Surgical Scrub Tech Population and Age Specific Competencies (3/2011 jyc) Name: Completion Year: Directions: Upon completing the selected skill for the selected age group, the evaluator will place their initials, date, and method used to evaluate in the space provided. This will signify all aspect of care have been demonstrated correctly for the corresponding age group. The full signature and title are required of the evaluator. All sections must be addressed, use N/A to indicate not applicable. Method Codes: O=Observation of care provided, W=Written exam (must be used in conjunction with an observation of care provided to establish competency), S=Skills Lab (simulation), N/A = Not Applicable results in non-competence. All competency checklists will be forwarded to Human Resources and filed in the colleague s record. 2011 Surgical Scrub Tech Competencies Page 1 of 8
Cultural Diversity Demonstrates cultural specific interventions while assessing, planning and evaluating patient care.see Cultural Diversity Table located on the intranet, education department page Medical Record Number (For cultural diversity use only) Aspect of Care Pediatrics Adult Geriatrics Code Blue Management X Retrieves crash cart when requested. X Initiates BLS (CPR) as indicated X Call 1999 as indicated X Act as a runner for needed supplies. X Ensures patient privacy is maintained X Controls visitor traffic X Answers other patient call lights as needed Latex Allergy X Demonstrates care for the patient with latex allergy X Demonstrates assessment skills to identify latex allergy/sensitive skin X Demonstrates process of notifying surgical staff of patient s latex allergy X Identifies latex versus non latex supplies and equipment. Malignant Hyperthermia X Demonstrates knowledge of the care of the patient with Malignant Hyperthermia X Describes pathophysiology and identifies early signs and symptoms, X Identifies medications to treat condition X Identifies non-pharmaceutical interventions required to treat condition X Identifies location of MH cart. Indicate TRUE (T) or FALSE (F) for each below: Malignant Hyperthermia is an uncontrolled increase in skeletal muscle metabolism where a patient s body temperature raises to potentially lethal levels as a result of certain anesthesia agents. You will need to obtain 36 vials of Dantrolene during a Malignant Hyperthermia crisis. A bottle of Dantrolene requires 60 ml non-bateriostatic sterile water for reconstitution. 2011 Surgical Scrub Tech Competencies Page 2 of 8
Fire Safety X Demonstrates knowledge of fire safety X Identify risk factors and high risk procedures or equipment X Identify location of fire extinguishers X Identify fire evacuation route for surgical services. Indicate TRUE (T) or FALSE (F) for each below: Head and neck procedures present a higher risk for fire. Allowing prep solutions to dry helps diminish fire potential. It is the responsibility of everyone to be familiar with use location and proper use of fire extinguishers and the location of pull stations. Patient Care / Safety Demonstrates universal protocol requirements. Verbalizes possible risk factors which may X interfere with universal protocol. Identifies and evaluates the fall risk potential of surgical patients prior to transport. Ensures side X rails on transport devices are locked during transfers for safety. Demonstrates universal precaution standards of infection control in the care of patients. Demonstrates proper hand hygiene prior to and after patient contact. Demonstrates ability to apply gloves in a sterile fashion. Recognizes when sterile gloves are contaminated. Provides X continuous surveillance of operating room environment to ensure adherence to aseptic technique. Assist with moving and positioning of patients. Demonstrates proper use of body mechanics for self and patient. Assists with surgical preps and draping under the guidance of the circulating X nurse. Assures patient privacy, safety and warmth during transfer and transport. X Obtains assistance with set up and re-connection by a nurse to ensure proper oxygen delivery. Identifies isolation rooms and follows precautions as designated/posted. Communicates isolation X precautions to nurse in holding area upon arrival. X Maintains HIPAA and patient confidentiality at all times. X Demonstrates use of 2 patient identifiers at all times prior to transport. Demonstrates knowledge of anesthesia awareness by verbalizing the definition, contributing factors and at risk patient populations, strategies to reduce risk and management if awareness X occurs. X Demonstrates ability to trouble shoot and correct equipment problems. X Demonstrates ability to effectively respond in emergent situations. Ensures all electrical cables/cords are intact and takes actions to remove faulty cords/cables from X service. Ensures all instrumentation is in working order and marked if broken. Maintains order and safety in surgical hallways, storage areas, and patient care areas. Complies X with OR traffic control parameters. 2011 Surgical Scrub Tech Competencies Page 3 of 8
Communication and Team Building Demonstrates the ability to communicate with others any information necessary to ensure a safe patient care and work environment. Including patient issues to the RN when transporting to a new X unit. Demonstrates a positive attitude and role model for new staff members. Assists team members with X completion of tasks and improvement of turnover times. Assists in all peri-operative departments as needed. Including Endoscopy, Special Care, PACU, X and Nursing Units. Introduces self to patients and informs patient and family of purpose of transport to surgery, X endoscopy, etc. Maintains professional behavior during all contact with patients and family members as well as X peers and co-workers. X Assists family members to the surgical waiting room. Resolves conflicts in a mature manner in compliance with RMCBP policies and procedures. Seeks X assistance as needed from charge nurse or Director. General Surgery Procedures X Sets up and passes instruments for abdominal procedures, both open and laparoscopic. X Properly utilizes instrumentation, stapling devices, and retractors. X Verbalizes understanding of grafting materials: tissue vs. synthetic and the related responsibilities. X Demonstrates use of the nims, harmonic scalpel, neoprobe, and ligasure equipment. X Ability to understand clean and contaminated instruments / gloves during bowel procedures. X Demonstrates ability to prepare and care for laparoscopic lenses, insufflators, light cables, instrumentation, and trocars. Vascular Surgery Procedures (includes pacemaker, AICD, bypass and percutaneous, and aneurism) X Prepares and sets up for vascular procedures. X Demonstrates knowledge of vascular instrumentation, stapling, devices, clips, inserts, and vascular loops. X Verbalizes understanding of grafting, dilating, stenting, and power injecting. X Demonstrates placement of R2 pad and set up of defibrillator. X Verbalizes understanding of the implant / stenting carts and vascular cart. Orthopedic Procedures X Sets up and passes instruments for orthopedic procedures, both open and arthroscopic X Verbalizes understanding of fracture reduction procedures, i.e.; rodding, plating, and pinning X Prepares for Total Joint replacement procedure. X Operates powered drills, saws, and screwdrivers X Verbalizes understanding of the operation / function of the tourniquet, irrigators, and implant carts. X Verbalizes understanding of arthroscopic lenses, pumps, light cables, instrumentation, and trocars. X Demonstrates safe positioning of the patient on the fracture table. 2011 Surgical Scrub Tech Competencies Page 4 of 8
Neurological Procedures X Sets up instrumentation for neurological procedures X Verbalizes understanding of neuro instrumentation including drills and microscopes. X Verbalizes understanding of related irrigations, medications, hemostatic agents, implants (both hardware and bone grafts). X Verbalizes understanding of neuromonitoring and techniques used by neuro technicians as well as the stealth navigation system and assists with equipment set up. Thoracic Procedures X Sets up and passes instruments for thoracic procedures, both open and thorascopic. X Verbalizes knowledge of thoracic instrumentation and use of stapling devices, specialized retractors, saws, and wound closure devices. X Verbalizes knowledge of thoracic endoscopic lenses, light cables, and instrumentation. Urology Procedures X Sets up and passes instruments for closed urology procedures, cystoscopy, ureteroscopy, stone manipulation / extraction, dilatation, retrograde pyelogram, TUR resection, and prostate / bladder tumor. X Sets up and passes instruments for open urology procedures: nephrectomy, prostatectomy, and laparoscopic assisted nephrectomy. ENT / EYE Procedures X Sets up and passes instrumentation for eye procedures. X Demonstrates ability to operate and drape both Eye and ENT microscopes. X Sets up and passes instrumentation for ENT procedures including endoscopic. Plastics Procedures X Sets up and passes instrumentation for plastics procedures: Reduction mammoplasty, augmentation, reconstruction, wound flap repairs, skin grafting, and application wound care devices. X Demonstrates ability to use dermatome, mesher, and wound vac. 2011 Surgical Scrub Tech Competencies Page 5 of 8
Sterilization X Demonstrates ability to properly use gravity / steam sterilization. X Demonstrates ability to properly use steris. X Verbalizes and demonstrates guidelines for tracking and documentation of all sterilized items. X Demonstrates efforts to prevent unnecessary flashing of instruments. Indicate TRUE (T) or FALSE (F) for each below: Flash sterilization is an approved method to follow to reduce hospital costs. An indicator / integrator has not changed color to reach the Accept level. The time is still safe to use because the steam sterilizer or Steris System 1 ran the correct cycle for the correct time. Electrosurgical Safety X Demonstrates ability in safe use and operation of the electrosurgical units (ESU): X Verbalizes the definition of mono-polar and bipolar. Verbalizes knowledge of the dispersive electrode (grounding pad) placement site and its proper X use. X Demonstrates knowledge regarding safety with the ESU. X Demonstrates ability to correctly hook up the ESU to the patient. X Demonstrates ability to correctly adjust settings of the ESU (Cut, coag, blend). X Manages and controls smoke plume. Verbalizes understanding of electrosurgical safety regarding head and neck surgeries for fire X prevention. Specimens Demonstrates ability to handle specimens according to procedure: - Verifies name and location of tissue with MD - Routine pathology specimens - Frozen section - Cultures X - Identifies forensic cases and handles specimens accordingly per policy Medication Responsibilities X Verbalizes and demonstrates proper handling and marking of medication on the OR field. X Assures medications are marked appropriately while on field. X Verifies medication with RN circulator regarding medications added to surgical field. Checks bottle / bag with RN circulator for proper medication name, concentration, and expiration X date. 2011 Surgical Scrub Tech Competencies Page 6 of 8
Universal Protocol X Verbalizes the definition of Universal Protocol. Verbalizes risk factors that may interfere with Universal Protocol and action plan if Universal X Protocol is not followed. Verbalizes who participates in the Universal Protocol, the method followed and completes X appropriate documentation. X Verbalizes the appropriate persons who may mark the procedure / surgical site. Demonstrates Universal Protocol with verification of: - Correct patient - Correct procedure - Correct surgical site - Availability of equipment and implants - Skin marking is visible after draping - Imaging studies present as indicated X - Antibiotic administration Indicate TRUE (T) or FALSE (F) for each below: Universal Protocol is the procedure used by staff to assure correct person, procedure, and procedure site for invasive procedures. The MD initials designating the appropriate incision site must be visible after draping. The Universal Protocol Time Out is performed in the OR or Endoscopy Room immediately prior to the surgery or procedure. Aspect of Care Pediatrics Adult Geriatrics Wound Classification Verbalizes and identifies CDC wound classifications: - Class I Clean - Class II Clean-contaminated - Class III Contaminated X - Class IV Dirty X Verbalizes changes in classification of the surgical field to the RN circulator. KNOWLEDGE TEST - Indicate TRUE (T) or FALSE (F) for each below: Correct wound classification is an integral part of determining hospital acquired infection. It is a collaborative effort of the Surgical Team to assure correct wound classification. 2011 Surgical Scrub Tech Competencies Page 7 of 8
End of Case Process Demonstrates correct procedures for sponge, needle, and instrument counts: - Identifies high risk groups for potential incorrect counts (emergencies and obese patients) X - Inspects drapes for instruments, sharps, needles, or sponges X Notifies surgical team of any incorrect count and performs a recount when asked or is necessary Demonstrates ability to process: - Routine pathology specimens - Frozen specimens - Cultures - Other tissue specimens X - Forensic evidence / specimens X Notifies supervisor, follows chain of custody procedure and documentation requirements X Prepares dressings as needed appropriate to case. Separates linen and trash into appropriate containers, labels broken equipment or dull instruments X for repair, and actively participates in room turnover. X Ensure back table remains sterile until the patient has completely left the room. The above competency checklist identifies the age population for which the Surgical Scrub Tech completed the aspect of care and the method used to validate competency. Completion of the above checklist validates the Surgical Scrub Tech is competent to provide care for patients in the validated aspects of care. INITIALS SIGNATURE AND TITLE 2011 Surgical Scrub Tech Competencies Page 8 of 8