a wound requires skin closure. The purpose of this standardized procedure is to allow the Allied health professional to safely suture. II. Background Information A. Setting:
Adults Both Inpatient and Outpatient clinical setting

A. Supervision: The necessity of the procedure will be determined by the Allied Health Professional in corroboration with the attending physician or their designee. Direct supervision will not be necessary once competency is determined. The Allied Health Professional will notify the physician immediately under the following circumstances: 1. Patient decompensation or intolerance to the procedure 2. High fever, marked leukocytosis, or expanding cellulitis 3. Outcome of the procedure other than expected B. Indications: 1. 2. 3. 4. 1. 2. 3. 4. 1. 2. 3. 4. 5. 6. 7. 8. Percutaneous tube that is insecure; Significant tenderness, erythema or irritation at current securing suture site; Evidence of weeping, such as in ascites; Accidental dislodgement of a suture The patient may need wound culture & antibiotics Cellulitis should be determined Effectiveness of the drain should be established Appropriateness of wound condition for closure Lidocaine 1%, 24g needle, 1cc syringe Betadine swabs Needle holder Nonabsorbable suture material Needle Forceps Scissors Gauze sponges

C. Precautions:

III. Materials

Gynecologic Oncology NP_Regan CIDP Approval: EMB/GAC Approval: Future Review Due: At reappointment

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IV. the outcome. curve the needle and suture through the tissues. 2. inject local anesthetic agent. and any teaching performed. The tube site or wound will be inspected by the Allied Health Professional and/or a physician to determine the necessity for suturing. 2. the expected outcomes of the procedure. Competency Assessment A. B. B. Inform patient of the treatment plan. Evaluate for the potential to experience pain. Position the patient in a comfortable position that gives adequate access to the site. tie knot in a manner that minimizes wound tension 6. technique should allow for proper wound eversion 5. and pre-medicate the patient appropriately. Follow-up treatment Monitor site as needed for suture patency V. D. clean area with betadine or similar appropriate solution 2. VI. dress the site as appropriate E. The Allied Health Professional will be instructed on the efficacy and the indications of this therapy and demonstrate understanding of such. All abnormal or unexpected findings are reviewed with supervising physician. which includes placing one or more sutures. Suturing Procedure A. Gynecologic Oncology NP_Regan CIDP Approval: EMB/GAC Approval: Future Review Due: At reappointment Page 2 . pierce the epidermis and the dermis at 90 degree angle 4. Post-procedure Record the procedure and the outcome and the plan in the progress note F. The Allied Health Professional will observe this procedure at least once in entirety. the patient’s tolerance. 2. the indications. allowing time for effectiveness 3. Prepare patient: 1. and the treatment plan. Written record reflects the procedure. the plan of care. Pre-treatment evaluation: 1. Initial competency: 1. ensure the involved tube is secure and optimally positioned for comfort 7. Set up: Gather all necessary supplies B. Documentation A. Procedure 1.

The Allied Health Professional will perform three (3) treatments/procedures under the observation of the supervising physician or their designee and such additional procedures as may be necessary to verify clinical competence. Gynecologic Oncology NP_Regan CIDP Approval: EMB/GAC Approval: Future Review Due: At reappointment Page 3 . Continued proficiency will be documented on annual evaluation or re-credentialing.3. A.

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