Surgical Technology Handbook

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 Students participating in externship programs at hospitals and other medical facilities will be subject to that medical facility’s policies and procedures relating to employment at that facility. City College exercises no control over the extern/student’s employer during the externship. The medical facility employing the student/extern may have policies and procedures that may include requirements that the extern be able to perform the essential functions of the externship job position with or without reasonable accommodation. It is up to the extern/student to ascertain the essential job functions of the position and determine whether or not a particular externship job position is or is not suitable for him or her. City College disclaims any responsibility for decisions of the employing health facility relating to the extern/student’s employment status.

 I have had the City College Medical Waste and Biohazard Policy explained to me and do fully understand that, in some classroom procedures, I may be required to comply with this policy as part of my education and assessment.

 I have read and understood the City College Health, Externship and Clinical Policy.

 City College is currently accredited by ACICS. The Surgical technology programs are accredited through the Accrediting Bureau of Health Education Schools (ABHES). As a result of being accredited by ABHES City College Surgical Technology graduates are eligible to sit for the national certifying exam through NBSTSA.

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 I have read, understood and agree to abide by the rules of City College’s Surgical Technology Classroom and Lab rules.

 I have read City College’s dress code for Surgical Technology and I understand that it is my responsibility to wear the assigned uniform and/or use the following protective clothing and/or gear when carrying out my clinical duties: Gloves, face mask/shields, lab coats, goggles, disposable gowns, fluid resistant clothing, head coverings, shoe coverings, lead aprons, and laser goggles. I have been instructed by my teacher as to the use of this clothing and/or gear and I realize failure to comply will result in disciplinary action.

____________________________________ Student Name (Print)

____________________________________ Student Name (Signature)

____________________________________ Date

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PROGRAM OVERVIEW

Welcome to City College’s Surgical Technology Program.

The Surgical Technology Program at City College is a comprehensive entry-level program designed to prepare the student for a rewarding career that is academically challenging and professionally rewarding. As a student you will take a variety of didactic and clinical courses with a focus on the Patient Simulation Center that will provide “real life” scenarios of a demanding clinical environment. The integration of lecture, simulation and clinical will help each student transition from the academic/clinical environment to the profession upon graduation. Students are required to complete 690 hours of didactic lecture, 160 hours of lab and 780 hours of clinical training in both classroom labs and a hospital setting. The Surgical Technology curriculum is comprised of 103 credits over 8 quarters.

Classroom instruction conducted on campus includes anatomy and physiology, medical terminology, microbiology, patient care in surgery, sterile technique, surgical techniques, instrumentation and surgical procedures. During the pre-clinical phase of the program, emphasis is placed on classroom and laboratory instruction as preparation for participation in the clinical phase. The clinical experience is received at a variety of locations including hospitals, clinics and surgical outpatient centers. The student functions under the supervision of the instructor, staff Surgical Technologists, in performing as a member of the operating room team. The clinical phase includes further classroom instruction that will be scheduled, but emphasis is placed on extensive clinical experience in actual surgical procedures.

The following information will provide information about each course in the program and what is expected of you as a student in the program.

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PROFESSIONAL ORGANIZATION

The Association of Surgical Technologists (AST) is your professional organization.

Membership is strongly encouraged in the first year of the program and required in the second year of the program.

Benefits include:

1. Association with other students and other practicing Surgical Technologists. 2. Surgical Technologist - a monthly scientific publication.

3. Discounts in registration fees at AST sponsored educational programs. 4. A forum for voicing your concerns for the profession.

5. A discounted fee for taking the National Certification Examination.

CODE OF ETHICS OF THE ASSOCIATION OF SURGICAL TECHNOLOGISTS 1. To maintain the highest standards of professional conduct and patient care.

2. To hold in confidence, with respect to the patient’s beliefs, all personal matters. 3. To respect and protect the patient’s legal and moral rights to quality patient care. 4. To not knowingly cause injury or any injustice to those entrusted to our care.

5. To work with fellow technologists and other professional health groups to promote harmony and unity for better patient care.

6. To follow principles of asepsis.

7. To maintain a high degree of efficiency through continuing education.

8. To maintain and practice surgical technology willingly, with pride and dignity. 9. To report any unethical conduct or practice to the proper authority.

10. To adhere to the Code of Ethics at all times with all members of the health–care team.

(From: http://www.ast.org)

SURGICAL TECHNOLOGY PROGRAM DESCRIPTION AND OUTCOMES

The mission of City College’s Associate of Science in Surgical Technology program is to provide

didactic and clinical instruction that will enable individuals to perform as competent, entry-level Surgical Technologists ready to sit for certification; and to help satisfy the need for Surgical Technologists in the local community.

Program Outcomes

To prepare competent entry-level surgical technologists in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains.

Program Goals

Cognitive Domain The student will:

 Comprehend the fundamental concepts of Human Anatomy and Physiology, Pathophysiology, Microbiology and infectious process and recognize their relationship to safe patient care.

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 Understand the principles of safe patient care in the preoperative, intra-operative and postoperative settings.

 Recognize the interdependent role of the surgical technologist with the other team members and ancillary service providers.

Psychomotor Domain The student will:

 Develop and apply fundamental surgical assisting skills through practice and evaluation in the clinical setting.

 Accurately apply the principles of asepsis across the spectrum of common surgical experiences

 Employ the Standard Precautions and other recognized safe practice guidelines in every surgical setting.

Affective Domain The student will:

 Recognize the variety of patients’ needs and impact of their personal, physical, emotional and cultural experiences on rendering patient care

 Demonstrate professional responsibility in performance, attitude and personal conduct.

 Practice within the confines of the recognized scope of practice within the healthcare community to provide optimal patient care.

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SURGICAL TECHNOLOGY PROGRAM GRID

Associate of Science in Surgical Technology v.4 - Program version began 10/2/2013 Quarter COURSE

NUMBER

COURSE NAME LECTURE

CONTACT HOURS LAB CONTACT HOURS EXTERN CONTACT HOURS TOTAL CONTACT HOURS TOTAL CREDIT HOURS PRE-REQUISITES 1

SLS1201 Personal Development 40 0 0 40 4 None

STS1302 Introduction to Surgical

Technology 40 0 0 40 4 None

HSC1531 Medical Terminology 40 0 0 40 4 None

STS1021 Surgical Observation 0 0 30 30 1 None

TOTAL HOURS 120 0 30 150 13

2

ENC1100 College English 40 0 0 40 4 None

SPC1017 Oral Communications 40 0 0 40 4 None

STS1307C Operating Room Technique

I - Instrumentation 20 0 0 20 2 HSC1531

BSC1085 Anatomy and Physiology I 40 0 0 40 4 None

BSC1085L Anatomy and Physiology I

Lab

0 20 0 20 1 None

TOTAL HOURS 140 20 0 160 15

3

STS1304C Operating Room Technique

II 20 40 0 60 4

STS1303C, STS1340C (coreq)

BSC1086 Anatomy and Physiology II 40 0 0 40 4

BSC1085 and BSC1085L

BSC1086L Anatomy and Physiology II

Lab 0 20 0 20 1

BSC1085 and BSC1085L

STS1340C Surgical Pharmacology and

Aseptic Technique 20 40 0 60 4

STS1302, HSC1531 TOTAL HOURS 80 100 0 180 13

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4 STS2325C Surgical Procedures I 20 40 0 60 4 STS1302, HSC1531, BSC1085, BSC1085L, BSC1086, BSC1086L

ENC1101 English Composition 40 0 0 40 4 ENC1100 or _ENC1201

MCB2010 Microbiology 40 0 0 40 4 None

MCB2010L Microbiology Lab 0 20 0 20 1 None

TOTAL HOURS 100 60 0 160 13

5

STS2326 Surgical Procedures II 30 20 0 50 4 STS2325C

MEA2235 Medical Law and Ethics 40 0 0 40 4 None

PHI2014 Introduction to Philosophy 40 0 0 40 4 None

TOTAL HOURS 110 20 0 130 12

6

STS2270 Clinical Aspects I 0 0 240 240 8 STS2326,

STS1304C

MAT1030 College Algebra 40 0 0 40 4 None

TOTAL HOURS 40 0 240 280 12

7

STS2271 Clinical Aspects II 0 0 240 240 8 STS2270

PSY1012 Principles of Psychology 40 0 0 40 4 None

TOTAL HOURS 40 0 240 280 12

8

STS2272 Clinical Aspects III 0 0 240 240 8 None

SLS2301 Professional Strategies 40 0 0 40 4

STS2936 Exam Prep 10 0 0 10 1 STS2271

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CITY COLLEGE HEALTH, EXTERNSHIP AND CLINICAL POLICY

Students in the Surgical Technology program are required to complete labs and externships in health settings. City College adheres to all policies set forth by the clinical sites inclusive of screenings, specific health requirements and notifications.

In order to adhere to these guidelines, City College has the following as entry and program requirements: 1. Proof of the following medical requirements:

• Current physical examination performed by an MD, DO or ARNP with a signed Health Clearance Form.

• Proof of immunity via documentation of immunization or titers for the following: -- Hepatitis B series. The first of three injections must be completed prior to admission. -- MMR (Measles, Rubella, and Mumps).

-- VZV (Varicella) vaccine – 2 injections. • Absence of Tuberculosis (TB)

-- Negative PPD skin test within the last 6 months (2-step PPD or single step PPD as part of an annual series) or a negative chest x-ray.

• A tetanus (Td) booster within the last ten years. Results of a Health Clearance Form and PPD must be updated yearly.

2. A negative urinary drug screen indicating a 10 panel drug screen.

a. Students who have a positive finding on their initial drug test but subsequently have a negative drug panel fining may be subject to random drug tests though out their academic career at City College. If a drug test comes back positive, they will be administratively dismissed from City College for violating the Student Conduct Policy and will be ineligible for re-entry into City College.

3. Student must hold personal health insurance throughout the program. 4. Student must have a VECHS background check.

5. Student must complete an Acknowledgement of Florida Statute Section 456.0635.

Note: Individual clinical sites may require additional screenings, health requirements and/or background checks.

ATTENDANCE

Students who are absent are required to make up the hours missed on clinical rotation during the current term. Excessive absences may lead to dismissal from the externship site. If a student is DISMISSED from an externship site there is no guarantee clinical re-placement can be achieved within the 14 day attendance policy as set forth in City College Catalog. Students that are dismissed from a site due to attendance or behavior problems may immediately receive a failing grade for the current externship course.

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SURGICAL TECHNOLOGY SAFETY FOR LAB AND CLINICAL

INFECTIOUS DISEASES GUIDELINES

Each clinical facility is expected to practice universal precaution procedures in the care of patients with infectious diseases. The Surgical Technology student is educated in, and is expected to be knowledgeable in the practice of these precautions and care for these patients.

 Clinical grades are awarded according to student performance. Refusal to render care to any patient in a manner which follows the clinical facilities guidelines may result in dismissal from the program.

PROCEDURES FOR ACCIDENTAL EXPOSURE TO BLOOD OR BODY FLUID BLOODBORNE PATHOGENS / NEEDLESTICK POLICY

Students must comply with current CDC and OSHA guidelines for infectious disease control. Students receive updated information of standard precautions as they become available. Universal Precautions, CDC and OSHA Guidelines are reviewed annually and a post-test will be kept in the student file for documentation of clinical compliance.

In keeping with standard precautions, blood and certain body fluids of all clients are considered potentially infectious for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other blood borne pathogens.All nursing students and faculty are professionally and ethically obligated to provide client care with compassion and respect for human dignity. No nursing student or faculty may refuse to treat a patient solely because the patient is high risk for contracting, or is HIV positive, or has hepatitis, or any other infectious disease. The CDC recommends that standard precautions apply to blood and to body fluids containing visible blood, as well as semen and vaginal secretions, to tissues and to the following fluids: cerebrospinal, synovial, pleural, peritoneal, pericardial and amniotic.

Standard precautions do not apply to nasal secretions, sputum, saliva, sweat, tears, urine, feces and vomitus unless they contain visible blood. However, current infection control practices already in existence include the use of gloves for digital examination of mucous membranes and endotracheal suctioning, and hand washing after exposure to saliva.

Students with exudative lesions or weeping dermatitis should refrain from all direct client care and from handling client-care equipment.

POST-EXPOSURE PROTOCOL FOR PROPHYLAXIS OF HBV AND HIV

The use of personal protective equipment, appropriate engineering controls, and proper work practices must be continually reinforced among faculty and students to prevent exposure incidents to blood or other potentially infectious materials (OPIM). However, if an incident occurs, faculty and students should report the incident as soon as possible and be thoroughly familiar with the procedures for testing,

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 Percutaneous inoculation – needle stick or sharps

 Non-needle percutaneous injury – open cuts or abrasions

 Direct mucous membrane contact – accidental splash

 Non-intact skin contact with blood or OPIM.

INITIAL RESPONSE TO EXPOSURE 1. Immediately apply first aid as needed:

 Allow to bleed freely; clean with 70% alcohol (for needle stick/puncture injury)

 Wash thoroughly with soap and water

 Mucous membrane: flush copiously with water

 Eyes: irrigate and/or flush copiously with water 2. Document the incident, including:

 Route of exposure

oHow and when exposure occurred

oIdentify source individual, if known

 Report exposure immediately to nursing instructor and appropriate supervisor in school or the clinical agency.

MEDICAL WASTE AND BIOHAZARD GUIDELINES

City College adheres to the highest standards of handling and disposing of medical waste and bio-hazardous materials. Each City College campus has an OSHA Compliance Officer that ensures that medical waste and biohazard waste are properly disposed of.

ALWAYS dispose of these items in

sharps disposal containers: Any medical needles

Syringe barrels (with or without needle)

Pasteur pipettes

Scalpel and razor blades Blood vials

Microscope slides and cover slips Glassware contaminated with infectious agents

NEVER dispose of these items in sharps disposal containers:

Plastic items (except for syringes) Beverage containers (no pop cans!) Non-biologically contaminated laboratory glassware*

Solvent/Chemical bottles Light bulbs

Any paper materials Pipette tips

Plastic pipettes

Aerosol cans or can of any type Scintillation vial

Any item with liquid (except for blood in vacutainers)

From: http://www.drs.illinois.edu/bss/factsheets/sharps.aspx

If you see blood, vomit or other biohazards, call Facilities for cleanup and safe disposal. Contact the Department Chair or notify the instructor if there are sharps.

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STUDENT HEALTH

Students are responsible for personal health care expenses, including those incurred as a result of

participation in the nursing education program, and are required to carry their own health care insurance. Written acknowledgement of financial accountability and responsibility is a clinical requirement. Some clinical agencies may require proof of insurance. A lack of insurance may cause an alteration in a student’s schedule or delay in graduation.

PREGNANCY

1. It is the intention of the City College not to unfairly prejudice the interest of students who are pregnant. A student may choose to continue with her program during pregnancy with the understanding that she is expected to satisfactorily meet the same standards of clinical and classroom performance as are all other students enrolled in the program.

2. A pregnant student wishing to remain in the program must sign a waiver releasing the school and any of its affiliated clinical agencies from ANY liability concerning her pregnancy or the unborn child. The student’s health care provider must also provide a written statement

concerning any restrictions on activity or weight lifting, in order for the student to continue in the program. Restrictions that interfere with patient safety or learning objectives will require that the student is withdrawn from the course. The pregnancy waiver must be updated following each prenatal visit.

3. If at any time during pregnancy the student’s ability to meet City College performance standards is questioned, the student may be required to submit a statement from her private physician. Such statement must indicate that the student is able to satisfactorily perform in the clinical or classroom area without undue detriment to herself and/or the unborn fetus/baby. Without such medical assurances, the student may be required to discontinue her program until said medical assurances have been received and accepted.

4. The above policies do not mitigate the student’s responsibility for maintaining her own well being as well as that of responsible behavior with respect to the fetus or unborn child. If at any time the student believes she is medically unable to continue with class/clinical

responsibilities, the student should notify her instructor, academic advisor, or Nursing Program Director.

5. The student must be able to complete all course objectives in order to successfully complete the course. Students who are unable to complete the clinical requirements may register for the course at the next opportunity, space permitting. No spaces are saved for students not taking courses in their original sequence. Students who are not actively enrolled in classes for more than one (1) term must adhere to the catalog curriculum and policies in effect at the time the student resumes classes.

It is recommended that students who are pregnant read the following article from the American Journal of Nursing to be fully informed about any potential dangers to their pregnancy while pursuing their coursework in a clinical setting.

http://journals.lww.com/ajnonline/Fulltext/2011/01000/Occupational_Hazards_for_Pregnant_Nurses. 24.aspx

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COMMUNICABLE DISEASE GUIDELINES

 Any student who has or contracts a communicable disease as so stated by a physician will be academically withdrawn from theory and clinical with an excused absence.

 Make-up work will be assigned on an individual basis.

 All theory and clinical work must be made up; i.e. test, assignments, and quizzes.

 It is the students’ responsibility to request make up work and to keep up with what he/she has missed.

 Re-entry is contingent on a signed physicians’ statement stating the student is no longer communicable.

COMMUNICABLE DISEASE PREVENTION

All Surgical Technology students, in order to protect themselves, fellow health care personnel, and patients, will comply with each of the following:

 Uniforms and lab coats will be fresh each day.

 All equipment will be thoroughly cleaned, disinfected, or sterilized between patients according to appropriate procedures for each piece of equipment regardless of the patient’s diagnosis.

 Good hand washing practices will be followed before and after patient contact.

 Disposable gloves will be worn at all times when in either direct or indirect patient contact. Disposable gloves are MANDATORY for all patient transfers.

 Masks will be work when it is likely that blood or body fluids could splash in the nose or mouth.

 A gown will be worn should a splash of blood or body fluids onto the skin or clothing be anticipated.

 Cuts, scratches, or other non-intact skin will be covered to avoid contact with blood or body fluids and could preclude the student from participation in laboratory or clinical activities until such time as these wounds have healed

 Goggles or other eye protection will be worn when a splash of blood or body fluid into the eye is anticipated.

 Blood or body fluid inadvertently coming in contact with the skin should be quickly and thoroughly washed away.

 Students that experience exposure to blood or body fluid will report to their clinical instructor and follow clinical exposure protocol.

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SURGICAL TECHNOLOGY CLASSROOM AND LABORATORY RULES

BEHAVIOR

Students are expected to demonstrate professional behavior at all times in the classroom, laboratory and at clinical sites. All students, teachers, visitors, and employees are to be treated with courtesy and respect. Inappropriate behavior or language is not permitted.

 Students are expected to be on time when reporting to classroom/laboratory sessions and clinical rotations.

 City College rules on Academic Integrity, as part of City College’s Conduct Policy are strictly enforced. Refer to the General City College Student handbook and the Catalog for detailed information about City College’s Conduct Policy.

 Students are expected to stay in class for the entire meeting time. As such, students are

encouraged to take care of all personal, non-class related activities prior to class, or during the assigned break.

 All cell phones must be on vibrate or turned off during class. If you need to make or take a call or text, please step out of the classroom. If you are aware that there will be a need for you to have access to your phone during class, it is polite to advise the instructor of this need at the beginning of class.

 To maximize the educational experience, students are to be attentive and courteous at all times. Smoking, eating, chewing gum, hard candy or drinking are ONLY allowed during break in designated areas at the school and affiliated agencies.

 All students must notify their instructor directly not less than 2 hours prior to clinical or class if they will be absent or tardy.

 Please keep classroom conversations to a minimum. Excessive and non-class related conversation during lectures, labs and clinicals may result in your being asked to leave the classroom or site. There is no early dismissal for lecture, lab or clinicals, unless you have made prior arrangements with your instructor.

COURSEWORK

 Students are expected to have all required textbooks and supplies for the first class session.

 Students are expected to attend ALL lecture, lab and clinical sessions.

 All student assignments must be turned in at the beginning of each class. Late work will not be accepted

 If you are tardy or absent for a written exam, you must complete a make-up exam within one calendar week, with an automatic 10% deduction unless the student can document their mitigating circumstance.

 If applicable, students are responsible for making up any missed assignments or obtaining the information that was presented in class.

 All assignments will be given back to the student for review. Additionally, exams will be handed back for review purposes only. All exams MUST be returned to your instructor prior to leaving

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the classroom. Failure to return exams will be viewed as an infraction of Academic Integrity pursuant to City College’s Conduct Policy.

CLASSROOM MAINTENANCE

All students are responsible for maintaining a neat and orderly classroom:

 Do NOT attempt to use or operate any equipment until you have received the appropriate instruction for its use.

 When using equipment, treat it kindly. All equipment should be replaced in the appropriate storage area after use.

 Class or Laboratory sessions are not considered adjourned until the lab and classroom are in proper order.

 No food or drinks are allowed in the classroom or lab at anytime

SURGICAL TECHNOLOGY DRESS CODE

1. Uniforms must be worn whenever the student is on school grounds, at the clinical site, and on field trips unless other arrangements have been authorized by City College officials. Uniforms are to be kept clean, neat, and professional at all times.

2. Scrub tops and ties on the pants are to be tucked into pants. 3. ID badges are to be worn at or near eye level.

4. Sweatshirts, sweaters or warm–up jackets may NOT be worn over scrubs. Long sleeve shirts are

not permitted to be worn under the scrub top. Only a T–shirt or an under shirt may be worn under the scrub top, providing that the sleeves do not extend below the sleeves of scrub top.

5. For your safety and the safety of those around you, only shoes that are comfortable and suitable for standing for extended periods should be worn. Shoes worn in the clinical setting must be constructed with non-skid, non-marking soles. They are to be kept clean and in good repair. Open–toed sandals, dress shoes, and clogs are NOT permitted for safety reasons. Shoes should be all white. Leather is preferred as it protects the feet from being cut.

6. Jewelry is limited to one small stud earring in each ear, and one short neck chain. No other jewelry is allowed. Watches, bracelets, and rings are not to be worn into or while at the clinical site.

7. Hair must be neatly combed, clean and arranged in a simple style. All hair (head and/or facial) must be completely covered prior to entering the surgical area. In keeping with the principles of aseptic technique, excessive mousse, hair spray or gel is not permitted. Hats or caps are not to be worn outside the OR.

8. No perfume or cologne.

9. Fingernails are to be kept clean and neatly manicured (fingertip length). Artificial nails and nail polish are not permitted. Also, false eyelashes or any other type of temporary aesthetic products are prohibited within the surgical setting.

10.Personal hygiene is essential since students work very closely with others.

11.All Surgical Technology students must wear protective eyewear during all clinical activities. Please comply with all dress code requirements. Non–compliance will result in a verbal warning and/or dismissal from the clinical site; continued abuse will result in additional disciplinary action

Students preparing for a career in the health field bear the responsibility of conducting themselves and dressing in a manner that reflects professionalism. Proper attire and appearance enhances both your

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credibility and that of City College with clients, their families, and medical personnel. Professional conduct is expected at all times, e.g., not talking loudly, not chewing gum and no transaction of personal business in the clinical unit except for emergency situations.

Faculty and clinical instructors have the responsibility and reserve the right to judge the appropriateness of a student’s attire, and may modify the policy in accordance with agency guidelines and standards.

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CLINICAL EDUCATION REQUIREMENTS

Clinical Education rotations are designed to ensure that students meet the following objectives:

 Demonstrate compassion and professional conduct at all times while working with patients.

 Be able to communicate properly with patients.

 Be able to communicate and work with fellow students and Surgical Technologists.

 Exhibit professional conduct and adhere to dress codes at all times while assigned to the clinical area.

 Be able to cope and function during stressful situations.

 Complete the required competencies within the specified time and retain proficiency

Clinical Education Requirements are designed to help the student learn to adjust to the requirements of the professional workforce. Students are required to do the following:

 Two weeks prior to clinical rotation meet with the clinical coordinator to discuss the clinical assignment.

 Arrive on time for all clinical assignments.

 Call the clinical coordinator if sick or cannot be at their clinical assignment at least two hours prior to the start of the schedule rotation. If s/he cannot be reached, the student may call the program director.

 Pass the physical requirements of the program.

 Rotate through all clinical assignments and gain working knowledge of the instrumentation, equipment, techniques and procedures done.

 Complete all clinical competency objectives on or before the required deadlines set each quarter.

 Complete all clinical assignment before the start of the next semester. This includes making up approved missed days during quarter breaks, etc.

 Maintain satisfactory clinical evaluations completed by staff Surgical Technologists and clinical instructors

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CLINICAL ASSESSMENT

During the student’s clinical education the staff Surgical Technologists or Preceptor, Clinical Instructor, and Program Director on an ongoing basis will evaluate his/her performance. The student is evaluated on specific Surgical Technologist duties as well as on their overall performance. A student’s overall

performance is assessed by the clinical instructor and the staff Surgical Technologist during each clinical rotation and at predetermined intervals.

Midterm conferences will be scheduled with the clinical instructor during each quarter in order to review the student’s progress and standing. Conferences will also be scheduled at the end of each quarter by the clinical instructor and program director.

Completion of Preceptor Evaluations

The student must:

 Request the preceptor complete a Weekly Externship Evaluation Form (unless told differently by the program director).

 Before giving the evaluation form to the preceptor fill in the following:

o Student Name

o Facility

o Date

o Type of procedure(s) performed

 Give the preceptor the form at least one hour before scheduled to leave the department. The Preceptor will:

 Score the student’s performance by placing a check in the column appropriate to the task.

 If the student’s performance is unacceptable a written comment is required.

CLINICAL REQUIRED CASES

Students will be required to document all surgical cases in the Externship Case Log records.

A faculty member will review case reports and ensure an appropriate case mix balance. Students will observe and begin participation in core and specialty cases with potential exposure to the following areas:



 Diagnostic Endoscopy

 General surgery

 Obstetric and Gynecologic

 Otorhinolaryngologic

 Genitourinary

 Orthopedic



 Ophthalmic

 Oral and Maxillofacial

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 Cardiothoracic

 Peripheral vascular

 Neurosurgical

 Procurement/Transplant

CLINICAL CASE REQUIREMENTS

Surgical Specialty Total Number of

Cases Required

Minimum Number of First Scrub Cases Required

Maximum Number of Second Scrub Cases that can be Applied Towards 120 Cases General Surgery 30 20 10 Surgical Specialty:  Cardiothoracic  ENT  Eye  GU  Neuro  Ob-Gyn  Oral/Maxillofacial  Orthopedics  Peripheral vascular  Plastics  Procurement/Transplant 90 60 30 Diagnostic Endoscopy:  Bronchoscopy  Colonoscopy  Cystoscopy  EGD  ERCP  Esophagoscopy  Laryngoscopy  Panendoscopy  Sinoscopy  Ureteroscopy 0 required but 10 cases in this area may be applied towards the 90 total cases required

0 10 diagnostic

endoscopy cases may be applied toward the second scrub cases

Labor & Delivery 0 required but 5

cases in this area may be applied towards the 90 total cases required

0 5 vaginal cases may be

applied toward the second scrub cases

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 The clinical externship student must complete 120 cases.

 Clinical students must complete 30 cases in the area of General Surgery. Twenty of which must be in the First Scrub Role. Clinical students must also complete 90 cases in various specialties. Sixty of the cases must be in the First Scrub Role and evenly distributed between a minimum of 5 surgical specialties. Please note that 15 cases is the maximum number of cases that can be counted in any one specialty.

 The surgical technology program is required to verify through clinical documentation the students’ progression in First and Second Scrubbing procedures that increase in complexity as the student advances through the externship portion of the program and towards graduation.

 Up to 10 diagnostic endoscopy cases and 5 vaginal delivery cases can be counted towards the maximum number of Second Scrub Role cases. However, they are not a mandatory

requirement.

 Observation cases do not count towards the required 120 cases, but must be documented.

 Cases will be counted according to surgical specialty. If a trauma patient requires two procedures that are different specialties, the two procedures may be documented separately. Example: (Craniotomy and Bowel resection)

FIRST SCRUB ROLE

The student surgical technologist shall perform the following duties during any given surgical procedure with proficiency. The student must be able to perform a minimum of 70% of the procedure unassisted. The list below must be completed in order to document a in the first scrub role. Should the clinical student not meet these criteria, the case must be documented in the second scrub role.

 Check supplies and equipment needed for the surgical procedure

 Set up the sterile table with instruments, supplies, equipment and medication / solutions needed for the procedure

 Perform appropriate counts with the circulator prior to the procedure and before the incision is closed

 Pass instruments and supplies to the sterile surgical team members during the procedure

 Maintain the highest standard of sterile technique during the procedure

 Prepare sterile dressings

SECOND SCRUB ROLE

The second scrub role is described as the student who is at the sterile field who has not met all the criteria for the first scrub role, but actively participates in the surgical procedure by completing any of the

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 Sponging

 Suctioning

 Cutting suture

 Holding retractors

 Manipulating endoscopic camera

OBSERVATION ROLE

The observation role is described as the student who is in the operating room performing roles that do not meet the criteria for the first or second scrub role. The observation cases must be documented by the program but are not to be included in the required case count.

PRIMARY SCRUB ROLE

The primary scrub role is described as the student who has actively participated in more than 90% of the procedure without assistance.

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EXTERNSHIP CASE LOG Name: ________________________________ Course: ___________________ Clinical Site/Supervisor: ________________________________________________ Preceptor(s) ________________________ __________________________ ________________________ __________________________ ________________________ __________________________ ________________________ __________________________

O/SO –Observe/Sterile Observe FS –First Scrub

SS-Second Scrub PS-Primary Scrub

Checklist must be completed during rotation in specialty area, Preceptor and student must initial under appropriate column.

GENERAL SURGERY O/SO SS FS PS

Appendectomy, laparoscopic Appendectomy, open

Abscess, I&D Anal Fissure, fistula Axillary Dissection Axillary node biopsy Low anterior resection Lysis of Adhesions Exploratory Laparotomy Open Cholecystectomy Common duct exploration Gastric Resection

Hemorrhoidectomy Inguinal Herniorrhaphy Umbilical Herniorrhaphy Laparoscopic Herniorrhaphy Herniorrhaphy with Mesh Small Bowel Resection Large Bowel Resection Colostomy

Closure of Colostomy Ileostomy

Lymph Node Dissection Breast Biopsy

Simple, Modified Radical Mastectomy Pyloroplasty

Thyroidectomy Splenectomy Parathyroidectomy

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Cyst Excision

Vein Ligation/Stripping Pilonidal Cystectomy

Excision of Mass (anywhere) Nissen Fundoplication Amputation, Above Knee Amputation, Below Knee Amputation, Toe

Hickman Catheter Insertion PermCath Insertion

Pacemaker Insertion Temporal Artery Biopsy Tracheostomy

Abdominal Perineal Resection

EYE SURGERY Cataract Extraction IOL Enucleation Strabismus Retinal Detachment Vitrectomy Cryopexy ENT SURGERY T&A BMT SMR Tympano-mastoid surgery Laryngectomy Parotidectomy

Excision of Salivary Gland Radical Neck Dissection Endoscopic Sinus Surgery Caldwell Luc

Stapedectomy Mastoidectomy Tympanoplasty

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PLASTIC SURGERY

Blepharoplasty Dermal Abrasion Scar Revision

Breast Augmentation Mammoplasty Breast Reduction Mammoplasty Excision of Skin Lesion

Split Thickness Skin Graft Full Thickness Skin Graft Carpal Tunnel Face Lift Lipectomy Liposuction Debridement Rhinoplasty

Open Reduction of Facial Fracture Abdominoplasty GYNECOLOGICAL SURGERY Abdominal Hysterectomy Vaginal Hysterectomy Repair Cystocele/Rectocele D&C D&E Diagnostic Laparoscopy Operative Laparoscopy Cold Knife Cone Biopsy Laser Cone Biopsy Leep

Bartholin Cystectomy BSO

Salpingectomy, Ectopic Mini-Laparotomy – Tubal Post Partum Tubal Ligation Cervical Cerclage

C-Section Hysteroscopy

Tubal Reanastomosis Myomectomy

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GENITOURINARY SURGERY Circumcision Hydrocelectomy Hypospadias Repair Pelvic Lymphadenectomy Nephrectomy Orchiopexy Orchiectomy Penile Prosthesis Suprapubic Prostatectomy Retropubic Prostatectomy Ureterolithotomy Nephrolithotomy Vasectomy TURP TURBT Cystoscopy Ureteroscopy Bladder Suspension Ileoconduit/Cystectomy Radical Prostatectomy Vas-reanastomosis VASCULAR SURGERY

Abdominal Aortic Aneurysm Pseudoaneurysm

Carotid Endarterectomy Fem-Pop Bypass

Fem-Tib Bypass Aorta-Bifem Graft A-V Fistula Creation Embolectomy

NEUROSURGERY

Carpal Tunnel Release

Anterior Cervical Laminectomy Posterior Cervical Laminectomy

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Craniotomy Burr Holes

Lumbar Laminectomy V-P Shunt

Harrington Rods

Laminectomy with Instrumentation

ORTHOPEDIC SURGERY Knee Arthroscopy Shoulder Arthroscopy Ankle Arthroscopy ORIF Wrist ORIF Arm ORIF Ankle ORIF Leg

Closed Fracture Reduction Pins and Plaster

IM Rodding Richard’s Hip Total Hip Total Knee Total Shoulder Rotator cuff Repair Tendon Repair ACL

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CASE REPORT

SCORE: _TOTAL__x 100 = % FSS ______ FSA___________ 50

NAME: ______________________________________________________________ DATE: ________________ PROCEDURE (s): ________________________________________________________________________ WEEK: (circle one) 1 2 3 4 5 6 7 8 9 10

3 points INDICATION (S) _{Points Earned:}

Please give reason (s) why this procedure was performed on this particular patient:

15 points PROCEDURE (S) _{Points Earned:}

Please give a brief description of the procedure (s) in proper sequence:

INSTRUMENTATION/ SUPPLIES

Please list instrument trays, special instruments, special supplies (including injectables), and dressings used for this procedure:

5 points Instrument tray (s):

Points Earned: 3 points Special instruments:

Points Earned: 5 points Special supplies:

Points Earned: 2 points Dressing (s): Points Earned: 5 points Sutures: Points Earned: FUNDAMENTALS:

3 points Type of Anesthesia:

Points Earned: 2 points Surgical Position:

Points Earned: 5 points Drapes used (list in order):

Points Earned: 2 points Incision (s):

Points Earned:

TOTAL:

Scored By: ______________________________________________________________ Date: _______________

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MIDTERM EVALUATION

Name:______________________________________________________Date:________________ Clinical Instructor:____________________Procedure:________________________Score:_________

O.R. ATTIRE: (maximum points 5) Total: _______

_____a. (3) Hair cover and mask on properly; protective eye-wear on. _____b. (2) Fingernails short, no polish and no jewelry.

GATHERING/OPENING OF STERILE SUPPLIES: (max points 15) Total: _______ _____a. (5) Performs basic hand wash; gathers and checks supplies according to surgeons preference card. _____b. (5) Lays appropriate packs on furniture; opens basic pack, instrument tray, gown (on mayo) and basin

set so the inside wrapper becomes a sterile field.

_____c. (5) Opens other sterile items (rayteks, towels, laps, gowns, gloves, suction, etc.) following aseptic technique.

SCRUBBING/GOWNING/GLOVING (max points 15) Total: ______

_____a. (5) Performs a proper surgical scrub. _____b. (5) Dons gown properly.

_____c. (5) Dons gloves properly.

STERILE FIELD SET-UP: (max points 35) Total: ______

_____a. (2) Drapes the mayo stand with sterile mayo cover; layers the top of the mayo with at least one towel _____b. (3) Prepares and organizes the back table (minimal movement)

_____c. (3) Counts instruments, sponges, knife blades, Bovie tip and suture needles _____d. (2) Arranges instruments on the mayo stand.

_____e. (3) Loads blades on knife handle using needle holder; prepares sutures in order of use; _____f. (2) Properly prepares two sponge sticks

_____g. (5) Properly labels solutions/medications on the sterile field

_____h. (5) Prepares and labels syringe. Recaps needle using one handed scoop method _____i. (3) Gowns and gloves the surgeon as soon as he/she enters the room

_____j. (3) Drapes in correct order or use; assists in draping the patient

_____k. (4) Positions mayo stand over patient; assists in attaching the suction/Bovie to drapes; places two rayteks on field.

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INTRA-OPERATIVE ROUTINE: (max points 25) Total: ______ _____a. (5) Passes knife in safe and functional manner.

_____b (2) Passes instruments in a decisive manner, keeping field clear of unused instruments by returning them to the mayo after use

_____c. (2) Properly passes irrigation _____d. (5) Properly loads and passes suture

_____e. (5) Properly passes syringe to surgeon, stating the type and strength of the medication. _____f. (3) Initiates sponge, needle, instrument counts. Counts from surgical field, mayo, back table _____g. (3) Properly labels and passes off specimen to circulator following sterile technique.

POST-OPERATIVE ROUTINE: (max points 5) Total: ______

_____a. (3) Has clean, saline moistened sponge ready to wash the incision site; Appropriate dressing are prepared

_____b. (2) Undrapes patient observing Universal Precautions. Proceeds with sterile field breakdown. Notes/Observations: ____________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Student Signature: ______________________________________________ Date:__________________ Instructor Signature: ______________________________________________ Date:_________________

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FINAL EVALUATION

Name:______________________________________________________Date:________________ Clinical Instructor:____________________Procedure:________________________Score:_________

O.R. ATTIRE: (maximum points 5) Total: _______

_____a. (3) Hair cover and mask on properly; protective eye-wear on. _____b. (2) Fingernails short, no polish and no jewelry.

GATHERING/OPENING OF STERILE SUPPLIES: (max points 15) Total: _______ _____a. (5) Performs basic hand wash; gathers and checks supplies according to surgeons preference card. _____b. (5) Lays appropriate packs on furniture; opens basic pack, instrument tray, gown (on mayo) and basin

set so the inside wrapper becomes a sterile field.

_____c. (5) Opens other sterile items (rayteks, towels, laps, gowns, gloves, suction, etc.) following aseptic technique.

SCRUBBING/GOWNING/GLOVING (max points 15) Total: ______

_____a. (5) Performs a proper surgical scrub. _____b. (5) Dons gown properly.

_____c. (5) Dons gloves properly.

STERILE FIELD SET-UP: (max points 35) Total: ______

_____a. (2) Drapes the mayo stand with sterile mayo cover; layers the top of the mayo with at least one towel _____b. (3) Prepares and organizes the back table (minimal movement)

_____c. (3) Counts instruments, sponges, knife blades, Bovie tip and suture needles _____d. (2) Arranges instruments on the mayo stand.

_____e. (3) Loads blades on knife handle using needle holder; prepares sutures in order of use; _____f. (2) Properly prepares two sponge sticks

_____g. (5) Properly labels solutions/medications on the sterile field

_____h. (5) Prepares and labels syringe. Recaps needle using one handed scoop method _____i. (3) Gowns and gloves the surgeon as soon as he/she enters the room

_____j. (3) Drapes in correct order or use; assists in draping the patient

_____k. (4) Positions mayo stand over patient; assists in attaching the suction/Bovie to drapes; places two rayteks on field.

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_____a. (5) Passes knife in safe and functional manner.

_____b (2) Passes instruments in a decisive manner, keeping field clear of unused instruments by returning them to the mayo after use

_____c. (2) Properly passes irrigation _____d. (5) Properly loads and passes suture

_____e. (5) Properly passes syringe to surgeon, stating the type and strength of the medication. _____f. (3) Initiates sponge, needle, instrument counts. Counts from surgical field, mayo, back table _____g. (3) Properly labels and passes off specimen to circulator following sterile technique.

POST-OPERATIVE ROUTINE: (max points 5) Total: ______

_____a. (3) Has clean, saline moistened sponge ready to wash the incision site; Appropriate dressing are prepared

_____b. (2) Undrapes patient observing Universal Precautions. Proceeds with sterile field breakdown. Notes/Observations: ____________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Student Signature: ______________________________________________ Date:__________________ Instructor Signature: ____________________________________________ Date:_________________

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EXTERNSHIP/CLINICAL TIMESHEET

Program:  Surgical Technology  Anesthesia Technology

Student name: ______________________ Clinical Site: ______________________________ Phone: ____________________________ Clinical Supervisor: ________________________ Alternate Phone: ____________________ Phone: ___________________________________ Week Ending: ______________________ Course Code: ______________________________

Day Date Time In Lunch

Out

Lunch In

Time

Out Total General Duties Performed

Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total Hours __________________________________________ ____________________

Student Signature Date

__________________________________________ ____________________ Clinical Site Supervisor Signature Date

Time Checked for Accuracy and Recorded by:

__________________________________________ ____________________

Signature Date

General Instructions

1. For Shifts greater than 6 hrs, you must take a 30 minute meal break. Credit will not be given for more than 10 hours per day or 40 hours per week.

2. For each day of attendance, please include a brief description of duties performed. 3. Timesheet must be signed and dated by both the student and clinical site supervisor 4. Fax Timesheet each Friday to before 4pm.

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WEEKLY EXTERNSHIP EVALUATION FORM

SCORE = ________ = ____ %

Name: _______________________________________________Date: ___________________ Hospital: ______________________________ Preceptor: __________________________

POINTS EVALUATION PERFORMANCE - For the level of training indicated

3 Satisfactory Consistently meets or exceeds all expectations; demonstrates desired behaviors independently

2 Needs Reinforcement Generally meets most expectations; demonstrates desired behaviors with prompting required regularly

1 Unsatisfactory Inconsistent performance often not meeting expectations: rarely demonstrates desired behaviors without prompting or direction

AREA OF EVALUATION 3 2 1 COMMENTS

Willingness to learn:

Open to critique and uses it constructively Willingly follows direction and regulations Willingness to Help:

Shows initiative in identification of tasks other than those assigned, and follows through on those tasks

Cooperative and willing worker Dependability:

Attendance/Punctuality

Displays motivation, interest and personal responsibility Organizational ability

Rapport with the staff and Surgical team Participated as a team member

Attendance: # Days Absent __________ # Days Tardy __________ Please indicate strong or weak points of this student’s performance:

_____________________________________________________________________________________________ _____________________________________________________________________________________________ Evaluator’s Signature: _________________________________________ Date: ___________

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STUDENT EVALUATION OF CLINICAL SITE

Student’s Name____________________________ Date________________________ Clinical Site____________________________________________________________ Please rate the following statements according to this scale:

5=Strongly Agree 4=Agree 3=Somewhat Agree 2=Disagree 1=Strongly Disagree

1. The clinical site provided me with an adequate orientation to the facility 5 4 3 2 1 2. Clinical preceptors were knowledgeable and skilled at instructing in the clinical area 5 4 3 2 1 3. The surgeons at the clinical site offered assistance and guidance when needed 5 4 3 2 1 4. The staff/preceptor at the clinical site provided clinical evaluations in accordance to program

policy 5 4 3 2 1

5. I was treated with respect during my clinical rotation 5 4 3 2 1

6. The staff/preceptor at the clinical facility created a non-threatening environment 5 4 3 2 1 6. Program policies and procedures were enforced and clearly communicated to staff 5 4 3 2 1 7. I was assigned to surgical procedures/specialties appropriate for my learning needs 5 4 3 2 1 8. I received consistent, constructive feedback pertaining to my clinical performance 5 4 3 2 1

9. What were the strengths of the clinical site and staff/preceptors?

_____________________________________________________________________________________ _____________________________________________________________________________________ 10. Were there any areas of the clinical site that could be improved?

_____________________________________________________________________________________ _____________________________________________________________________________________ 11. What did you like best about your experiences at the clinical site?

_____________________________________________________________________________________ _____________________________________________________________________________________ 12. What did you like least about your experiences at the clinical site?

_____________________________________________________________________________________ _____________________________________________________________________________________