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Fundamentals of Surgical Technology

ST 220

Fundamentals of Surgical Technology

ST 220

Course Description

Prerequisites: Prerequisites: Admission to the Surgical Technology program and concurrent enrollment in ST 207,ST 210, ST 230, and ST 240.

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. Credit may be earned in ST 120 or ST 220 but not in both. (45-120)

Outcomes and Objectives

Demonstrate progress incommunication and language skills, critical thinking, interpersonal/collaborative skills, and information literacy.

Objectives:

  • Communicate in acceptable English and in medical terminology appropriate to the discipline.
  • Analyze data and discipline-based knowledge to formulate logical conclusions.
  • Work constructively within a group.
  • Demonstrate the ability to access, analyze, and use information appropriate to the discipline.

Demonstrate awareness of the physical environment and staffing of an Operating Room Department.

Objectives:

  • Summarize the history and evolution of the field of Surgical Technology.
  • Discuss variations in the administrative organization of the Operating Room Department.
  • Discuss variations in the physical organization of the O.R. suite.
  • List the major pieces of furniture in an operating room.
  • Define the purpose and contents of a Job Description.
  • Identify the members of the surgical team and describe their primary roles.

Demonstrate knowledge and proper application of aseptic and sterile techniques.

Objectives:

  • Define terminology related to medical and surgical asepsis.
  • Describe and demonstrate post-operative clean-up techniques.
  • List the categories of chemical agents and physical agents or methods that can be used to remove, inhibit, or destroy microorganisms.
  • Define "terminal sterilization" and "terminal disinfection."
  • List the factors that affect the destruction of microorganisms.
  • Correlate disinfection procedures with the resistance of different types of microorganisms.
  • List the various methods of sterilization and discuss the principles of action of each method.
  • List and compare the various types of steam sterilizers.
  • Identify the correlations between pressure and temperature in an autoclave.
  • Identify the time required for steam sterilization at different temperature settings for different kinds of items and for different wrapping materials.
  • Define the general rule for when gas sterilization is required and when ETO is contraindicated.
  • Discuss the hazards of and the precautions to be taken when using an ethylene oxide sterilizer.
  • List the various monitoring methods for sterilizers, including both biological monitors and process monitors.
  • Discuss the principles and precautions of sterilization or disinfection using activated glutaraldehyde, including timing, and correct soaking and rinsing methods.
  • Discuss the indications and use of paracetic acid sterilization.
  • Discuss the indications and use of gas plasma sterilization.
  • Discuss other methods of sterilization and their uses.
  • Categorize and describe the action and uses of various chemical disinfectants:
  • Categorize and describe the actions and uses of various antiseptic agents:
  • Identify factors that influence the choice of a specific disinfectant or antiseptic agent.
  • Describe the vectors of transmission of microorganisms and indentify and explain the major principles of aseptic technique as they relate to sources of contamination.
  • Discuss and demonstrate proper attire for operating room personnel.
  • Discuss the properties, advantages and disadvantages of the various types of wrapping materials.
  • Explain and demonstrate correct methods of packaging items for steam sterilization.
  • Describe the proper method of loading an autoclave.
  • Define "event-related sterility" and identify its conditions regarding packaging.
  • Demonstrate correct methods of dispensing supplies onto a sterile field.
  • Describe and demonstrate the principles of establishing and maintaining a sterile field.
  • Demonstrate the proper method of removing gown and gloves after a case.

Demonstrate knowledge of the use of basic surgical instruments and supplies.

Objectives:

  • Define the seven categories of surgical instruments and give examples of each.
  • Identify by name(s) the most commonly used basic General surgical instruments and give examples of their use.
  • List the types of absorbable suture materials and discuss the characteristics, uses, and contra-indications for each.
  • State the absorption times for each of the above, and relate those absorption times to the stages of wound healing.
  • Compare the characteristics of braided or twisted suture materials with monofilament materials and relate these to their uses.
  • List the types of non-absorbable suture materials and the characteristics, uses, and contra-indications for each.
  • Identify the color coding used for each type of suture material.
  • Describe the uses of accessory suture materials.
  • Discuss the factors influencing the choice of suture material, and list the attributes of the "ideal" suture material.
  • List and define terms relating to different ligating methods and common suturing techniques.
  • Define "tensile strength" and discuss how this is different than "gauge."
  • Describe and demonstrate the proper techniques for handling various types of suture materials.
  • Discuss the uses of different types of surgical stapling appliances.
  • 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.
  • Compare the advantages and disadvantages of eyed needles and swaged needles.
  • Discuss the packaging of swaged sutures, including multiple-needle packs and control release needles.
  • Describe and demonstrate the correct placement of a needle in a needleholder.
  • Describe and demonstrate the proper handling of surgeon's needles, including their safe disposal.
  • Relate needle types and sizes and suture material types and sizes to appropriate tissue usage.
  • Identify the various types of surgical sponges (including alternative names) and give examples of appropriate usage.
  • List and demonstrate the materials needed for different types of draping procedures.
  • Describe the purpose and potential complications of wound drainage.
  • List the various types of capillary/wick drains and tubular drains, including reservoir systems.
  • Discuss the principles of chest drainage.
  • List the purposes of a post-operative dressing, the types of materials used for dressings, and the probable usage of each type.
  • Identify selected specialty instruments used during simulated surgical procedures in the laboratory and know when and how they are used.

Demonstrate understanding of safety practices in the O.R.

Objectives:

  • List the rules for prevention of explosions and fire with regard to personnel and patients, equipment and flooring, and the environment.
  • Explain the functioning and safety devices of an electrosurgical unit.
  • List the precautions to be taken when grounding a patient to prevent injury from an electrosurgical unit.
  • Discuss other electrical hazards and the precautions to be taken to prevent patient burns or electrocution.
  • Discuss the problem of latex allergy.
  • Discuss and demonstrate the principles of proper sponge, needle, and instrument counts.
  • Demonstrate safe handling of knife blades, needles, and other sharps.

Demonstrate competence in the scrub role during laboratory simulation.

Objectives:

  • Describe and demonstrate the principles involved in the performance of a surgical scrub.
  • Compare and demonstrate different drying techniques.
  • Describe and demonstrate the principles of gowning and gloving oneself and others.
  • Discuss and demonstrate variations in Mayo stand and back-table arrangements of instruments and supplies, indicating an understanding of priorities during case setup.
  • Discuss and demonstrate the basic principles of draping.
  • Describe and demonstrate the role of the Scrub Person in preparing to begin surgery.
  • Demonstrate during laboratory simulated procedures the correct intraoperative handling of sterile supplies and equipment in the scrub role:

Demonstrate competence in the circulating role during laboratory simulation.

Objectives:

  • Safely transport a patient on a stretcher.
  • Transfer and secure a patient onto the operating table.
  • List the essential elements of proper positioning of a patient, and discuss the safety precautions to be observed during patient positioning.
  • Identify the principles, usage, precautions, and necessary equipment for positioning a patient, and demonstrate various positionings.
  • Demonstrate the proper preparation of a wash prep set, and proper techniques in open gloving.
  • Describe the extent of the area to be prepped for various typical procedures.
  • Describe and demonstrate the correct methods of performing various kinds of wash preps.
  • Discuss and demonstrate the principles of performing urinary catheterization
  • Describe and demonstrate the role of the Circulator in preparing to begin surgery.
  • Demonstrate during laboratory simulations the intraoperative role of the circulator:

Demonstrate competence in the intraoperative role of an assistant ("Second Assistant") to the surgeon during laboratory simulations.

Objectives:

  • Appropriately use sponges, suction, and electrocautery.
  • Correctly hold retractors and provide adequate exposure for the surgeon.
  • Cut sutures correctly.
  • Place skin staples with the surgeon.

Demonstrate development of a level of behavioral and technical practices acceptable for continuation into clinical externship.

Objectives:

  • Demonstrate acceptable skills in the cognitive domain.
  • Demonstrate acceptable skills in the psychomotor domain.
  • Demonstrate acceptable skills in the affective domain.