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Preoperative Duties Performed to Assist the Surgeon for Maximum Patient Care, Safety, and Economy of Time
1. STERILE TECHNIQUE:
A. Perform the appropriate preoperative skin scrub for the particular procedure
and circumstance.
B. Demonstrate the understanding of aseptic technique and sterile vs.
non-sterile areas.
C. Display surgical conscience for the safety of the patient, other employees
and themselves.
D. Wear appropriate barriers as outlined in the Infection Control Manual for
protection against blood and body contamination of patient and self.
2. PREOPERATIVE PREPERATION OF THE PATIENT
A. Demonstrate timely movement of the patient to the OR.
B. Properly identifies the patient:
1. Verbally check with the patient (patient name, surgeon,
and procedure)
2. Visually checks the ID band, chart, surgery schedule and bed tag.
3. Display a professional and courteous manner while reassuring
the patient that asks questions; give support to the patient.
4. Respect the patient’s confidentiality.
C. Facilitate voluntarily in an assistant or non-assistant room, and work
efficiently with the OR team, performing duties in an efficient and safe
manner, proceeding smoothly throughout the day.
D. Collect and properly display the appropriate x-rays.
E. Properly measure patients for intra-operative procedures.
F. Review patient chart.
G. Assist anesthesia under direct supervision, if time permits.
H. Properly bi-valve any cast that needs to be removed, having patient
safety in mind at all times.
I. Position the patient properly, being aware of and padding areas that
require special protection, making adjustments for surgeon’s preferences.
J. Prepare and properly perform surgical preps and urethral catheter insertions.
1. Routinely inspects the surgical site to insure that a proper shave
prep was performed according to the type of surgery and
surgeon’s preference.
2. Routinely verify any patient allergies and changes the prep
solutions accordingly.
3. Display knowledge of the surgeon’s preferences and prepare
the prep tray in a sterile, economical, and uniform manner with the
supplies needed.
4. Ready to insert the catheter and/or perform the skin prep when
anesthesia permits.
5. Following skin preparation, checks that there is no pooling of fluids beneath the patient or near the Bovie pad.
INTRA-OPERATIVE: The Ability to First or Second Assist Any Surgeon on Any Case With Minimum Difficulty
1. KNOT TYING
a. Knots are square, secure and they approximate the tissue, do not slip, and have
the correct number of knots required for that particular tissue.
b. Is familiar with tensile strength using appropriate tension for the
type of suture.
c. Demonstrates dexterity and knowledge of one handed and two handed ties,
surgeon’s knot, and instrument ties in a smooth and efficient manner.
2. EXPOSURE OF INCISIONAL SITE
a. Demonstrates skill and knowledge of maintaining hemostasis by proper use of
pressure, clamps, ties, suture ligatures, clips or electrocautery according to
surgeon’s preference.
b. Provides and maintains the proper exposure necessary to perform the
operative procedure while protecting vital organs, tissues and other structures.
c. Sponges and suctions at the appropriate time without interfering with the flow
of the surgery in order to allow a clear and unobstructed view of the
operative field.
3. KNOWLEDGE OF EQUIPMENT AND INSTURMENTATION
a. Demonstrates the proper use of equipment in a smooth, safe, and
efficient manner.
b. Demonstrates proper use of instrumentation at the field:
1. Selects appropriate instrument according to need and
doctor’s preference.
2. Operates instrumentation in a smooth, safe, and efficient manner to
achieve the desired result.
c. Practices care and economy in the use of equipment and materials.
4. CUTTING SUTURE
a. When cutting suture, the assistant demonstrates promptness, proper
handling of scissors, and safe cutting techniques.
b. Assistant displays ability to adjust cutting length to various sutures
and doctor’s preference.
5. WOUND CLOSURE
a. Assistant closes the proper anatomical layers with the appropriate type
of suture and stitch according to the surgeon’s preference.
b. Demonstrates knowledge of suture material, various types of stitches,
and properly closes the incision in a smooth and efficient manner
according to the surgeon’s preference.
c. Applies the appropriate dressing for the procedure and according to
surgeon’s preference.
6. ANTICIPATION OF THE SURGEON’S NEEDS
a. Assistant follows the pace set by the surgeon, and without delay in the
thought process, participates in the procedure to maintain a smooth
and efficient flow of the operation.
b. Displays knowledge of the different routines, procedures and anatomy
which enables anticipation of the surgeon’s needs.
EXTRA-OPERATIVE RESPOSIBILITIES
1. Maintains a Professional Working Relationship with Staff and Physicians.
a. Changes behavior in response to guidance. Collaborates, communicates, and works
harmoniously with peers and other departments.
c. Observes own verbal and nonverbal communication and selects proper
communication techniques.
d. Demonstrates awareness of team responsibility by accepting additional
duties and responsibilities to improve the SA department, OR and
Aultman Hospital.
- Works harmoniously with other health care personnel in the adjustment of
duties in a team like fashion as necessary to attain patient care goals.
f. Establishes a professional rapport with physicians.
2. Self Responsibility and Accountability for Own Practice
a. Remains current with changes by promptly attending meetings, inservices, and
reading meeting notes.
b. Gives and attends department inservices willingly and professionally.
c. Demonstrates a cooperative attitude toward improving the department’s
standing in the OR, hospital, and community.
d. Openly receives criticism and strives toward improvement.
e. Demonstrates calm and reasoned judgment in an emergency.
f. Recognizes the need for emergency procedures, and implements
accordingly. (e.g. patient in distress)
g. Willingly complies with JCAH regulations concerning CPR standards.
3. Adheres to Departmental Policies and Procedures
a. Accountability
1. Assistant is dressed and ready to work at the start of their shift.
2. When ill, calls off at least one hour before their shift is to begin.
3. When on call, the assistant is at the OR table within thirty minutes or
less after being notified.
4. When leaving the department, the assistant routinely lets the Charge
SA know of their whereabouts and remains within the overhead
paging system or is available by beeper.
b. Time sheets and beepers.
1. Posts worked times daily at the beginning and end of the shift. c. Dress code
1. In the OR, the assistant maintains a professional appearance
by wearing clean scrub clothes, has the appropriate hair covering
and limits the amount of jewelry and colognes.
- Outside the OR, the assistant maintains a professional appearance by
wearing a clean white lab coat, no mask or shoe covers and has the
proper identification badge.
d. Communication
1. Notifies the Unit Director when a call change is made.
2. Informs the Charge SA of any changes with the daily schedule.
e. Is familiar with and adheres to the Aultman Employee Handbook.
4. Shows Flexibility in Working Hours and assist the department with any task or duty
delegated to them within their educational ability. Manages equipment within the OR.
5. Charge Responsibilities
a. Assigns assisting staff according to need and skill level.
b. Communicates with surgeons, staff, charge nurse, anesthesia, and the Unit
Director of any status or problem areas.
- Communicates with the next shift about the status of the department and any
information on patient, equipment, staffing or procedure changes.
- Checks and makes assignments on the tentative schedule, notifying the Unit
Director of any potential scheduling or staffing problems.
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