ST 210 - The Surgical Patient

1. Demonstrate communication skills.
   1. Communicate in acceptable English and in terminology appropriate to the discipline.
      1. Understand and critically evaluate what is read.
      2. Write in a clear, organized, succinct, and effective manner.
      3. Demonstrate proper spelling, grammar, and sentence structure in formal writing.
      4. Use medical terminology accurately and appropriately.
2. Demonstrate critical thinking skills.
   1. Analyze data and discipline-based knowledge to formulate logical conclusions.
      1.  Integrate and correlate concepts from different courses.
      2. Exhibit development of both inductive and deductive reasoning skills.
      3. Take a position on an issues and provide evidence or adequate rationale to support that position.
   2. Demonstrate the ability to apply conversion formulas and perform basic mathematical calculations.
3. Demonstrate interpersonal/collaborative skills.
   1. Work constructively within a group, demonstrating respect and consideration for others.
      1. Listen to, respect, and critically evaluate the ideas and opinions of others.
      2. Contribute to the product(s) of a study or work group, function within the guidelines established by the group, and accept responsibility for one's own level of participation.
      3. Respect the perspectives, values, and choices of others.
4. Demonstrate understanding of the concepts of the continuity of care of the surgical patient.
   1. Identify the components of a pre-operative check list for preparation of a surgical patient.
   2. Explain the meaning, purpose and limitations of “informed consent”.
   3.  Differentiate various types of operative permits in terms of appropriate conditions and signatories.
   4. Explain the use of other types of consents or records.
   5. Define the two purposes of a shave prep.
   6. Identify the areas to be shaved for various kinds of operations.
   7. Discuss different authority’s opinions regarding the appropriate time, location and method for performing a “shave” prep or whether such a prep is indicated at all.
   8. Describe the proper attire for a patient entering the O.R. and explain the safety reasons for these rules.
   9. Discuss the appropriate safeguarding of a patient’s personal possessions.
   10. Explain the reasons for establishing baseline pre-operative vital signs.
   11. Describe the purposes of pre-operative medications.
   12. Describe the proper safety measures to be taken while transporting a patient to the O.R., including special situations.
   13. Describe the identification process of a patient entering the O.R. suite.
   14. Identify the safety precautions involved in transferring a patient onto the O.R. table before surgery and onto a stretcher/gurney after surgery.
   15. Discuss the legal implications of operative record keeping.
   16. Define the terms Time-Out, Briefing, and Debriefing as they pertain to the operating room.
   17. List the information elements commonly required for various kinds of O.R. records and forms.
   18. Explain the purposes and uses of Incident Reports.
   19. Define the circumstances that determine a Medical Examiner’s (Coroner’s) case, and recognize indications for such a case.
   20. Describe the proper procedures for measuring intraoperative blood loss and urine output.
   21. Discuss the proper methods for monitoring a patient receiving local anesthesia (in the absence of anesthesia personnel).
   22. Describe the special procedural elements involved in intraoperative X-ray technique, bowel technique, cancer technique, and multiple set-up technique.
5. Demonstrate knowledge of incisional approaches and healing for General Surgery procedures.
   1. List the factors affecting the choice of the type of surgical incision.
   2. For General Surgery incisions, describe the indications, uses, advantages and disadvantages for each.
   3. Name the three stages of wound healing and describe the physiologic processes occurring during each one.
   4. List factors that influence the rate of wound healing.
   5. Differentiate healing by First, Second and Third Intentions and relate those to primary closure, secondary union and delayed primary closure.
   6. List and define complications that may occur during wound healing.
6. Demonstrate knowledge of different kinds of surgical specimens.
   1. Define “Frozen Section” and explain why such a specimen may be requested.
   2. Identify the different types of specimen collection containers.
   3. Describe specimen types and proper methods for handling the various types of surgical specimens:
      1. Frozen sections
      2. Permanent (paraffin) sections
      3. Cultures
      4. Bronchial washings or other fluids
      5. Cytology specimens
      6. Stones
      7. Foreign bodies
      8. Amputated limbs
      9. Legal evidence
      10. Tissue for banking/preservation
7. Demonstrate competence in preparing medications and solutions on the sterile field.
   1. Identify various types of syringes and their uses.
   2. Explain the sizing (gauge) of hypodermic needles.
8. Demonstrate knowledge of environmental risks to Operating Room personnel.
   1. Compare Septic Case Technique with the use of Standard Precautions.
   2. List and differentiate the types of hepatitis viruses and know how they are transmitted.
   3. Discuss Hepatitis B and C viruses and the risks to Operating Room personnel.
   4. Discuss the Human Immunodeficiency Virus and the risks to Operating Room personnel.
   5. Discuss the risks of other microbial hazards for Operating Room personnel.
9. Demonstrate understanding of Radiology/Radiography as it relates to the Surgical Technologist.
   1. Differentiate between “curative” and “palliative” therapy.
   2. Compare surgery, radiation therapy, and chemotherapy as modalities for treating cancers.
   3. Explain what ionizing radiation does to both normal and malignant tissue, including the dangers of underdosage and overdosage in therapeutic use.
   4. Review the electromagnetic spectrum, the elements of radioactive disintegration, and the concept of half-life.
   5. Define and characterize radionuclides (radioisotopes) and discuss their uses.
   6. Identify the sources, attributes, and uses of external radiation methods.
   7. Identify the uses and methods of administration of internal radiation sources.
   8. Compare the half-lives of commonly used radioactive elements and relate those to therapeutic dosages.
   9. List the general safety rules for handling radioactive materials; describe radiation hazards to personnel and proper monitoring precautions.
   10. Discuss the concept of stereotactic radiosurgery (“gamma knife”) vs. “cyber knife”.
   11. Identify the characteristics of irradiated tissue and their relevance to subsequent surgical intervention.
10. Demonstrate understanding of concepts or terminology of legal, moral and ethical responsibilities toward patients.    
    1. Define various legal concepts as they apply to the O.R. situation.
    2. List ways that the Standard of Care may be determined in a court of law.
    3. Discuss how the principles of legal responsibility apply to a student.
    4. Give examples of common acts of negligence in an O.R. setting.
    5. Discuss moral and ethical responsibilities and obligations, as opposed to legal precepts.
    6. Summarize the intentions of Risk Management.
11. Recognize the special needs of pediatric and geriatric patients.
    1. Discuss psychological concerns in different age groups of Pediatric patients facing surgery.
    2. List and describe the special needs of infants and young children undergoing surgery, in terms of both anatomical and physiological considerations.
    3. Discuss the physiologic changes associated with aging and identify the special needs of a geriatric patient undergoing surgery.
12. Demonstrate familiarity with the different conditions involved in ambulatory surgery.
    1. Discuss the advantages of Ambulatory/Out-Patient surgery and the types of procedures for which it may be indicated or desirable.
    2. List the four major types of settings for ambulatory surgery and their relative merits and disadvantages.
    3. Describe the differences in pre-operative, intra-operative and post-operative routines for ambulatory surgery patients.
13. Demonstrate knowledge and understanding of All-Hazard Preparation.
    1. Describe the types of disasters or public health emergencies.
    2. Discuss the effects of emerging infectious disease.
    3. Describe the purpose and coordination of the all-hazards systems, including the hospital incident command system, national incident management system, and national response framework.
    4. Describe the components of a healthcare facility emergency operations plan.
    5. Explain the personal and professional responsibilities of healthcare workers when participating in the management of a disaster or hazard.
    6. Describe how to mitigate casualties according to specific types of hazards.
    7. Describe the triage process.