ASHEVILLE-BUNCOMBE TECHNICAL COMMUNITY COLLEGECourse Outline

Course: SUR 111 Periop Patient Care

Credit Hours: (5-6-0-7) 7 Credit Hours Lecture Meeting Times Wednesday and Thursday 9:00am-11:20am LAB Times Wednesday OR Thursday 12:30pm-3:30pm and 4:00pm-6:50pmCourse Description:

This course provides theoretical knowledge for the application of essential operative skills during the perioperative phase. Topics include surgical asepsis, sterilization/disinfection, and perioperative patient care. Upon completion, students should be able to demonstrate the principles and practices of aseptic technique, sterile attire, basic case preparation, and other relevant skills.Course Notation: This course is a web-enhanced course. The student will need access to Moodle to retrieve class work, homework, Power-point lectures, and test material. Additionally, students are required to communicate with instructors exclusively via their ABTECH student e-mail accounts. Communication via e-mail is routine and frequent. The student is responsible for all material and communications delivered via e-mail.

Instructors: Robin Keith and Daniel StokoePhone numbers: Office: 254-1921 ext. 892 – Robin

254-1921 ext. 7618 - Daniel Home: Robin 301-2353

Daniel 279-4800 (call/text before 8pm) e-mail: rkeith@abtech.edu dstokoe@abtech.edu OFFICE HOURS: Mondays 10am-1pm & Tuesdays 10am-12pmPREREQUISITES: Enrollment in the Surgical Technology Program

COREQUISITIES: SUR 110 & BIO 163

REQUIRED TEXTS:

ABTCC Surgical Technology Handbook

AST. (2008). Surgical Technology for the Surgical Technologist: A Positive Care Approach, (3rd ed.). Clifton Park, NY: Delmar.

AST. (2008). Study Guide to Accompany Surgical Technology for the Surgical Technologist: A Positive Care Approach, (3rd ed.). Clifton Park, NY: Delmar.

Dennerll, J. (2007). Medical Terminology Made Easy, (4th ed.). Clifton Park, NY: Delmar.

Pieknik, R. (2006). Suture and Surgical Hemostasis: A Pocket Guide. Philadelphia, PA: W.B. Saunders.

Rutherford, C. (2005). Differentiating Surgical Instruments. Philadelphia, PA: F. A. Davis Company. Snyder & Keegan. (2006). Pharmacology for the Surgical Technologist, (2nd ed.). St. Louis, MO: Saunders Elsevier.

Snyder & Keegan. (2006). Pharmacology for the Surgical Technologist: Study Guide, (2nd ed.). St. Louis, MO: Saunders Elsevier.

OPTIONAL TEXTS:

AORN. (2010). AORN Standards, Recommended Practices, and Guidelines. Denver, CO: AORN.

*Goldman, M. (2009). Pocket Guide to the Operating Room, (3rd ed.). Philadelphia, PA: F.A. Davis. (Required for spring and summer clinicals)

Rothrock, J. (2008). Alexander’s Care of the Patient in Surgery, 13 th ed.). St. Louis, MO: Mosby.

Prepared by: Daniel Stokoe & Robin Keith Revision Date: May 7, 2023

I verify that this course outline is accurate, complete and timely

_Robin B. Keith Chairperson

Dolly Horton Dean

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COURSE POLICIES:

The instructor reserves the right to alter course content, presentation, or sequence. There will be no make-up tests or quizzes. Homework is due the week after it is assigned unless otherwise indicated on the syllabus. Late or incomplete homework will not be accepted and the student will receive a zero homework grade on that day. Homework is due at the beginning of class every Wed/Thur morning (depending on the day it was assigned). Failure to arrive on time will result in you not being able to turn in homework and paperwork on time or take the daily test; therefore, you will receive a grade of zero on ALL paperwork that was due. You are expected to arrive to class prepared and ready to start at 0900. Arriving before 0900 will ensure that you are able to be prepared. The classroom door will be shut and locked at 0900. The classroom will be accessible to you after the first class break.

Open Grade Book Policy:The Surgical Technology Program Faculty maintains an “open grade book” policy as well as an open door policy and will make every effort to keep students aware of their progress throughout the semester. If you at any time have a question about any grading procedure, status of your grade, or overall progress throughout the curriculum, please do not hesitate to ask!

Academic Dishonesty You may not deceive any official of the college by cheating on any assignment, exam, or paper. This includes plagiarism, which is the intentional theft or unacknowledged use of another’s words or ideas. Plagiarism includes (but is not limited to) paraphrasing or summarizing another’s words or works without proper acknowledgement, using direct quotes of material without proper acknowledgement, or purchasing or using a paper or presentation written or produced by another. The faculty at A-B Tech may also consider presenting as original work a paper written for one class to satisfy a requirement in another class to be academic dishonesty.

Approved by the Academic Affairs Committeeon November 18, 2003

DisabilitiesAny student with a documented disability needing academic adjustments or accommodations is requested to speak with the coordinator of Disability Services in the Azalea building, Annie Clingenpeel (254-1921 ext. 141 or e-mail Aclingenpeel@abtech.edu ).

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CLASSROOM ATTENDANCE POLICY The Program Faculty believes that anytime a student is not in attendance at a didactic class, laboratory session, or clinical rotation, he or she is not able to receive the full benefits of a presentation or experience even if competencies are eventually met. It is also believed that regular and punctual attendance is expected of all students for them to achieve their potential in the surgical technology program and to develop desirable personal traits necessary to obtain employment in any Allied Health profession. These traits are among the first looked for by prospective employers. In fact, the student should be reminded that every time they put on their uniform and go for clinical instruction they may be completing part of an informal job interview whether they know it or not. For these reasons, full-time attendance is expected in all didactic classes, laboratories, and clinical rotations.

1) Proper Call-in Procedure

The student is responsible for contacting the program faculty regarding absences prior to the scheduled class time. Faculty offices are equipped with voice mail. The extension numbers are listed in this syllabus. When calling in, please leave your name, the time you called, the reason for your absence, and when you expect to return to class. If a phone call to the instructor's office should go unanswered, please call the Allied Health secretary at ext. 281 and leave a message. Her usual office hours are 8:30 AM-12 noon and 1:00-4:30 PM. Messages must not be sent through other people unless extenuating circumstances prevail. This is our attempt at beginning your acceptance of responsibility and accountability for your actions as a health care professional.

2) To receive course credit, a student should attend a minimum of 90 percent of the contact hours of the class. Upon

accumulating absences exceeding 10 percent of the course contact hours, the student may be dropped from the class with a grade of “U” at the discretion of the instructor. Being tardy for class is a serious interruption of instructional time. It is not tolerated in this program. A tardy is defined as arriving late for class (any minutes), leaving early (any minutes,) or being away from class without permission during class hours. It is departmental and college policy that three tardies is the equivalent of one full day’s absence from class or clinic. For every third tardy, the student will have one full day’s absence counted for the course. These accumulated absences due to tardiness will count toward the 10% for that course.

Students will NOT be admitted to class in the event of tardiness. The classroom door will be locked at the scheduled start of class. Tests will not be made up if missed due to tardiness. Homework will not be

accepted due to tardiness. The student may enter the class at the first break, if they are present when that time comes.

3) The student is also responsible for adhering to the ABTCC Guidelines for Classroom Conduct. See the most current version of the ABTCC Student Events Calendar and Handbook.

PROLONGED ILLNESS

Students must notify the appropriate classroom or clinical instructor each day of an absence until it is established exactly how long the student will be out. Any student who misses more than three consecutive school days of class and/or clinic must obtain proper documentation for the missed time before they will be allowed to return to classes or clinic.

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HOLIDAYS AND VACATIONS

Surgical Technology students are committed to one year of full-time study. Within this time, students are eligible for holidays recognized by the College and vacation time during semester breaks. The student should consult the academic calendar that is published in the College Catalog and Student Calendar for the dates of recognized holidays and semester breaks. The student is reminded that up to three inclement weather days may made up at the end of fall or spring semester and semester breaks should be planned accordingly. APPOINTMENTS Medical, dental, and other appointments should not be scheduled during didactic and clinical times. Appointments scheduled during these times will create a tardy or unexcused absence unless extenuating circumstances prevail.

EVALUATION CRITERIA

DIDACTIC LAB

Homework 10% Quizzes*/Tests*/Midterm* 50% Final (Comprehensive) 40%

TOTAL 100%

Skill Assessments (3 attempts) Pass/FailLab Practicals (2 attempts) Pass/FailLab Final Identification (2 attempts) Pass/Fail

Lab ID Final Pass/Fail

* All testing for this class will be conducted in Balsam, Room 217. Tests will be every Wednesday from 0900-0950.*All tests will have a time limit of 50 minutes. All tests are comprehensive.* Please report to Balsam, NOT Rhododendron, by 0900 each Wednesday to be eligible to take the daily exam. * Please refer to the class rules found in the SUR 110 PowerPoint Lecture #1.* All Clinical Education modules MUST be completed before you can go on a fieldtrip to that clinical site. Refer to your lab schedule for fieldtrip information.*Always keep all returned homework and papers for future use in this program! Throw nothing away!!!

(ALERT: We will have to do our VA field trip all in one day. You will need to make arrangements to attend lab both Wednesday and Thursday 9/28 and 9/29. To be fair to all, Wednesday Lab will be expected to attend the lab on Thursday 9/29. Thursday lab will be expected to attend the lab on Wednesday 9/28. Our visit with the VAMC is something we have to work around. Should you not attend, you will not be eligible to perform clinical there at all. Please make arrangements to be available for lab on both days. I apologize for any inconvenience this may cause. The date we will go to the VAMC is September 28th. We will conduct lab skills and start lab practicals on September 29th.)

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GRADES 90-100 =A

80-89 = B70-79 = C60-69 = D

BELOW 60 =F

NOTE: Skill Assessments: Three attempts will be allowed to correctly perform skill

assessments. It is the student’s responsibility to be in attendance for all lab sessions. If for some reason a student cannot attend lab, it is the student’s responsibility to obtain assistance from a fellow classmate. It is the student’s responsibility to demonstrate the attained skill(s) on a day that is conducive to the lab and chairperson’s schedule.

Lab Practicals: The highest grade that can be earned in SUR 111 by a student, who fails to score a minimum of 80% on either taped Lab Practical, after two attempts, will be a grade in SUR 111 of “D”. This student will not be allowed to progress in the program to spring semester. This is to ensure the safety of the surgical patients that students are exposed to during spring clinical rotations. Students are given opportunities to come to lab and practice with and without an instructor. It is the student’s responsibility to take advantage of open lab times and to refine their skills. Students who require a second attempt on their lab practical may do so after all students have completed their first attempt. Lab practical retesting must be scheduled at a time when faculty and lab facilities are available. The Department Chair will coordinate make up lab practical schedules.

Lab Final Identification: One re-test is allowed. Failure to pass the identification portion of the lab final exam with a minimum of 70% will result in a grade in SUR 111 of “D”. This student will not be allowed to progress in the program to spring semester. Students are responsible for learning equipment, instrumentation, and supply items. This is to ensure the safety of the surgical patients that students are exposed to during spring clinical rotations. Students are given opportunities to come to lab and practice with and without an instructor. It is the student’s responsibility to take advantage of open lab times to learn and to read their texts. These lab identification final exam components cannot easily be duplicated. Therefore, the student may only make up the lab identification final exam when the availability of reconstructing that situation is possible. Lab identification final exam retesting must be scheduled at a time when faculty and lab facilities are available. The Department Chair will coordinate make up lab identification final exam schedules. Students who fail to pass the final on either Wednesday or Thursday will be required to re-test on the Friday of that same week.

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SUR 111PERIOPERATIVE PATIENT CARE

COURSE OBJECTIVES: Upon completion of this course, the student will:

1. Recognize and demonstrate principles of asepsis related to the surgical environment.2. Identify and discuss concepts related to cleaning, disinfection, and sterilization.3. Describe and demonstrate the process and concepts involved in preparing for surgery in the surgical technologist role, establishing the sterile field, and preparing other team members, as well as the patient.4. Identify and recognize basic instrumentation according to classification and name fro the following surgical tray types: Minor, Major, Abdominal Retractor, Laparoscopic, GYN, D & C, Urology/Cysto, Otorhinolaryngological, Orthopedic, Plastic, Tracheotomy, Ophthalmology, Neurosurgery, Cardiovascular, and Thoracic5. Discuss and recognize various specialty equipment used in the operating room setting.6. Identify and demonstrate basic positioning principles.7. Recognize components of case management and categorize them as pre-operative, intra-operative, or post-operative.8. Explain and demonstrate patient preparation related to vital signs and skin preparation.9. Recognize appropriate timing of and demonstrate counting during simulated surgeries.

10. Anticipate the sequence of events for the following procedures: Open Umbilical Hernia Repair Laparoscopic Cholecystectomy Tracheotomy

GENERAL EDUCATION OBJECTIVES: Incorporated into course objectives:

1. Develop ability to communicate effectively in a team-oriented environment.2. Develop ability to safely integrate all aspects of the surgical setting in preparation for spring clinical.

3. Demonstrate ability to function as a self-directed learner.

Learning activities that reinforce learning objectives:a. Team oriented surgical setting simulationb. Skills assessments demonstratedc. Lab Practicals 1 and 2 demonstrate ability to integrate all skills assessmentsd. Open lab times encouraged and taken advantage of by the student to reinforce learned skills

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SUR 111PERIOPERATIVE PATIENT CARE

CONTENT OUTLINE

I. Introduction to the Educational ProgramA. General information

1. Introduction to course and program2. Course and program objectives3. Course and program policies

II. AsepsisA. Surgical attireB. Asepsis and Sterile Technique

1. Sterile Field2. Sterile Team Member Attire3. Movement in and Around the Sterile Field4. Developing a Surgical Conscience

C. Cleaning and Disinfection

III. Sterilization and packagingA. Instrument preparation

1. Packaging material2. General packaging materials

B. Steam sterilization1. Components of a steam sterilizer2. Sterilization parameters3. Gas Sterilization4. Ionizing Radiation

C. Event related SterilityStorage and Distribution

IV. Establishing the Sterile Field

A. Furniture set upOpening sterile supplies

B. The Surgical Scrub1. Hand Drying and Donning the Surgical Gown2. Closed Gloving Technique3. Open Gloving Technique

C. Gowning and Gloving a Team Member

V. Maintaining the Sterile FieldA. The Mayo Stand

1. Draping the Mayo Stand2. What to put on the Mayo Stand

B. Back Table set up

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1. Principles of Back Table Set up2. Draping the Back Table3. Limit Movement4. Work in Sections5. Keep Organized

C. Basin Stands and Prep Tables 1. Draping

2. Organizing and positioning

VI. Pre-operative Case Management A. Case Selection

1. Preference Card Usage2. Equipment Selection

B Instrumentation1. Classification2. Care and Handling3. Major and Minor Trays

C. Other instruments Sets1. GYN / Urology Sets and D & C Set

2. Tracheotomy trayD. Specialty Instrumentation Sets

1. Cardiac, Vascular and Thoracic Sets2. Orthopedic Sets3. Neurosurgery Sets4. ENT, Plastic, Ophthalmic Sets

E. Minimally Invasive Surgery

VII. Specialty EquipmentA. Power EquipmentB. Laser use in the OR

Laser SafetyC. Microscopes in the ORD. Electrosurgical Safety

VIII. SuppliesA. Sterile PacksB. Drapes and Draping the Surgical patient

1. Principles of Draping2. Laparotomy Draping3. Lithotomy Draping4. Extremity Draping5. Craniotomy Draping

IX. Basic Positioning Principles

A. Transfer and PositioningB. Positions

1. Supine2. Trendelenberg /Reverse Trendelenberg3. Lithotomy4. Fowler’s and Sitting Positions5. Prone position6. Jackknife (Kraske) Position7. Lateral Positions

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X. In Room Patient PreparationA. Vital Signs

1. TPR, BP2. Thermoregulatory Devices3. Urinary Catheterization

B. Skin Preparation1. Clean and Contaminated areas2. Hair Removal3. Skin Preparation

C. Counts1. Sponge and sharp counts2. Instrument counts

XI. Intra-operative Case ManagementA. The Operative Sequence

1. Incision2. Hemostasis3. Dissection & Exposure4. Exploration & Isolation5. Surgical repair/Removal6. Hemostasis & Irrigation7. Specimen Collection8. Closure

B. Surgical Wound ClassificationC. Emergency ProceduresD. Catheters and DrainsE. Surgical Dressings

XII. Post-operative case ManagementA. Final CountsB. Keeping Field SterileC. Table Breakdown and TransportationD. Preparing for the next Case

XIII. Diagnostic Procedures A. History and Physical B. Diagnostic Imaging C. Laboratory Findings D. Endoscopic Findings E. Electrodiagnostic Studies

XIV. Case ReviewsA. Open Umbilical HerniaB. Laparoscopic Cholecystectomy 1. Laparoscopic Tower

2. Operative laparoscopy10

C. TracheotomyEmergency Cricothyroidotomy

D. Life Threatening Surgical Emergencies

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SUR 111 - PERIOPERATIVE PATIENT CARETENTATIVE SYLLABUS BASED UPON AVAILABILITY

OF GUEST LECTURERS AND LEARNING AIDSWEEKLY COURSE OBJECTIVES

WEEK # CLASS # DAY/DATE TOPICS RESOURCES OBJECTIVES

1 1 WED 8-17 Introduction to course and program policies and procedures Microbiology Surgical Attire

RESOURCES Surgical Technology Student Handbook AB TECH Student Handbook TEXT AST CH. #12 pg 305-312

AST Ch. # 7 pg 139-149 AORN REC. PRAC. Attire Surgical SUR 111 Course and content outlines, syllabus Objectives The student will be able to verbalize class rules, program policies, program objectives, class rules, grading and attendance policies. The student will recognize appropriate surgical attire and demonstrate appropriate wearing of this attire in the Surgical Technology skills lab. HOMEWORK #1-List and memorize the 8 AB-TECH principles of asepsis ST Workbook CH #12: Key Terms and Questions 3-36 (pages 166-168)

2 THU 8-18 Asepsis and Sterile Technique Team members attire within the sterile field Movement in and around the sterile field Developing a Sterile Conscience RESOURCES TEXT AST CH. #7 pg 153-155 AORN REC. PRAC. Sterile Field Maintaining Objectives The student will be able to define terms related to asepsis, discuss sources of contamination and list 8 principles of surgical asepsis. The student will be able to demonstrate appropriate aseptic technique in the Surgical Technology skills lab.

2 3 WED 8-24 Cleaning and Disinfection Sterilization and packaging Instrumentation and packaging materials RESOURCES TEXT AST CH. #7 pg 156-162 AORN REC. PRAC. Disinfection, High level Packaging Systems-Selection Use Objectives The student will compare and contrast disinfecting agents. The student will be able to describe the process for decontaminating instruments and demonstrate appropriate actions for cleaning instruments and supplies in the Surgical Technology Skills Lab. The student will be able to identify the concepts of microbial barriers and compare and contrast the materials used for creating microbial barriers.

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4 THU 8-25 Steam Sterilization and the steam sterilizer Sterilization parameters and flash sterilization Gas sterilization / Ionizing Radiation

Monitoring the Sterilization Process Event Related Sterility Storage and Distribution RESOURCES TEXT AST CH. #7 pg 167-183

AORN REC. PRAC. Sterilization in the Practice Setting Environmental Cleaning Objectives The student will be able to list the process for preparing items for sterilization. The student will define terms related to the sterilization process and compare and contrast methods of sterilizing products. The student will be able to process monitoring devices and methods. The student will be able compare and contrast shelf life and event related sterility. HOMEWORK #2- ST Workbook Chapter #7 Key Terms through T/F

(pages 50-54)

3 5 WED 8-31 Establishing the Sterile Field Opening sterile supplies Supplies Sterile Packs

RESOURCES TEXT AST CH. # 10 pg 266-276 & CH. #12 pg 313-315 Objectives The student will plan methods of care, handling and assembly of basic Operating Room furniture and identify the use of various supplies and and accessory equipment in the operative environment. The student will demonstrate the ability to use the principles of asepsis to prepare instruments and supplies for a surgical procedure in the skills lab. 6 THU 9-01 The Surgical Scrub Hand drying and donning the surgical gown Open and Closed gloving techniques Turning the Gown RESOURCES TEXT AST CH. # 12 pg 317-324

AORN REC. PRAC. Hand Scrubs, Surgical Objectives The student will identify preliminary preparations for a surgical scrub. The student will demonstrate the steps of the surgical scrub while employing sterile technique in the skills lab. The student will demonstrate sterile technique when self gowning and gloving. 4 7 WED 9-07 Gowning and gloving another team member

Gown & glove removal RESOURCES TEXT AST CH. # 12 pg. 357-358

Objectives The student will demonstrate sterile technique when assisting other team members and appropriate technique when removing soiled

gown and gloves. HOMEWORK #3 ST Workbook Chapter 12 Page 169 Masks and Eyewear.Page 171 Matching 11-24

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8 THU 9-08 Maintaining the Sterile Field Preparing the Mayo Stand, Back Table, Prep Table, & Basin

RESOURCES TEXT AST CH. # 12 pg. 324-331 Objectives The student will demonstrate proper aseptic technique in draping

and setting up the back table, mayo stand, basin stand, and prep table in the skills lab. This will include scrubbing, gowning and

gloving. THIS IS LAB PRACTICAL #1 TO HERE 5 9 WED 9-14 Principles and draping

Economy of motion Preoperative Case management Use of Preference Card Equipment Selection RESOURCES TEXT AST CH. # 12 pg. 357-359 Objectives The student will be able to demonstrate successfully setting up and preparing a room for a surgical procedure following all principles of asepsis. Using a preference card as a guide the student will gather the instruments, supplies, and equipment needed for a surgical procedure. The student will demonstrate these skills in the skills lab.

HOMEWORK #4 ST Workbook CH # 12 Page 170 Preference CardQuestions 5-9

10 THU 9-15 Instrumentation Classification Care and Handling Minor & Major Trays RESOURCES TEXT AST CH. # 10 pgs. 254-263 TEXT Rutherford Chapter 1 HANDOUTS: MAJOR & MINOR AB-TECH TRAYS Objectives The student will identify the classifications, names, parts, materials, finishes, and uses of basic surgical instrumentation. The student will demonstrate this knowledge in the skills lab. The student will gain an understanding of the relationship between instrument type and usage. The student will apply knowledge of basic surgical instrumentation to specific surgical procedures. The student will demonstrate the ability to identify and differentiate the instrumentation on the AB-TECC major and minor trays in the skills lab.

HOMEWORK #5 ST Workbook CH# 10 Key Terms through Matching (pages 111-117)

6 11 WED 9-21 Instrumentation GYN and D & C Trays Urology Trays RESOURCES TEXT AST Chap 15 pgs. 504-508

TEXT Rutherford Chapter 2 and 3 Objectives The student will demonstrate the ability to identify and differentiate the instrumentation on the AB-TECC D & C and GYN trays in the skills lab. The student will be able to identify and differentiate among the basic instruments for GYN and Urology surgery. The student will be able to discuss the features and details of the instruments and why they are classified as GYN or Urology instruments.

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12 THU 9-22 Specialty Instrument sets Orthopedic & Neurosurgery sets ENT, Plastic, Ophthalmic RESOURCES TEXT AST pgs. 856-860, 1030 TEXT Rutherford Chapter 4 and 5 (Just look over 6, 7, 9) Objectives The student will be able to identify and differentiate among the basic instruments for orthopedic & neurosurgical, OHN, plastic, ophthalmic, and endoscopic surgical Instruments. The student will be able to discuss the features and details of the instruments and why they are classified as they are. 7 13 WED 9-28 Specialty Instrumentation sets Tracheostomy, Peripheral Vascular, and Thoracic sets RESOURCES TEXT AST pgs 486-488, 936, 987-988, 991 TEXT Rutherford Chapter 8 Objectives The student will be able to identify and differentiate among the basic instruments for tracheotomy, vascular,& thoracic surgery. The student will be able to discuss the features of vascular, or thoracic instruments.

14 THU 9-29 Specialty Equipment Endoscopic Equipment Powered Equipment Lasers and Microscopes RESOURCES TEXT AST pgs. 91-92, 263-265 AORN REC. PRAC. Instruments and Powered equipment Laser Safety in Practice setting Objectives The student will describe the applications and surgical technologists role and responsibility in the use of various pieces of equipment in the surgical setting. The student will demonstrate ability to identify laparoscopic components in lab after inservice on ASC field trip and lab review. 8 15 WED 10-12 Electrosurgical Safety Pneumatic Tourniquets RESOURCES TEXT AST CH. # 10 pgs. 267-268 AORN REC. PRAC. Electrosurgery Objectives The student will be able state the principles of electrosurgery and discuss the safety measures that must be taken to avoid electrosurgical policy of standard precautions and how it impacts on the surgical team especially the surgical technologist. The student will demonstrate in lab the proper procedure for operating the electrocautery unit and patient considerations. The student will be able discuss the pneumatic tourniquet components and mechanics of operation.

HOMEWORK # 6 ST Workbook CH# 10 Short Answer 1-15 (pages 117-119)

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16 THU 10-13 Transportation and Transferring Patients Positioning principles Positioning Aids Functions and operating the OR table RESOURCES TEXT AST pgs. 83-84, 331, 333 AORN REC. PRAC. Positioning the patient in the perioperative setting. Objectives The student will discuss methods of patient transfer and identify equipment utilized for safe transfer of a surgical patient. The student will demonstrate proper body mechanics in transferring a patient in

the skills lab. The student will demonstrate OR table functions.

9 17 WED 10-19 MIDTERM - Comprehensive Positioning the patient Common surgical positions; supine, prone, lithotomy, lateral, trendelenberg, reverse trendelenberg, sitting. RESOURCES TEXT AST pgs. 342-354

AORN REC. PRAC. Positioning the patient in the perioperative setting. Objectives The student will analyze the use, components, and aides used to achieve various surgical position. The student will demonstrate the functions of the OR table and safely position a patient using proper techniques in the skills lab.

FALL BREAK OCTOBER 14-16th

18 THU 10-20 Hair removal Skin preparation Prep Set-ups/Types of Preps RESOURCES AST CH. #12 pg 357-357

AORN REC. PRAC. Skin Preparation of patients Objectives The student will contrast and compare different types of skin preparation and compare and contrast the different chemical agents used for skin preparation. The student will demonstrate proper skin prep technique in the skills lab.

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10 19 WED 10-26 In Room Patient Preparation Vital Signs, TPR and BP

Urinary Catheterization RESOURCES TEXT AST CH. #12 pg 334-342

Objectives The student will be able to state normal ranges of temperature pulse, respiration and blood pressure for patients taking into consideration patient specifics such as age and current medical condition. In the skills lab the student will demonstrate proper technique in taking a patient’s vital signs. The student will list the indications for urinary catheterization and discuss the basic considerations for urinary catheterization. The student will demonstrate urinary catheterization using proper technique in the skills lab. HOMEWORK #7 Answer these Questions: What are the indications for urinary catheterization? Who is responsible for placing the indwelling catheter? Is this a sterile procedure? What type of glove technique is employed in placing the catheter? State the most common reason for nosocomial infections.

20 THU 10-27 Draping Drape Characteristics Principles of Draping Procedural Draping-Laparotomy, Lithotomy, Extremity, Etc. RESOURCES TEXT AST CH. # 12 pg 357-363, CH. #10 pg 268 AORN REC. PRAC. Gowns and Drapes Use and Selection of Barrier materials Objectives The student will describe the various types of draping material used in surgical procedures and demonstrate how to use the appropriate drapes to drape a patient for a laparotomy, pelvic, or extremity procedure and drape all necessary equipment in the skills lab. HOMEWORK #8-Describe in detail the sequence of events in draping for a laparotomy using a universal drape and Laparotomy drape. Describe all variations the surgeon might use for each type of drape.

11 21 WED 11-2 Intraoperative Case Management (APOS) Communication Surgical Counts Sponge, sharp, instruments Passing Instruments & Supplies

TEXT AST CH. # 12 pg 364-370

AORN REC. PRAC. Counts-Sponge, sharp, instruments Objectives The student will discuss the purposes and legal responsibilities of counts. The student will show knowledge of proper counting techniques, timing and methods. The student will demonstrate the procedures for counting instruments, sponges, needles and other items on the sterile field in the skills lab. The student will employ basic routines of case management and assess specific variations of intraoperative technique.

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22 THU 11-03 The Operative Sequence 1-Incision 2-Hemostasis 3-Dissection 4- Exposure 5- Procedure (Specimen Collection possible) 6-Hemostasis

7- Irrigation 8-Closure

9- Dressing Application Hemostasis

Exposure RESOURCES AST CH.#8 p. 185-191, CH.#12 p. 306-307, 372-373

Handout related to: The Operative Sequence and Exposure Objectives The student will be able to explain the logical sequence of events for a typical operation and what their responsibilities would be during any of these time periods. The student will analyze the principles of hemostasis and differentiate among various methods of hemostasis. The student will describe principles of exposure and identify criteria used to select exposure devices. The student will identify several types of retracting instruments used in general surgery and demonstrate proper passing and use of these instruments in the skills lab.

12 23 WED 11-09 Specimen CollectionCatheters and Drains

Dressings RESOURCES TEXT AST CH. #10 p.270-274, CH. #12 p.370

Handout related to: Specimen care Objectives The student will assess method of obtaining and identifying surgical specimens. The student will describe how particular specimens are handled, what containers may be used and what if any preservatives are required the student will describe how to label a specimen and and to transfer a specimen to the appropriate department. The student will

compare and contrast the types and characteristics of various catheters and drainage devices and compare and contrast the conceptual differences between gravity and vacuum drainage. The student will demonstrate proper technique in preparing catheters and drains for intraoperative use and anchoring in the skills lab. The student will evaluate the purpose of surgical dressing and analyze their importance to wound care. The student will compare and contrast the most commonly used types of surgical and specialty dressings. The student will demonstrate the proper principles of sterile technique in applying commonly used dressings in the skills lab.

24 THU 11-10 Wound Closure

Surgical Wound Classifications RESOURCES TEXT AST CH. #11 pg. 278-285

Ethicon Wound Closure Manual CH. # 1 Objectives The student will differentiate between primary and secondary wound

closure and give examples of appropriate suture to close an abdominal wound. The student will analyze the classifications of surgical wounds and distinguish the surgical procedures that fit the various categories.

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13 25 WED 11-16 Emergency Procedures Malignant Hyperthermia Trauma, Surgical Emergencies, CPR Hemolytic and Anaphylactic Reactions (Drugs & Latex) Blood replacement

RESOURCES TEXT AST CH 5 pgs 98-99 CH. # 8 pg 185-197, Objectives The student will describe the emergency procedures carried out in the

OR setting. The student will describe the surgical technologist’s responsibilities related to emergencies in the OR setting. The student will describe the rationale of triage and how it would relate to the surgical schedule in the event of a local disaster. The student will recognize symptoms associated with malignant hyperthermia. The student will name the drug used to treat malignant hyperthermia. The student will identify ways they as the surgical technologist can aid in the treatment of MH within the sterile field. the student will discuss various methods of blood and volume replacement. The student will describe the ST responsibilities related to the OR setting during cardiac arrest. The student will recognize the ABCs of CPR. The student will recognize signs of blood loss and measures to correct blood loss. The student will explain blood salvage methods utilized in the OR setting. The student will recognize signs and symptoms of anaphylaxis.

HOMEWORK #9 ST Workbook CH# 8 Key Terms through Short Answer (pages 69-72)

26 THU 11-17 Postoperative case management Final counts, Table breakdown and transportation RESOURCES TEXT AST CH.#12 pg 371-375 AORN REC. PRAC - Counts, sponge, sharp, and instrument - Environmental Responsibility Objectives The student apply standard precautions to the performance of postoperative case management duties. The student will demonstrate postoperative case management duties in an organized and timely manner in the skills lab.

. 14 27 WED 11-30 Patient Assessment/Interview History and Physical Examination

Diagnostic Imaging Laboratory Findings Endoscopic & Electrodiagnostic studies RESOURCES TEXT AST CH#13 HANDOUT Objectives The student will describe the components of a preoperative assessment and interview. The student will identify information that needs to be passed on to other surgical team members and who those team members are. The student will describe age specific, physiological, and psychosocial elements of this assessment. The student will discuss the methods used and importance of a history and physical for the preoperative patient. The student will list and discuss techniques used to establish a patient’s diagnosis. The student will determine which diagnostic procedures may require a surgical intervention and identify the major indications for surgical intervention. The student will identify various diagnostic procedures and their use.

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HOMEWORK #10-ST Workbook CH #13 Key Terms through Matching (pages 252-256)

28 THU 12-01 Open Umbilical Herniorrhaphy

RESOURCES TEXT AST CH. #14 pg 414-420 Objectives The student will discuss the operative sequence in the open repair of an incisional hernia with the responsibilities of a STSR in this type of surgical procedure. The student will differentiate between ventral, inguinal, hiatal, umbilical, and incisional hernias. The student will demonstrate proper aseptic technique, pre, post and intraoperative case management skill for this procedure in the skills lab. HOMEWORK #11: Differentiate between ventral, inguinal, hiatal, Umbilical hernias. List operative sequence for each including description/location, prepping and draping for each. A “HERNIORRHAPHY” IS LAB PRACTICAL #2 16 29 WED 12-07 Tracheotomy/Tracheostomy Appendectomy

RESOURCES TEXT AST CH. #14 pg.485-488

Objectives The student will discuss room set up, supplies, equipment, operative sequence, use of a preference card, instrumentation, and STSR responsibilities in a Tracheotomy/tracheostomy and appendectomy procedure both routine and emergent. Student will identify and explain wound classifications for each.

HOMEWORK #12 ST Workbook Chapter 14 pg. Specific variations 1-29 (pages 289-294)(Add: Surgical Wound Classification and Incision Type to your report)Use the following case study and your textbooks/internet

Case Study: Jimmy is a fifteen year old male. He was admitted to the ER with right lower quadrant pain, nausea, and a low grade fever. He has been diagnosed with an acute appendicitis. Surgery is scheduled.

30 THU 12-08 Laparoscopic CholecystectomyOpen Cholecystectomy

RESOURCES TEXT AST CH. #14 pg 460-462

Objectives The student will discuss room set up, supplies, equipment, operative sequence, use of a preference card, instrumentation and STSR responsibilities in a laparoscopic and/or open cholecystectomy. This will include; pre, post and intraoperative case management principles. The student will demonstrate proper set up of needed video equipment for general surgery laparoscopic procedures in the skills lab.

17 31 WED 12-14 D&C/HYSTEROSCOPY (Asepsis During Vaginal Procedures) RESOURCES TEXT AST CH. # 15 pgs 539-540, 553-556

32 THU 12-15 COMPREHENSIVE FINAL EXAM

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SUR 111 LAB SECTIONS 1 & 2

SUR 111 contains a 6 hour lab meeting either Wednesday or Thursday between 12:30pm and 6:50pm. We will divide the lab into two groups, each group consisting of eight students. Each block of time will be divided into two sections, section A and section B. Session A will go from 12:30pm until 3:20pm and session B will go from 4pm until 6:50pm. This is a 6 hour lab that is to be used to orient oneself to the clinical component of this program and to master the basic competencies for an entry-level surgical technology student about to begin their clinical training. Sessions will have scheduled field trips to some of the clinical affiliates which will be used for clinical training next semester. Two instructors, using lecture, video presentations, guest lecturers, and handouts will teach each of these labs. The main emphasis will be on demonstration and return demonstration of these basic practices as well as the ability to integrate these skills into a lab practical/mock surgery. The two practical clinical examinations in this course will be videotaped and reviewed with the instructor and the student for critique and grading purposes.

All students must demonstrate successful completion of basic competencies and objectives on the program’s didactic and laboratory courses in the first semester, and have passed all SUR and BIO courses with a grade of C or better (SUR 110, SUR 111 and BIO 163) before gaining entry into SUR 122 and SUR 123. Before a student is eligible to begin clinical training the student MUST have successfully completed two videotaped practical examinations with a grade of 80% or better within two attempts and mastered all 44 skills assessments (see Surgical Technology Study Guide). The highest grade that can be earned in SUR 111 by a student, who fails to score a minimum of 80% on either taped Lab Practical, after two attempts, will be a grade in SUR 111 of “D”. This student will not be allowed to progress in the program to spring semester. This is to ensure the safety of the surgical patients that students are exposed to during spring clinical rotations. The student will score PASS OR FAIL for each Lab Practical.

The student will have three attempts at each skill assessment if needed. Skills assessments will begin as soon as the student feels they are prepared to demonstrate they have mastered the skill to an instructor properly following each procedural step. The student will score PASS OR FAIL for SKILL ASSESSMENTS. If the student fails to demonstrate mastery on the third trial, the student must schedule an appointment with an instructor. All of these skills must be mastered before a student will be considered for Lab Practical completion or clinical training. Some of these skills will be incorporated into the Practical Exams and may be graded concurrently with the practical examination review. Students are encouraged to attempt skills assessments when they feel ready and prepared for a proper demonstration and not fall far behind in these demonstrations. The lab will be available at times for student practice. Please see lab availability times on the door of RHO 412. Students are encouraged to make the best use of “open lab times”, which will be announced or posted on the lab door schedule. There will be an instructor available at these times to assist the student upon student request.

The Practical exams will be done in the Surgical Technology Skills lab and will build upon each other. Practical exam #1 will consist of scrubbing and gowning oneself and another, setting up back table, mayo stand, and basin stand. Practical exam #2 will include all elements of practical #1 along with prepping, draping and performing as a STSR (Surgical Technologist in the Scrub Role) for an Umbilical Hernia Repair with the instructor or another student in the surgeon role. This practical will also include explanation of preference card usage, positioning principles, demonstration of laparoscopic equipment knowledge, procedures, and a variety of instrumentation. LP#2 will be timed from the point of towel grasping to completion of back table set-up, mayo stand draping, and initial counts. Ten minutes will be the time to get!

If by the end of the semester the student has not successfully passed the two practical examinations, lab identification, and the skills assessments, they will not be allowed to proceed to SUR 122 and SUR 123.

Equipment, videos, and handouts will also be available to help the student master the basic competencies of a surgical technologist. When doing clinical skills training in the lab, whether during official class lab time or open lab time, the lab should be considered an OR and appropriate surgical attire should be worn. There will be no eating or drinking in the surgical skills lab which is a Biohazardous area. Students will exhibit a professional attitude at all times.

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THIS IS A TENTATIVE SCHEDULEOF THE REQUIRED LAB SECTIONS FOR SUR 111

LAB SESSIONS WILL BE IN ROOM 412 OR A DESIGNATED CLINICAL SITE (SEE SCHEDULE)

SECTION D-1

SESSION # DAY/DATE/TIME TOPICS COVERED SKILLS ASSESSED 1A WED 8-17 12:30PM OR attire 12-1 pg 191 Basic hand washing 7-1 pg 59 Peel pack packaging 7-4 pg 62 1B 4 PM Envelope fold wrap 7-2 pg 60 Square fold wrap 7-3 pg 61 Container system 7-5 pg 63

2A WED 8-24 12:30PM Field Trip MEDISOURCE 2B 4PM Glove oneself-open 12-12 pg 243 Remove soiled gloves 12-12A (insert RK)

3A WED 8-31 12:30PM Open Sterile Supplies Back Table 12-2A pg 209 Small Wrapped 12-2B pg 211 Small Wrapped 12-2B pg 211

Large Wrapped 12-C pg 213 Peel Pack 12-2D pg 215

3B 4PM Open Sterile Supplies Instrument Set Container 12-2E pg 217 Surgical Hand Scrub 12-1-A pg 193

4A WED 9-07 12:30PM Field Trip Park Ridge Hospital 4B 4PM Surgical Hand Scrub 12-1-A pg 193 Dry, Self-Gown, & Closed Glove 12-3 pg 219 Remove Tray From Container (insert RK) Videos

5A WED 9-14 12:30PM Field Trip Haywood Regional 5B 4PM Surgical Scrub 12-1-A pg 193 Dry, self-gown, closed glove 12-3 pg 219 Remove tray from container (insert RK)

6A WED 9-21 12:30PM Continue scrub, gown, glove 6B 4PM Prepare team member 12-4 pg 221 Disrobe to replace 12-1-C pg 197 Disrobe end of case 12-1-D pg 198 Dress the Mayo 12-6 pg 225

7A WED 09-28 12:30PM Field Trip VAMC 7B 4PM Fill a Bulb Syringe 12-6B pg 229

Pour Sterile Solution 12-6B pg 229 Case Management pre-scrub 12-7 pg 233 Case Management post-scrub 12-8 pg 235

(ALERT: We will have to do our VA field trip all in one day. You will need to make arrangements to attend lab both Wednesday and Thursday 9/28 and 9/29. To be fair to all, Wednesday Lab will be expected to attend the lab on Thursday 9/29. Thursday lab will be expected to attend the lab on Wednesday 9/28. Our visit with the VAMC is something we have to work around. Should you not attend, you will not be eligible to perform clinical there at all. Please make arrangements to be available for lab on both 9/28

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and 9/29. I apologize for any inconvenience this may cause. The date we will go to the VAMC is September 28th. We will conduct lab skills and start lab practicals on September 29th.

8A WED 10-12 12:30PM Assemble Instrument set 10-1 pg 130 Hand Signals 10-2 pg 132

Load, pass & unload knife 10-3 pg 134 Instrument Handling 10-4 pg 136 8B 4PM SKILLS ASSESSMENT REVIEW AND CATCH UP WE HAVE REVIEWED 31/44 SKILLS LAB PRACTICAL #1 = 12-7 12-8 Skills Assessments

9A WED 10-19 12:30PM Field Trip Asheville Surgery Center 9B 4PM Load and pass NH 10-4C pg 140

Load & pass free needles 10-4C pg 140 Ties, reels, free tie on a passer 10-4D pg 142 Load & pass staplers 11-2 pg 161 LAB PRACTICAL #1

10A WED 10-26 12:30PM Field Trip Mission Hospital 4PM Urinary catheterization 12-13 pg 245 Skin prep 12-14 pg 248 LAST CHANCE FOR LAB PRACTICAL #1

11A WED 11-02 12:30PM Drape (Laparotomy) 12-8 pg 235 4PM Sellick’s maneuver 9-1 pg 103 Syringe off field 9-2 pg 104 Syringe into field 9-3 pg 106 Accept meds to field 9-4 pg 108

12A WED 11-09 12:30PM Case Management set-up Intraoperative 12-9 pg 237 12B 4PM Case Management set-up Intraoperative 12-9 pg 237

13A WED 11-16 12:30PM POSITIONING LAB 13B 4PM LAB PRACTICAL #2

11/23-11/25/2011 THANKSGIVING HOLIDAY BREAK

14A WED 11-30 12:30PM LAB PRACTICAL #2 12-9 and Review 12-7, 12-8 14B 4PM Case management: Post –op 12-10 pg 239 15A WED 12-07 12:30PM LAB PRACTICAL #2 15B 4PM SKILLS ASSESSMENTS AND PRACTICALS 16 A WED 12-14 12:30PM SKILLS ASSESSMENTS AND PRACTICALS 16 B 4PM LAST CHANCE LAB PRACTICAL #2 CLINICAL PAPERWORK SUR 123 LAB ID PORTION OF SUR 111 FINAL EXAM

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THIS IS A TENTATIVE SCHEDULE

OF THE REQUIRED LAB SECTIONS FOR SUR 111LABS WILL BE IN ROOM 412

OR A DESIGNATED CLINICAL SITE (SEE SCHEDULE)SECTION D-2

SESSION # DAY/DATE/TIME TOPICS COVERED SKILLS ASSESSED 1A THU 8-18 12:30PM OR attire 12-1 pg 191 Basic hand washing 7-1 pg 59 Peel pack packaging 7-4 pg 62 1B 4 PM Envelope fold wrap 7-2 pg 60 Square fold wrap 7-3 pg 61 Container system 7-5 pg 63

2A THU 8-25 12:30PM Field Trip MEDISOURCE 2B 4PM Glove oneself-open 12-12 pg 243 Remove soiled gloves 12-12A (insert RK)

3A THU 9-01 12:30PM Open Sterile Supplies Back Table 12-2A pg 209 Small Wrapped 12-2B pg 211 Small Wrapped 12-2B pg 211

Large Wrapped 12-2C pg 213 Peel Pack 12-2D pg 215

3B 4PM Open Sterile Supplies Instrument Set Container 12-2E pg 217 Surgical Hand Scrub 12-1-A pg 193

4A THU 9-08 12:30PM Field Trip Park Ridge Hospital 4B 4PM Surgical Hand Scrub 12-1-A pg 193 Dry, Self-Gown, & Closed Glove 12-3 pg 219 Remove Tray From Container (insert RK) Videos

5A THU 9-15 12:30PM Field Trip Haywood Regional 5B THU 9-15 4PM Surgical Scrub 12-1-A pg 193 Dry, self-gown, closed glove 12-3 pg 219 Remove tray from container (insert RK) 6A THU 9-22 12:30PM Continue scrub, gown, glove 6B 4PM Prepare team member 12-4 pg 221 Disrobe to replace 12-1-C pg 197 Disrobe end of case 12-1-D pg 198 Dress the Mayo 12-6 pg 225

7A THU 9-29 12:30PM LAB PRACTICAL #1 = 12-7 12-8 Skills Assessments 7B 4PM LAB PRACTICAL #1 = 12-7 12-8 Skills Assessments

(ALERT: We will have to do our VA field trip all in one day. You will need to make arrangements to attend lab both Wednesday and Thursday 9/28 and 9/29. To be fair to all, Wednesday Lab will be expected to attend the lab on Thursday 9/29. Thursday lab will be expected to attend the lab on Wednesday 9/28. Our visit with the VAMC is something we have to work around. Should you not attend, you will not be eligible to perform clinical there at all. Please make arrangements to be

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available for lab on both 9/28 and 9/29. I apologize for any inconvenience this may cause. The date we will go to the VAMC is September 28th. We will conduct lab skills and start lab practicals on September 29th.

8A THU 10-13 12:30PM Assemble Instrument set 10-1 pg 130 Hand Signals 10-2 pg132 Load, pass & unload knife 10-3 pg 134 Instrument Handling 10-4 pg 136 8B 4PM SKILLS ASSESSMENT REVIEW AND CATCH UP WE HAVE REVIEWED 31/44 SKILLS LAB PRACTICAL #1 = 12-7 12-8 Skills Assessments

9A THU 10-20 12:30PM Field Trip Asheville Surgery Center 9B 4PM Load and pass NH 10-4C pg 140

Load & pass free needles 10-4C pg 140 Ties, reels, free tie on a passer 10-4D pg 142 Load & pass staplers 11-2 pg 161 LAB PRACTICAL #1

10A THU 10-27 12:30PM Field Trip Mission Hospital 4PM Urinary catheterization 12-13 pg 245 Skin prep 12-14 pg 248 LAST CHANCE FOR LAB PRACTICAL #1

11A THU 11-03 12:30PM Drape (Laparotomy) 12-8 pg 235 4PM Sellick’s maneuver 9-1 pg 103 Syringe off field 9-2 pg 104 Syringe into field 9-3 pg 106 Accept meds to field 9-4 pg 108

12A THU 11-10 12:30PM Case Management set-up Intraoperative 12-9 pg 237 12B 4PM Case Management set-up Intraoperative 12-9 pg 237

13A THU 11-17 12:30PM POSITIONING LAB 13B 4PM LAB PRACTICAL #2

11/23-11/25/2011 THANKSGIVING HOLIDAY BREAK

14A THU 12-01 12:30PM LAB PRACTICAL #2 12-9 and Review 12-7, 12-8 14B 4PM Case management: Post –op 12-10 pg 239

15A THU 12-08 12:30PM SKILLS ASSESSMENTS AND PRACTICALS 15B 4PM LAB PRACTICAL #2

16A THU 12-15 12:30PM SKILLS ASSESSMENTS AND PRACTICALS 16B 4PM LAST CHANCE LAB PRACTICAL #2

CLINICAL PAPERWORK SUR 123 LAB ID PORTION OF SUR 111 FINAL EXAM

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