Suturing and Improving Healthcare by Linking Clinical and Didactic Training
Responding to Chase
This is a great post, Chase. I agree with you. Linking clinical and didactic training can improve the healthcare provider’s skills and competence necessary for improved patient outcomes. Clinical training occurs within the hospital settings, whereas didactic training can be gained informally from fellow healthcare professionals as well as formally from formal learning centers. Clinical training helps the learners to be involved directly in clinical activities involving patient care and real problems to develop and improve skills necessary for patient and interprofessional communication, physical examination, and history taking, among other clinical practice competencies (Burgess et al., 2020).
On the other hand, didactic training improves the nurse’s understanding of their roles and helps them develop critical thinking and reflective skills for nursing. Therefore, the nurse understands how to translate theory into practice. Combined, both clinical and didactic training help develop all the necessary competencies for the delivery of necessary nursing services and efficiency in an individual’s nursing role.
Burgess, A., van Diggele, C., Roberts, C., & Mellis, C. (2020). Key tips for teaching in the clinical setting. BMC Medical Education, 20(2), 1–7. https://doi.org/10.1186/S12909-020-02283-2/TABLES/5
Responding to Bernardo
This is a good post, Bernardo. I agree with you. Suturing is one of the most important surgical skills for closing wounds to facilitate healing. Therefore, it is a necessary skill that every healthcare professional working in primary care and emergency care settings should seek to develop regardless of their roles. Seeking to develop basic surgical skills such as suturing while still in practice can be challenging due to issues with time constraints, the unavailability of resources for clinical training, and the lack of apprenticeship options. There are also several suturing techniques that medical students need to master for various wounds. However, the use of simulation-based training in medical education has been proven to improve the ease of surgical learning and the development of basic suturing skills (Emmanuel et al., 2021). Mastering the basic suturing methods can improve one’s confidence within the clinical environment as well as positively impact the safety of the care process provided to patients.
Emmanuel, T., Nicolaides, M., Theodoulou, I., Young, W., Lymperopoulos, N., & Sideris, M. (2021). Suturing Skills for Medical Students: A Systematic Review. In Vivo, 35(1), 1. https://doi.org/10.21873/INVIVO.12226
We’ll write everything from scratch
Since you have been in the NP program, discuss a procedure (not previously discussed) that you were able to observe and perform. Is there a particular skill that you want to complete during this clinical rotation? Citation and reference required.
Length: A minimum of 150 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last five years
In the family practice I am at, we do not get that many skill opportunities. I have done suture removal, freezing of warts, and pap smears. It seems almost all clients requiring pap smears will get them at the practice. These patients are typically assigned to my preceptor, who is a female NP. The male attending tends to refer out to OB/GYN, which is understandable. In this exact clinical rotation, I do not anticipate any more possibilities for new skills. My goal next semester is to get some elective hours at an urgent care or emergency department to participate in these skills. Although, through my RN job, I have aided in multiple suture placements. The physical hands-on portion is important to create muscle memory and help gauge the depth of tissues. My preceptor informed me there are post-graduate classes we can attend that will give continuing education units as well as crash courses on skills needed for nurse practitioners who want to work in more acute settings. Having these at our disposal shows the constant growth in the healthcare field as professionals. According to the American Association of Nurse Practitioners, approximately 15,000 NPs are working in emergency care (Veenema et al., 2021). More than 60% of the national NP workforce are certified family NPs, and less than 9% are acute care certified (Veenema et al., 2021). Misalignment of the practitioner’s education and skill set can create variations in the scope of one’s training. Creating the connection between clinical and didactic training will provide the preparation needed for increased patient outcomes.
I have long been fascinated by what it feels like to suture an open wound. Approximately 6 million wounds are treated in emergency rooms annually in the US. Most child injuries are to the head, and the most frequent method of damage is by blunt force. Two objectives guide the treatment of these tiny wounds: preventing infection and producing a functional scar that is acceptable from a cosmetic standpoint (Brancato, 2022). Working in the emergency department requires providers to care for patients with single or multiple trauma that requires surgical suturing. Most of the time, the provider would use the same technique of suturing in closing wounds. However, there are a few cases where they have to use a different method. After this course, the goal is to land a position in the emergency department. Therefore, learning the techniques of suturing and related materials used in the procedure is a must. Suturing has been used to close surgical and traumatic wounds for millennia. Still, it wasn’t until the invention of local anesthetics a hundred years ago that providers could shift their attention from employing the fastest suture placement technique to the most successful and efficient way. Surgical treatments on the skin and related tissues aim to restore the skin as closely to “normal” as possible. Therefore, handling tissue as gently as possible when performing the procedure is essential. In addition, it is crucial to pay close attention to hemostasis. Finally, before beginning extensive repairs, a full grasp of anatomy, tissue mechanics, flap mechanics, and geometry is critical (Kantor, 2016).
Sutures should be used as the primary method of closure when a wound extends through the dermis, and excessive scarring is likely to result if the wound edges are not adequately opposed. In addition, sutures are preferred when the wound requires careful approximation. However, there is a contraindication for suturing. Lacerations that require suturing carry a high risk of developing an infection, including those made via infected skin and deep piercing wounds. Finally, surgery should be performed if irrigation and debridement at the bedside are insufficient to remove the foreign debris from the laceration entirely (Delemos, 2022).
Finally, the simple interrupted suture, simple running suture, running locking suture, depth-correcting simple interrupted suture, horizontal mattress suture, running subcuticular suture, and many variations of the tip stitch are other frequently used laceration repair procedures (Kantor, 2016). These are the surgical techniques that are needed to learn to be able to handle almost every open wound.