Midlands Technical College INTRODUCTION TO SURGICAL PRACTICUM - SUR 110

Health Science Department Semester: Spring

Catalog Course Description: This course is an introduction to the application of surgical technique by assisting in the perioperative roles in various clinical affiliations. Prerequisite(s): SUR 101, SUR 103 Co-requisite(s): SUR 102, SUR 110 Credit Hours: 5.0 Total Credits 0 Lec 5 Lab Departmental Website: http://www.midlandstech.edu/surgtech D2L Brightspace Login Page: https://elearn.midlandstech.edu Instructor: Kathy Patnaude/Stacey Hook Office: Ms. Patnaude HSB 213, Mrs. Hook HSB 217 Telephone: Ms. Patnaude 822-3438, Mrs. Hook 822-4993 FAX: (803) 822-3417 E-mail: patnaudek@midlandstech.edu - hooks@midlandstech.edu Campus Mailbox: HSB 212 Departmental Assistant: Mrs. Fran Smith (smithfm@midlandstech.edu) Office: HSB 211 (803) 822-3491 Program Coordinator: Kathy Patnaude patnaudek@midlandstech.edu 822-3438 Class Schedule: SUR 110 A01,A02, A03 – MWF 6:30-11:30AM Office Hours: Mrs. Hook Tuesday 11:30-3:30, Thursday 11:30-3:30 or by appointment Textbook(s): N/A Equipment: PPE – safety glasses, hat, mask and shoe covers Course Objectives: Upon completion of this course the student will be able to: 1. Perform preoperative case management in a timely and organized manner. 2. Organize information with a procedural/individual patient focus. 3. Perform case analysis based on data and knowledge. 4. Implement activities based on patient, procedural and surgeon knowledge.

5. Integrate information and knowledge for application to each patient situation. 6. Gather the instruments, supplies, and equipment needed for a surgical procedure. 7. Demonstrate the initial steps for starting a surgical procedure. 8. Position furniture and equipment to begin the surgical procedure. 9. Place and secure supplies on the sterile field. 10. Apply and maintain aseptic techniques in all applications. 11. Demonstrate proper scrub technique. 12. Employ the basic routines of case management by: a. Applying knowledge of basic surgical instrumentation to specific surgical procedures. b. Demonstrating the general principles of surgical site preparation. c. Demonstrating the principles and techniques of draping the patient, furniture and equipment. d. Employing the correct techniques, timing and methods of performing counts. e. Assessing specific variations of intraoperative techniques. f. Applying techniques for tissue exposure. g. Demonstrating the proper placement, handling, loading and disposal of surgical needles. h. Demonstrating proper assembly of stapling instrumentation. i. Demonstrating proper use and care of equipment. j. Demonstrating the proper handling and management of surgical specimens. k. Applying principles of sterile technique and demonstrating the application of commonly used types of surgical dressings. 13.Demonstrate basic wound care concepts and apply the principles of asepsis to the practice of sterile technique. 14. Perform postoperative case management duties in an organized and timely manner. 15. Apply standard precautions to the performance of postoperative case management activities. 16. Perform decontamination of the OR environment and equipment. 17. Demonstrate correct techniques for preparing supplies for sterilization 18. Demonstrate appropriate use of sterilization and disinfection methods. 19. Apply principles of sterile storage to handling of sterile supplies. 20. Demonstrate proper technique in storing, handling, and distributing sterile supplies. 21. Demonstrate awareness of improper handling and use of sterile supplies. 22. Apply the steps of problem solving to given situations.

23. Integrate professional behaviors into practice. 24. Demonstrate responsible and accountable behavior within the role and competencies of the surgical technologist. 25. Produce a complete Clinical Procedure Journal. 26. Complete daily procedure log sheets accurately validating clinical case requirements. Program and course assessment activities are deployed and results collected in accordance with the College’s assessment schedule. Please refer to the information in the syllabus regarding the applicability of the assessment activity for the current semester. Course Outcomes and Competencies: Intended Course Outcome: Upon completion of this course, the student will possess the perioperative clinical skills to be able to successfully scrub in the operating room complete with critical thinking skills applicable to patient safety, hospital protocols, aseptic technique, and surgical case management. Thus, they will be able to function as an advanced- level surgical technology student. Course Competency: The students will obtain clinical coordinator, clinical instructor and preceptor evaluations. In addition, the student will maintain detailed daily procedure log sheets and a clinical procedure journal. Measurement Instrument and Success Criteria: 90% of the surgical technology students will pass the clinical portion of this course. Instructor midterm and final evaluations, daily employee evaluations, journals and daily procedure logs are part of the grading system. Course Attendance: See Clinical Attendance Policy Clinical Attendance Policy: SUR 110 meets Monday, Wednesday & Friday from 6:30-11:30 a.m. The department will allow no absences from the clinical portion of this program. If for some dire emergency you are unable to attend a clinical, it is your responsibility to contact your respective Clinical Instructor. You must contact your Clinical Instructor and Mrs. Hook by 6:30 A.M. Failure to contact your instructor will result in a warning slip for the first offense and departmental probation for the second offense. Any missed clinical must also be cleared with the Program Director or Clinical Coordinator that day. Before returning to the clinical setting you must have the permission of the Program Director or Clinical Coordinator. TWO (2) tardies make up an absence and will be treated as such. If for any reason ( i.e., illness, infraction of rules) a clinical instructor dismisses you from the clinical site before the end of scheduled class time all missed time is counted as an absence and must be made up. Any clinical absence prior to March must be made up during Spring Break or you will not be allowed to continue on with the remainder of the semester. Any clinical absence after March, must be made-up during the week of April. The student must make up the required clinical day at a time that is convenient for the Clinical Instructor, with a limit of two makeups. Withdrawal: Should the maximum allowable absences be exceeded prior to midterm, a "W" will be submitted to the registrar to be recorded on the student's transcript. Should the maximum allowable absences be exceeded after midterm, a "W" will be submitted to the registrar if the student was passing the course at the time of withdrawal OR a "WF" will be submitted if the student was failing the course at the time of withdrawal.

No Shows: If you register for a course and decide not to attend for any reason, you must complete a drop form and process it through the student Records Office. You will not be automatically purged for non-attendance. If you do not submit a drop form, you will be responsible for course tuition and fees. By not officially dropping the course, you will incur a bill with the college that can only be addressed through the College’s Finance Office. The college’s refund policy and dates are posted each semester. Effective Spring 2015, the Student Ombudsman’s office will no longer be the initial point of contact for requesting No Shows to be processed. Students who incur a bill must contact the Finance Office. Administrative Drop Requests: A student requesting an Administrative Drop resulting from medical event, death of family member, and other extenuating circumstances experienced while enrolled at Midlands Technical College should be directed to the Student Ombudsman’s office. Our policy dictates a request must be made no later than 30 days after the affected term. Supporting documentation is required and must be received before the request can be processed. Once the request form is received along with supporting documentation, it takes approximately three weeks for processing. As a result of an approved Administrative Drop Request, the student may be granted a refund of tuition and fees.

Military Withdrawal: According to College Procedure 3.10.1, students having to withdraw from college because of Military Deployment (active duty personnel) while enrolled must complete a withdrawal form and submit to the Records Office along with a copy of military orders. Disabilities Statement: The staff of Counseling and Career Services works to ensure that all educational programming and services are accessible to otherwise qualified students with disabilities. If you have a concern regarding the accessibility of websites, instructional materials, online courses and other electronic or information technology please contact Counseling and Career Services. It is the student's responsibility to self-disclose as a student with a disability and to request accommodations prior to beginning a program or course. Please contact the staff of Counseling and Career Services at 803-822-3505 (AC) or 803-738-7636 (BC) or via email at disability@midlandstech.edu if you have any questions or concerns. D2L Brightspace Help:

Online Learning Support Help Desk: Technical questions related to the operation and use of D2L Brightspace can be answered from our Support Help Desk. A response will be provided within one business day. To login: use your MTC e-mail account username and password. (Student Username Example: georgeasmith) (Faculty Username Example: smithg) D2L Brightspace Assistance: Technical questions related to the operation and use of D2L Brightspace can also be answered by leaving a voicemail at (803) 822-3561, or emailing D2LHelp@midlandstech.edu. A response will be provided within one business day. MyMTC Help: For MyMTC log-in issues please call 803-738-7888.

Academic Dishonesty: For more information about academic dishonesty, see the Academic Affairs Student Guidelines and Expectations attached.

If you are suspected of cheating, your instructor will inform you. You may explain or refute the allegation. If your instructor still thinks the charges are founded, you will be referred to the Office of the AVP, SDS. Documentation is submitted to the Office of the AVP, SDS, by the instructor. You will then meet with either Dr. Holloway or Mr. Hayden. After the meeting, you will receive a letter with the sanction grade of zero (0) and any other sanctions deemed appropriate. You have the right to file an appeal. Once the hearing and the notice of the right to appeal have been completed, the instructor will be notified to apply the sanction grade of zero (0). Course Requirements: All students must successfully complete a total of 120 clinical cases. Students are required to complete 30 cases in General Surgery. Twenty of the cases must be in the First Scrub Role. In addition, students are required to complete 90 cases in various surgical specialties. Sixty of the cases must be in the First Scrub Role and evenly distributed between a minimum of 5 surgical specialties. However, 15 is the maximum number of cases that can be counted in any one surgical specialty. Observation cases must be documented, but do not count towards the 120 required cases. Performance evaluations by your Clinical Instructors, Program Director, Clinical Coordinator and Perioperative team members help establish your grade for this course. These will be Daily, Mid Term and Final (See Attachments). You must perform a self evaluation within the first four weeks and then at the end of the evaluation period. This will help you to see strengths and weakness in areas necessary for a successful clinical experience. You will be evaluated in the following areas: Attendance, Professional Appearance, Cooperation and Attitude, Professional Ethics, Initiative, Quantity of Work, Quality of Performance, Dependability, Judgment, Care & Use of Equipment, Manual Dexterity, Learning Rate and Adaptability. Your clinical instructor will keep you up to date on your clinical performance throughout the semester. If any questions or concerns arise the Clinical Instructor, Program Director, or Clinical Coordinator will address the question/concern with you. You may also be required to access the internet, MyMTC e-mail account or D2L for additional information and resources. FAMILIARITY WITH D2L: This course could possibly utilize resources that are housed in the D2L online platform. Therefore it is the student's responsibility to become proficient in navigating this site and accessing the resources. The college has a student support site for online resources, http://www.midlandstech.edu/onlinelearning/StudentSupport/ which students are encourage to access. Technical questions related to the operation and use of D2L, should be submitted using the online support form at http://www.midlandstech.edu/lce/students/D2L form.htm. STUDENT E-MAIL ACCOUNTS: All Midlands Technical College students are assigned an e-mail account upon admission to the college. This student e-mail account is the official form of notification regarding important college information such as registration notices, course cancellations, financial aid transactions, academic probation/suspension notices, communications from faculty and other important information. Students are responsible for checking their college e-mail on a daily basis and for maintaining the account. It is the responsibility of each student opting to have their e-mail forwarded to an external account to verify this process is set up correctly to ensure all college e-mails are sent to the external account designated by the student. Students who do not have a personal computer or internet access at home may use computers in the Online Services Centers or Academic Success Centers. Course Grading: The final grade for this course will be determined as follows: 70% Clinical Instructor Midterm and Final Evaluations 15% Daily Procedure Logs - Accuracy, Neatness, Completion (1-3 Point deduction per error of omission/commission) Daily Evaluations 8/before midterm & 8/after midterm (minimum of 16) 15% Clinical Journal

Accuracy, Neatness/Legibility, Meets objectives Completion (See attached Journal Grade form) The student must submit all components to receive a passing grade. The student must achieve a final grade of “C” or higher to pass this course. A student may make only two (2) attempts at passing this course before they will be dropped from the program. You must successfully complete SUR 102, SUR 104 & SUR 110 to go to SUR 113 and SUR 120. Grading Scale: The Surgical Technology Program has a uniform grading system as follows: A = 93-100 B = 85-92 C = 75 -84 F = Below 75 W = Withdrawal WF = Withdrawal after midterm with failing grade on the last day attended

Surgical Technology majors must earn a "C" or higher in this course in order to count towards graduation.

Classroom Rules/Other:

DRESS CODE: The dress code remains as stated in the student handbook. Navy blue scrubs, MTC name pin, dosimetry badge, hospital

ID badge (as required), black ink pin, small pocket notebook and appropriate shoes will be worn to all clinical settings. Protective eyewear must be worn in the clinical settings. It is the student’s responsibility to bring their personal protective eye wear to the clinical setting.

CLINICAL ROTATIONS: Students are assigned to a major clinical site for the semester by the Program Director and Clinical Coordinator. All assignments are subject to change. It is the student’s responsibility to arrange for their transportation to and from all clinical sites. Each student is required to abide by all clinical and hospital policies and procedures. All clinical rules as stated in the Surgical Technology Handbook apply to each clinical site. The student must be dressed and ready to report to the clinical instructor according to the times listed in the syllabus.

CLINICAL DOCUMENTATION: Daily Evaluations: Perioperative team members are asked to complete a Daily Performance Evaluation on the

student. These evaluations serve as documentation for the Clinical Instructor about the student’s daily clinical performances. It is the responsibility of each student to ensure that the Clinical Instructor receives a minimum of sixteen (16) Daily Evaluations. (8/before midterm & 8/after midterm)

Clinical Log: The department requires that each student complete a daily clinical documentation record. This record provides a comprehensive list of procedures in which the student has participated and validation for clinical case requirements. They must be neat, accurate and honest. The log must be written in black ink and turned into Mrs. Hook EVERY Monday for the previous weeks’ cases. It is the responsibility of each student to

keep this log (attached) of all surgical procedures they participate in at the clinical site. The daily log is to include the date, procedure (legal accurate description to include site or side), team members (first initial, last name, title, i.e. ST or RN), student’s role and surgical specialty. It is the student’s responsibility to have the log initialed by their Clinical Instructor each Friday. The student needs to keep a copy but the Clinical Coordinator is to have the original log for the student’s file.

Clinical Journal: We require that you keep a detailed procedure journal. Clinical Journals may be checked regularly and without notice by the Clinical Instructor, Clinical Coordinator or Program Director. Failure to provide a journal within one day notice will result in the deduction of 5 points from the final clinical grade. The journal must be neat, accurate and cover every case in which the student has participated. Clinical journal documentation is the students’ own record of their clinical experiences. They must be accurate and honest. Each procedure must include: the surgeon’s name, specialty, & glove size; procedure; preoperative diagnosis; date; patient position with equipment; prep solutions and sites; the drape site, materials & method; custom packs, instrumentation, equipment, supplies, & dressings; sutures with layers; and special comments. Attached is a copy of the layout for the journal, along with an example. The student will submit the Journal to the Program Director/Clinical Coordinator for grading on April 25th, 2014. Late Journals will not be accepted. Failure to submit a journal will result in a grade of F. The Program Director will return these journals to you at the beginning of your next semester clinical rotation.

CLINICAL CONDUCT AND PREPARATION: Mastering surgical technology requires regular attendance, consistent study of text material and clinical notes. Students are expected to BE PREPARED, COMMUNICATE and PARTICIPATE in every surgical procedure you are assigned to.

You are in college. You will be treated and respected as an adult. Courteous, attentive behavior is expected at all times. Disruptive behavior in any form will not be tolerated. Students engaged in such behavior will be dismissed from the clinical site and subject to disciplinary procedures.

It is expected that all pagers, cellular telephones, and other electronic devices will be turned off at the clinical site. You may not receive or place telephone calls during clinical times.

GENERAL SAFETY REQUIREMENTS You are issued an Exposure Packet in the event you have a sharp injury or some other type of injury while at the clinical site. It is YOUR responsibility to have this packet with you while you are at the clinical site. You may keep it in the hospital locker that you will be issued. Points will be taken off of your final evaluation if you do not have this packet. Also note, you could be dismissed from the program due to excessive sharp safety issues and unsafe practices. You must immediately let your instructor know what has happened and follow the protocol that is on the packet. This means you must follow through by calling the appropriate phone numbers and doing the necessary blood work required. Also, call either Mrs. Hook or Ms. Patnaude so they are aware of the incident. Always remember sharp safety and follow standard precautions. If you misplace you packet, ask for a new one.

MTC STUDENT HANDBOOK: Students are expected to read the student handbook and abide by its policies. There are additional clinical policies in the handbook. Copies of the handbook may be obtained at various locations on campus.

MTC SURGICAL TECHNOLOGY STUDENT HANDBOOK: Students are expected to read the student handbook, abide by its policies, and refer back to it from time to time for clarification. Copies of the handbook are given to you at the Fall Orientation and the Program Director will always have extras if needed.

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EXAMPLE

SURGICAL TECHNOLOGIST STUDENT DAILY CLINICAL ROUTINE

ATTENDANCE REMINDER: Attendance at clinical experience is extremely important. Clinical absences should

not occur. If for some dire emergency you are unable to attend a clinical, it is your responsibility to contact

your respective Clinical Instructor and Clinical Coordinator. You must contact them by 6:30 A.M. Failure to do

so results in a warning slip for the first offense and departmental probation for the second offense. The only

excuse for not calling or sending a message is physical incapacitation. Please designate a "significant other" to

call for you in case of illness. Two tardies are an absence. You are to arrive no earlier than 6:15 A.M. Dress &

report to your clinical instructor to receive your assignment by 6:30 A.M.

6:40 A.M.

GUIDELINES FOR DAILY WORKDAY

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1. Check Scheduling Board for room assignment.

2. Note other personnel assigned and cases to be done.

3. Report to room assigned. Pull Surgeon's preference card.

4. Make sure pack and equipment on case carts is correct for procedure being done.

5. Always give your name to Circulator for documentation on the OR record.

6. Act as a team member in room preparation with other assigned room personnel.

7. If time allows, pull for following cases, especially if the same surgeon has more than one case. At least

pull packs, towels, light handles and instrument trays.

7:00 A.M.

If the first case is a 7:30 case and the patient is in the hospital, packs should be opened. It is the student’s

responsibility to take the correct measures to verify that the patient is in the hospital and that the case is

proceeding as scheduled before opening any supplies. The student should scrub and be in the room to begin

setting up the case by 7:00. Other personnel, if available, may finish opening while the student is scrubbing.

The student should always open their gown onto the Mayo and gloves onto the mayo stand before

scrubbing. If the case requires an extra gown for the student, they must pull it and open it before going to

the scrub sink.

The student should set up quickly and in an organized manner.

1. Organize back table and drape Mayo stand.

2. Receive instrument trays and organize them.

3. Perform sponge, sharp, and instrument counts.

4. Set up Mayo stand.

5. Complete Back table setup & case preparation

When the case is finished, instruments should be prepared and taken to the proper area for

decontamination. The student should sort and place paper trash and linen in proper containers. Repeat

above procedures for the next case.

When a substantial break occurs between cases, the student must tell other personnel in room as to their

whereabouts. If a long delay occurs between cases, the student must contact their Clinical Instructor or the

Charge Nurse for reassignment. Otherwise, if your assigned personnel have knowledge of your whereabouts,

you are to pull cases, work in instrument decontamination, wrap instruments and offer help to any rooms that

need assistance. Always check back with your room's personnel frequently for any changes in the schedule.

Students are expected to scrub in for every case for the day, unless a surgeon or staff member specifically asks

that you do not. If this should occur immediately contact the Clinical Instructor. You are not to drop out of a

case until relieved by someone or unless a co-member of the surgical team tells you to do so. Do not request

permission to leave a case unless you are going to become physically ill. Even if you feel that you are not

doing a duty during the case, remain sterile and use this time to observe the procedure and the team’s duties.

Attention to the procedure is vital to your education!

If your room has finished for the day, check with your instructor for next assignment. NO LEFTOVER SUPPLIES

FROM THAT DAY SHOULD BE LEFT IN ROOM. This means that part of your responsibility is to put these

supplies away in the correct location.

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Students are not to leave their assigned rooms without notifying the Circulator and/or scrub where

they are going. (Restrooms, supplies, etc.)

The hospital may give you an assigned number to put in the operative record with your name. Do not leave

room before signing count records if applicable.

No student scrubbed on a case should be sitting on a stool unless required by the physician to better help

them.

SURGICAL ATTIRE

1. All persons entering the restricted area will wear scrub clothes provided by hospital. No scrub

clothes are to leave the hospital.

2. Disposable caps will be worn. Students may wear white caps at certain hospitals for identification purposes. Cover and confine all head and facial hairs.

3. Disposable masks are to be worn in the required areas. They must cover the nose and mouth

completely and tie securely to prevent venting at the sides. Change masks between cases and they must not hang around your neck.

4. Wear disposable shoe covers and change them when they become soiled or wear through the bottom.

5. A clean, knee-length, white lab coat or cover coat may be required to be worn over OR attire

when leaving the surgical suite. They must be closed.

6. Hospital and college policy requires that students wear protective eyewear during procedures, cleaning instruments, or whenever activities could place one at risk for a splash to the face or eye.

7. Students will abide by the dress code and policies of the hospital to which the Program Director assigns them.

8. Always carry a black pen and a notebook.

9. No perfumes or scented lotions are to be worn in clinical areas.

10. Double glove (wear two pairs of gloves) when scrubbed on any surgical procedure.

11. Visible tattoos must be covered.

12. Refer to handbook in reference to jewelry in the operating room and nail length.

MTC SURGICAL TECHNOLOGY PROGRAM CLINICAL

CASE REQUIREMENTS

All students must successfully complete a total of 120 clinical cases. Students are required to complete 30 cases in

General Surgery. Twenty of the cases must be in the First Scrub Role. In addition, students are required to complete

90 cases in various surgical specialties. Sixty of the cases must be in the First Scrub Role and evenly

distributed between a minimum of 5 surgical specialties. However, 15 is the maximum number of cases

that can be counted in any one surgical specialty. Observation cases must be documented, but do not

count towards the 120 required cases.

CLINICAL CASE FIRST SCRUB ROLE

The student surgical technologist shall perform the following duties during any given surgical

procedure with proficiency. The following list is provided to identify the items that must be completed

in order to document a case in the first scrub role. A student not meeting the five criteria below

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cannot count the case in the first scrub role and the case must be documented in the second scrub

role.

• Verify supplies and equipment needed for the surgical procedure.

• Set up the sterile field with instruments, supplies, equipment, medication(s) and solutions

needed for the procedure.

• Perform counts with the circulator prior to the procedure and before the incisions is closed.

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

• Maintain sterile technique as measured by recognized breaks in technique and demonstrate

knowledge of how to correct with appropriate technique.

CLINICAL CASE SECOND SCRUB ROLE

The second scrub role is defined as the student who is at the sterile field who has not met all

criteria for the first scrub role, but actively participates in the surgical procedure in its entirety by

completing any of the following:

• Sponging

• Suctioning

• Cutting suture

• Holding retractors

• Manipulating endoscopic camera

OBSERVATION ROLE

The observation role is defined as the student who is in the operating room performing roles that do

not meet the criteria for the first or second scrub role. These observation cases are not to be included

in the required case count, but must be documented by the program.