Fundamentals

surg tech developed in

Britain and then the U.S.

four members of the surgical team

surgeon, first scrub, anesthesia care provider, and the circulating nurse

Three phases of surgical case management

preoperative, intraoperative, postoperative

all phases of surgical management

perioperative

preoperative

occurs prior to initiation of surgical procedure

intraoperative

occurs while procedure is being performed

postoperative

begins when procedure is terminated

non-sterile surgical team members

anesthesia care provider

circulating nurse

sterile surgical team members

surgeon

first scrub

how many people to count

two

who are the two people for count

circulating nurse and surg tech

who initiates count

surg tech

who calls for time-out

circulating nurse

operating surgeon

DO, MD, DPM, DDM

performs surgery

directs OR staff

who takes over if something happens to surgeon

Physicians Assistant

Anesthesiologist

in control to determine if surgery happens or not

scrub tech pre-op

gather necessary case cart, equipment, and supplies

review the patients information

arrange the OR furniture

perform the surgical scrub

don the sterile gown and gloves

create and maintain the sterile field

organize the sterile field for use including labeling of medications

scrub tech intra-op

pass instruments

supplies and equipment

anticipate surgeons needs

maintain aseptic technique

label medication

retracting tissue

cutting sutures

suctioning blood

irrigating wound

surg tech post-op

maintain sterile field (back table & mayo) until patient has left the OR

disassemble sterile field

remove used instruments and supplies

get OR ready for next patient

assistant to surgeon

PA, RNFA, SA, CSFA

assist with surgery

circulator

liaison for team and patient advocate

anticipate needs of sterile team members

RN or CNOR (certified nurse operating room)

duties of circulator

chart

transport correct patient

position patients on table

prep the patient (clean, make sterile)

put in foley (catheter)

provide additional items to surgical field

anesthesia care provider

provides drugs to alleviate pain and maintain patient homeostasis during surgery

can be anesthesiologist, CRNA, or anesthesia assitant

duties of anesthesia care provider

supervise patient care during and after surgery

monitor blood loss

order blood

pain management

critical care medication

who is surg tech under

DON (director of nursing)

other team members in OR

pathologist

radiologic technologist

perfusionist

pathologist

examines patient tissues

radiologic technologist

operates x-ray

perfusionist

operates heart-lung machine during open heart procedure

who is responsible for the patient to sign consent

doctor

consent cannot be signed when

the patient is under the influence of any drug

CAAHEP

Commission on Accreditation of Allied Health Education Programs

ARC/STSA

Accreditation Review Council on Education in Surgical Technology and Surgical Assisting

NBSTSA

National Board of Surgical Technology and Surgical Assisting

AST

Professional organization for surgical techs

what does AST ensure

STs have knowledge and skills required to administer patient care

where are sts employed

hospitals, labor and delivery, ambulatory surgery centers

employability skills

work ethics, detail oriented

communication skills

dedication and adaptability

responsibility and accountability (surgical conscience)

personal appearance and hygiene

key characteristics of ST

ability to prioritize

ability to consider alternative solutions (critically think of better solution)

evaluate the problem and if it can be solved on an individual basis

ability to work with others as a team (team player, communicate)

assess the results of a solution and determine if that solution can be improved if reencountered

ST lifestyle

standing for long periods of time

ability to lift and move heavy objects

exposed to communicable diseases

unpleasant sights

hazardous materials

teamwork in surgery

fundamental aspect of surgery

team members must know their role and the roles of others, must be observant

effective verbal and nonverbal communication

principles of teamwork

polite

respectful

willingness to compromise

collaboration

discuss processes and potential conflicts

acknowledge alternate solutions

basic relationships ST will effect

social

professional

therapeutic

social relationships

peers and friends

professional relationships

co-workers, doctors, and other health care providers

therapeutic relationships

patient and patient’s family

traditional ORs

hospitals

free-standing ambulatory surgical centers

outpatient surgeries

free-standing specialty centers

ortho

three general types of hospitals

proprietary

nonprofit

for-profit

proprietary hospitals

privately owned; cooperation

nonprofit hospitals

profits returned to hospital

for-profit hospitals

HMO’s

health maintenance organizations

insurance that limits choice of specific doctors and hospitals

examples of HMO’s

Medicare

Medicaid

Medicare

over 65 or disabilities/chronic or critical health condition

does not cover long term facilities

Medicaid

low incomes/physically disabled

PPO’s

preferred provider organization

Joint Commission

independent, nonprofit national organization that develops standards and accredits health care organizations

Aegar Primo

patient first

certification

becoming certified in surg tech by passing a certification exam is a voluntary demonstration of competency

registration

some states require surg tech to register in that state before practicing

licensure

attaining licensing by fulfilling a states requirements in regard to education, competence, and practice is the most restrictive of the 3 means of demonstrating competence

scope of practice

describes procedures and actions in progress that a healthcare practitioner is permitted to undertake in keeping with the term of professional licensure

free-standing facility

entity furnishing health care services for medicare beneficiaries

Cushing

father of neurosurgery

active listening

key to effective communication

characteristics of active listening

listen to understand

ask deeper questions

avoid interruptions

take non-verbal cues

withhold judgement

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office areas

OR management and anesthesia personnel

labratory

immediate access to pathologist

instrument room

for storage of surgical instruments, sometimes called sterile processing

utility and decontamination room

contains sink or ultrasonic cleaner for cleaning of instruments prior to sending them to central processing area

sterile supply rooms

contains supplies used daily in OR, sometimes called materials management

CHIP

uninsured children under state income poverty level

DRG

diverse related groups

ACS

American College of Surgeons Care of Surgical Patients

AMA

American Medical Association

AAMI

Association for the Advancement of Medical Instrumentation

AORN

Association of periOperative Registered Nurses

FDA

Food and Drug Administration

OSHA

Occupational Safety and Health Administration

what is OSHA

agency of the U.S. Department of Labor dedicated to preventing work-related injuries, illnesses, and occupational fatalities by issuing and enforcing standards for workplace safety and health

what is AMA

professional organization dedicated to ensuring sustainable physician practices that result in better health outcomes for patients

what is AAMI

nonprofit organization involved in the development, management, and use of safe and effective medical technology and devices

what is AORN

nonprofit professional organization that represents the interests of perioperative nurses by establishing standards in nursing education and clinical practice

what is FDA

agency of the U.S. Department of Health and Human Services responsible for promoting public health through the regulation of food safety, tobacco products, medications, blood transfusions, medical devices, and cosmetics

Emergency surgery

immediate surgical intervention

examples of emergency surgery

GSW, ruptured appendix, heart attack, craniotomy for a subdural hematoma

urgent surgery

requires treatment within a short period

examples of urgent surgery

gallbladder, lysis of adhesions, unruptured ectopic pregnancy with stable vital signs

elective surgery

does not have to be performed immediately, optional

examples of elective surgery

total joint arthroplasty, rhinoplasty

professional

maintain competence in a specialized body of knowledge and skills

Clinical ladder for ST

level 1: entry-level practitioner

level 2: proficient practitioner

level 3: expert practitioner

level 1: entry-level practicioner

less than a year

level 2: proficient practitioner

certified surg tech

cases by themselves

level 3: expert practitioner

preceptor role

components of communication

sender, message, receiver, feedback

sender

shares a message with an individual or group

senders deliver or “encode” this message through verbal and nonverbal means

message

information, it might be distorted by outside influences such as noise