ST 220 - Fundamentals of Surgical TechnologyCredits: 6
Demonstrates fundamental principles of operating room function: roles of surgical team members, sterilization and disinfection methods, aseptic technique, surgical instruments, sutures and equipment, electrical safety, patient positioning and preparation, draping the sterile field, and care of supplies. Develops beginning technical skills through laboratory practice; later, operating room observational experiences are provided.
Prerequisite(s): Admission to the Surgical Technology program
Corequisite(s): ST 207 , ST 210 , ST 230 , and ST 240
Lecture Hours: 45 Lab Hours: 120
Meets MTA Requirement: None
Pass/NoCredit: No
Outcomes and Objectives 1. Demonstrate progress incommunication and language skills, critical thinking, interpersonal/collaborative skills, and information
literacy.
A. Communicate in acceptable English and in medical terminology appropriate to the discipline.
1. Understand and critically evaluate what is read.
2. Organize and integrate information into a format that illustrates patterns, clusters, and hierarchies of information.
3. Write in a clear, organized, succinct, and effective manner.
4. Demonstrate proper spelling, grammar, and sentence structure in formal writing.
5. Use medical terminology accurately and appropriately.
6. Speak effectively when participating in class discussions and when expressing a reasoned point of view.
B. 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. Demonstrate problem-solving skills in both hypothetical and mock-clinical situations.
4. Recognize patterns and trends in data and be able to justify any conclusions drawn.
5. Make predictions based on evidence.
6. Differentiate coincidental and causal relationships.
7. Utilize graphs, tables, and charts to summarize, analyze, and interpret information.
8. Apply the scientific method of inquiry and research.
9. Take a position on an issue and provide evidence or adequate rationale to support that position.
C. Work constructively within a group.
1. Demonstrate respect and consideration for others.
2. Listen to, respect, and critically evaluate the ideas and opinions of others.
3. Respond appropriately to other's communications.
4. Value differences and diversity within a group.
5. Contribute to the product(s) of a study or work group and accept responsibility for one’s own level of participation.
6. Function within the guidelines established by the group.
7. Identify and analyze one’s own values and responses.
8. Respect the perspectives, values, and choices of others.
D. Demonstrate the ability to access, analyze, and use information appropriate to the discipline.
1. Identify and access appropriate print and media resources to expand his/he understanding of subject matter.
2. Access web sites using URL’s and hyperlinks.
3. Conduct an Internet search pertinent to course subject matter.
4. Evaluate the quality of information gathered from print and electronic sources with reference to reliability of the source, currency, and
applicability.
5. Paraphrase, synthesize, and summarize information gathered from multiple sources.
6. Demonstrate word processing skills for the preparation of written assignments.
2. Demonstrate awareness of the physical environment and staffing of an Operating Room Department.
A. Summarize the history and evolution of the field of Surgical Technology.
B. Discuss variations in the administrative organization of the Operating Room Department.
C. Discuss variations in the physical organization of the O.R. suite.
D. List the major pieces of furniture in an operating room.
E. Define the purpose and contents of a Job Description.
F. Identify the members of the surgical team and describe their primary roles.
3. Demonstrate knowledge and proper application of aseptic and sterile techniques.
A. Define terminology related to medical and surgical asepsis.
B. List the categories of chemical agents and physical agents or methods that can be used to remove, inhibit, or destroy microorganisms.
C. List the factors that affect the destruction of microorganisms.
D. List the various methods of sterilization and discuss the principles of action of each method.
E. List and compare the various types of steam sterilizers.
F. Identify the correlations between pressure and temperature in an autoclave.
G. Identify the time required for steam sterilization at different temperature settings for different kinds of items and for different wrapping
materials.
H. Define the general rule for when gas sterilization is required and when ETO is contraindicated.
I. Discuss the hazards of and the precautions to be taken when using an ethylene oxide sterilizer.
J. List the various monitoring methods for sterilizers, including both biological monitors and process monitors.
K. Discuss the principles and precautions of sterilization or disinfection using activated glutaraldehyde, including timing, and correct soaking
and rinsing methods.
L. Discuss the indications and use of paracetic acid sterilization.
M. Discuss the indications and use of gas plasma sterilization.
N. Discuss other methods of sterilization and their uses.
O. Categorize and describe the action and uses of various chemical disinfectants:
P. Categorize and describe the actions and uses of various antiseptic agents:
Q. Identify factors that influence the choice of a specific disinfectant or antiseptic agent.
R. Describe the vectors of transmission of microorganisms and indentify and explain the major principles of aseptic technique as they relate
to sources of contamination.
S. Discuss and demonstrate proper attire for operating room personnel.
T. Discuss the properties, advantages and disadvantages of the various types of wrapping materials.
U. Explain and demonstrate correct methods of packaging items for steam sterilization.
V. Describe the proper method of loading an autoclave.
W. Define “event-related sterility” and identify its conditions regarding packaging.
X. Demonstrate correct methods of dispensing supplies onto a sterile field.
Y. Describe and demonstrate the principles of establishing and maintaining a sterile field.
Z. Demonstrate the proper method of removing gown and gloves after a case.
AA. Describe and demonstrate post-operative clean-up techniques.
BB. Define “terminal sterilization” and “terminal disinfection.”
CC. Correlate disinfection procedures with the resistance of different types of microorganisms.
Outcome 4: Demonstrate knowledge of the use of basic surgical instruments and supplies.
A. Define the seven categories of surgical instruments and give examples of each.
B. Identify by name(s) the most commonly used basic General surgical instruments and give examples of their use.
C. List the types of absorbable suture materials and discuss the characteristics, uses, and contra-indications for each.
D. State the absorption times for each of the above, and relate those absorption times to the stages of wound healing.
E. Compare the characteristics of braided or twisted suture materials with monofilament materials and relate these to their uses.
F. List the types of non-absorbable suture materials and the characteristics, uses, and contra-indications for each.
G. Identify the color coding used for each type of suture material.
H. Describe the uses of accessory suture materials.
I. Discuss the factors influencing the choice of suture material, and list the attributes of the “ideal” suture material.
J. List and define terms relating to different ligating methods and common suturing techniques.
K. Define “tensile strength” and discuss how this is different than “gauge.”
L. Describe and demonstrate the proper techniques for handling various types of suture materials.
M. Discuss the uses of different types of surgical stapling appliances.
N. List and define terms pertaining to the point, the shaft, and the eye of a surgeon’s needle, and how each is related to usage.
O. Compare the advantages and disadvantages of eyed needles and swaged needles.
P. Discuss the packaging of swaged sutures, including multiple-needle packs and control release needles.
Q. Describe and demonstrate the correct placement of a needle in a needleholder.
R. Describe and demonstrate the proper handling of surgeon’s needles, including their safe disposal.
S. Relate needle types and sizes and suture material types and sizes to appropriate tissue usage.
T. Identify the various types of surgical sponges (including alternative names) and give examples of appropriate usage.
U. List and demonstrate the materials needed for different types of draping procedures.
V. Describe the purpose and potential complications of wound drainage.
W. List the various types of capillary/wick drains and tubular drains, including reservoir systems.
X. Discuss the principles of chest drainage.
Y. List the purposes of a post-operative dressing, the types of materials used for dressings, and the probable usage of each type.
Z. Identify selected specialty instruments used during simulated surgical procedures in the laboratory and know when and how they are used.
5. Demonstrate understanding of safety practices in the O.R.
A. List the rules for prevention of explosions and fire with regard to personnel and patients, equipment and flooring, and the environment.
B. Explain the functioning and safety devices of an electrosurgical unit.
C. List the precautions to be taken when grounding a patient to prevent injury from an electrosurgical unit.
D. Discuss other electrical hazards and the precautions to be taken to prevent patient burns or electrocution.
E. Discuss the problem of latex allergy.
F. Discuss and demonstrate the principles of proper sponge, needle, and instrument counts.
H. Demonstrate safe handling of knife blades, needles, and other sharps.
6. Demonstrate competence in the scrub role during laboratory simulation.
A. Describe and demonstrate the principles involved in the performance of a surgical scrub.
B. Compare and demonstrate different drying techniques.
C. Describe and demonstrate the principles of gowning and gloving oneself and others.
D. Discuss and demonstrate variations in Mayo stand and back-table arrangements of instruments and supplies, indicating an understanding
of priorities during case setup.
E. Discuss and demonstrate the basic principles of draping.
F. Describe and demonstrate the role of the Scrub Person in preparing to begin surgery.
G. Demonstrate during laboratory simulated procedures the correct intraoperative handling of
sterile supplies and equipment in the scrub role:
1. Passing and isolating the skin knife
2. Passing the deep knife
3. Passing instruments, including retractors
4. Passing ties
5. Maintaining the supply of sponges
6. Exchanging instruments between the Mayo stand and the back-table
7. Using suction and electrocautery
8. Receiving sterile items from the Circulator
9. Anticipating patterns of instrument use
10. Recognizing and responding to hand signals
11. Identifying medications and solutions on the sterile field in an acceptable manner
12. Handling syringes and hypodermic needles
13. Preparing irrigation
14. Caring for specimens
15. Selecting appropriate suture materials and sizes
16. Threading needles and passing sutures
17. Performing appropriate counts with the circulator
18. Preparing drainage mechanisms
19. Preparing dressings
7. Demonstrate competence in the circulating role during laboratory
A. Safely transport a patient on a stretcher.
B. Transfer and secure a patient onto the operating table.
C. List the essential elements of proper positioning of a patient, and discuss the safety precautions to be observed during patient positioning.
D. Identify the principles, usage, precautions, and necessary equipment for positioning a patient, and demonstrate various positionings.
E. Demonstrate the proper preparation of a wash prep set, and proper techniques in open gloving.
F. Describe the extent of the area to be prepped for various typical procedures.
G. Describe and demonstrate the correct methods of performing various kinds of wash preps.
H. Discuss and demonstrate the principles of performing urinary catheterization
I. Describe and demonstrate the role of the Circulator in preparing to begin surgery.
J. Demonstrate during laboratory simulations the intraoperative role of the circulator:
1. Anticipating the needs of the scrub person
2. Dispensing sterile supplies onto the field
3. Transferring medications onto the sterile field using various methods
4. Arranging discarded sponges for blood-loss estimate and for count
5. Caring for specimens
6. Filling out operative records and forms
7. Performing appropriate counts with the scrub person
8. Taping dressings after wound closure
8. Demonstrate competence in the intraoperative role of an assistant (“Second Assistant”) to the surgeon during laboratory simulations.
A. Appropriately use sponges, suction, and electrocautery.
B. Correctly hold retractors and provide adequate exposure for the surgeon.
C. Cut sutures correctly.
D. Place skin staples with the surgeon.
9. Demonstrate development of a level of behavioral and technical practices acceptable for continuation into clinical externship.
A. Demonstrate acceptable skills in the cognitive domain.
B. Demonstrate acceptable skills in the psychomotor domain.
C. Demonstrate acceptable skills in the affective domain.
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