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Domicillary kit contents

Discussion in 'General Issues and Discussion Forum' started by charliebhoy, Aug 25, 2010.

  1. charliebhoy

    charliebhoy Member

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    Hi all,
    I am looking at starting up in Domicillary work and I`m seeking advice on what are the essential contents of an efficient Domicillary kit.

  2. Catfoot

    Catfoot Well-Known Member

    Hi Charlie,
    The most important criteria is to make sure you are following the recommendations of your professional organisation with regard to cross-infection control. If you are an SCP Member then these are available on their website.

    Otherwise, it's just personal preference as to what you put in it !

    I would recommend one with wheels, to stop you getting a frozen shoulder in later life, but size, shape and material are your choice.

    Good luck !

    Last edited: Aug 25, 2010
  3. carol

    carol Active Member

    Hi, Ive been at this game for 20 odd years and I wish we'd had a forum like this when I started, I've made some VERY expensive mistakes and wrecked my left shoulder, lugging heavy bags.
    Keep a large plastic box with a lid in the car with a days worth of kit, then use a plastic 'nappy box' from Mothercare (other nappy boxes are available) to transport individual kit to each client. Keep another plastic box to put the 'dirty' stuff in. Keeps cross infection to a minimum. Buy a rechargable battery drill, don't try to lug an electric clinic drill around,even in a trolly, its just not worth risking your back/shoulders/neck. ( chances are there won't be a socket close enough anyway~) Keep everything to a minimum, make sure everything can be either steralised or cleaned with the appropriate spray cleaner.

    Hope this helps!
  4. Geoff Hull Footman

    Geoff Hull Footman Active Member

    What about instruments for doms.For each pt I carry Nippers, blacks file,scalpel handle and diamond deb nail file.With other seperate items as one offs left in the bag or car. I use large lockandlock boxes for clean and used. I carry seperate supply of drill burrs as I only use a nail drill when it is appropriate). I know some burr every time , but following other threads about air pollutantant , even when using a wet drill there is apparently aerosols with nail dust residue. I have used a rechargable Pure drill for over 10 years and still working fine. You watch,it will fail now that I have said this.:confused:
    What do others use?
  5. carol

    carol Active Member

    Ha ha! yes my Pure nail drill is over ten years old, held togther with duct tape! Its a bit tempermental when being recharged, but the nice man at DLT works wonders with his soldering iron when necessary for very little charge. I wouldn't be without it. I use the clipit boxes as well and wash them ( separately!) in the dishwasher, while the autoclave is running. I'm sure there is a rule somewhere that says you shouldn't keep an autoclave in the kitchen but it is the only area in my house with earthed 13amp sockets. I've never had a cross infection problem in 20+ years of practice so I must be getting something right......I think the NHS "managers" are a little too concerned with 'elf and safey' and potential litigtion and seriously lack common sense. Unfortunately the new generation of Pods will have been brainwashed the same way, so denying a lot pf patients treatment because strict (unecessary)protocols cannot be adhered to.
  6. DTT

    DTT Well-Known Member

    Always nice to hear of a really good professional approach to patient safety and infection control !!!!:mad:

    Read what you have written and seriously consider your future in this profession, because if what you have written is your practice principle...... You are not only a serious danger to your patients but to the professions reputation..just hope no one from the HPC reads this and traces it back to you:eek:

    BTW I have been in private practice for around 25 years so I'm more old school , part of the old "careing generation":bang:

  7. carol

    carol Active Member

    I think you are extreemly rude!
    200+ patients and the the associates I work with do not agree with you. I too am old school and put my patients safety above all else. I certainly care a lot for them frequently beyond the call of duty.If you have been practicing as long as you say then you will remember the days when dom. intsruments were 'cleaned' between visits in a jar of IPA and boiled on the cooker in the evenings. I have always had an autoclave and have an up to date model. Maybe I should have pointed out in detail that I 'sonic' and individually wrap instruments.
    Maybe you should read what YOU have written and realise how offensive and unprofessional your remarks are.
  8. DTT

    DTT Well-Known Member

    I appear to have touched a nerve:rolleyes:

    The fact that your duct taped drill will have mycotic nail dust stuck to it among other things for you to freely pass around and your washing instrument boxes in a domestic dishwasher for the residue of food waste to contaminate your instruments with who knows what are not matters for concern ???

    Yes I remember those days and the stropping of solid scalpels , days long gone and times moved on along with knowledge ( if you do some CPD that is).

    Glad to hear you " sonic" everyone should do these days, can I ask at what stage in your sterilisation process do you "wrap" your instruments individually?

    Your advice to others would be apparently to ignore "elf and safety" in relation to infection control because you do ??? not advice that can go unchallenged here I'm afraid
  9. carol

    carol Active Member

    Nice to see the inter profession bickering is alive and kicking.:bang:
    Its a wonderful advert for all the newbies just starting out. Poor thing was only asking for advice.:confused:
    My response was supposed to be a light hearted comment that my drill is pretty ancient too, the business end is sterile. The battery stays in the box.
    I suppose all the homes you visit are surgically sterile and animal free~
    Rest assured I follow all sterilization procedures correctly, and I use disposable dressing packs. but frankly it is none of your business, my track record speaks for itself. I was just trying to point out that what is 'right' in a hospital situation is not always possible in a clients home and that common sense should be allowed.
    We will have to agree to disagree on this in an adult and professional manner:D.
  10. DTT

    DTT Well-Known Member

    As you appear to be withdrawing without answering my question, perhaps next time you comment in answer to a request for help you will choose your words more carefully and not encourage bad practice.

    FYI I do not carry out domicilliary visits I am surgery based so yes a clinically clean environment is always present and the correct infection control protocols are ALWAYS carried out.
  11. carol

    carol Active Member

    " I do not carry out domicilliary visits, I am surgery based"
    I rest my case~

    Of course when you work in a clinical situation with all the equipment to hand it is easy to follow the rules and regulations, and I doI am an associate of a large private practice and worked for many years at a Doctors surgery. I am purely trying to get through to you that when 'out on the road' a little common sense goes a long way. My instruments leave my house sterile but once you open the packet they are as clean as the house you are in.

    The clipit boxes are for dirty instuments so they so not contaminate my car, the large storage boxes are sprayed with hard surface disinfectant every night. This system used by District Nurses so I fail to see how it is 'bad practice'

    When you have spent a day on the road with sticky carpets and urine soaked furniture, trying to stop the cat from climbing into your case and holding your breath from the stench of leg ulcers I think even you would agree, you might have a different veiw.
  12. DTT

    DTT Well-Known Member

    I never said I had never done domicilliary visits but I havent for several years for the very reasons you state.

    I agree common sense is very important but can you teach it ??

    Your reply was aimed at a new graduate still wet behind the ears and asking for advice nothing more and well done that he asks:empathy:.

    You then gave him not correct advice..just what you do :bash:

    The Arena is accepted as a learning medium at all levels of ability we all should strive to make that advice as helpful ( as I have done with you :rolleyes:) and correct in principle.

    I'll ask you again Carol, at what stage do you individually wrap your instruments in your sterilisation process ??? and what make and model / type is your new autoclave ?? I'm interested to know

    Last edited: Oct 17, 2011
  13. Suzannethefoot

    Suzannethefoot Active Member

    I just found this thread and though I would put in my two penny's worth, now that Carol and DDT seem to have stopped their 'discussion'. I use a child's folding stool to sit on, as you need to be a bit lower than the patient, not ideal, but better than the floor, I also have a footstool for their foot. I buy shower curtains and cut them into six rectangular pieces, to use as mats, after 11 years, I find these the best, they fold without tearing and you can wipe them clean after each patient with disinfectant wipes, a plastic mini dustpan and brush gets up the debris. The disinfectant wipes are one of the most important part of my kit, you can give everything a good clean as you put it back into the bag, ready for the next call. My instruments are pouched and go into a box in the boot of the car when used, it's nice to feel the bag getting lighter as the day goes on! Although I suppose I shouldn't put them all in the bag in the morning, as it makes it quite a weight to carry. No shoulder problems yet though, in fact, my right shoulder (I am left handed) actually improved after starting this job, I assume carrying the bag strengthened the muscles.

    Good luck with your business,


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