SURG 202 - Perioperative Case Management
Credits: 4
Lab Contact Hours: 8
Description: This course teaches the student how to further apply the principles of asepsis and application for sterile technique in the perioperative lab setting. Through weekly simulation exercises, students will explore equipment use, preparing for a surgical procedure, intraoperative case duties and patient safety concepts. Full mock procedures will demonstrate steps of various surgical specialties to understand case organization and anticipation. Students should be prepared for a full hands-on experience that requires lab safety practices and successful completion of all course skill competencies. Students must pass the course and skills competencies successfully with a 3.0 or better to continue in the program.
Prerequisites: BIOL 237 with a minimum grade of 3.0. BIOL 238 with a minimum grade of 3.0. SURG 101 with a minimum grade of 3.0. SURG 102 with a minimum grade of 3.0.
Corequisites: SURG 201 , if not previously taken, with a minimum grade of 3.0. SURG 210 , if not previously taken, with a minimum grade of 3.0. SURG 220 , if not previously taken, with a minimum grade of 3.0.
Recommended: None
Course Category: Occupational
This Course is Typically Offered: Winter
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Course Competencies
Main Learning Domains: Cognitive, Affective, Psychomotor
1. Evaluate standard operating room equipment and supplies necessary for each surgical procedure.
a. Demonstrate a room check for equipment prior to a surgical case.
b. Demonstrate a damp dust prior to first case of the day.
c. Demonstrate room turnover.
d. Examine steps necessary for a terminal cleaning.
e. Demonstrate pulling supplies for surgical procedures.
f. Demonstrate an understanding of surgeon preference cards.
2. Examine the order in which surgical supplies are opened for each surgical procedure.
a. Demonstrate equipment organization in an operating room.
b. Verify the integrity of all packages to be opened.
c. Demonstrate the creation of the sterile field by opening sterile supplies.
i. Back table
ii. Basin
iii. Instruments iv. Supplies
3. Evaluate each type of surgical scrub and manufacturer guidelines for use.
a. Demonstrate each type of surgical scrub and when they may be used.
b. Examine the different solutions available and how they are applied.
4. Examine the types of PPE.
a. Demonstrate when different types of PPE are required and in which procedures or areas.
i. Hair coverings
ii. Scrub attire
iii. Shoe covers
iv. Warm up jackets
v. Masks: procedural, surgical, laser, N95
vi. Eye protection
vii. Gowns: surgical, hazard, reinforced
viii. Gloves
5. Demonstrate entry into the sterile role.
a. Don a surgical gown.
b. Demonstrate hand drying.
c. Demonstrate the closed glove technique.
d. Gown and glove another.
e. Consider movement around and within the sterile field.
6. Organize the back table for a mock surgical procedure.
a. Drape a mayo stand.
b. Organize supplies and instruments in an efficient timeframe.
c. Perform a surgical count in the correct order.
d. Receive and label medications onto the field.
e. Load blade(s) and suture for either a right or left-handed surgeon.
7. Perform surgical draping of a patient.
a. Gather drapes needed for each type of surgical procedure.
b. Organize drapes in order of use.
c. Drape the surgical patient.
8. Demonstrate the tasks necessary to start a surgical procedure.
a. Secure and hand off cords and tubing.
b. Establish a neutral zone.
c. Prepare sponges for a case start.
d. Perform a surgical pause, ‘Timeout.’
9. Demonstrate intraoperative case management during a mock surgical procedure in the first scrub role.
a. Organize supplies and instruments during each phase of the procedure.
b. Pass all requested items to the surgical team.
c. Anticipate the needs of the surgeon while preparing supplies according to the steps of the procedure.
d. Recognize patterns for supply and instrument requests.
e. Demonstrate an example of point of use cleaning.
f. Request any additional necessary items from circulator.
g. Monitor the field for breaks in sterile technique.
h. Correct any breaks in sterile technique.
i. Establish a clean/dirty scenario.
j. Monitor all solution and medication amounts used in the field.
k. Keep track of blood/fluid loss and report.
l. Track all supplies that enter cavities and sponges on the field.
10. Demonstrate intraoperative case management during a mock surgical procedure in the second scrub role.
a. Prepare to retract tissue.
b. Cut the suture.
c. Hold additional instrumentation (clamps, scopes, retractors).
d. Assist with hemostasis.
11. Demonstrate knowledge of hemostasis by preparing hemostatic options on the field.
a. Examine each type of hemostatic option and surgeon preference.
i. Mechanical
ii. Chemical
iii. Thermal
b. Demonstrate suture knowledge by choosing the appropriate suture for each type of tissue.
i. Demonstrate knowledge of suture materials and when each may be used.
ii. Demonstrate knowledge of needle types and when they are used.
iii. Evaluate each patient for healing factors when choosing a suture or wound closure.
c. Determine wound classification for each surgical procedure.
i. Evaluate each type of wound classification.
1. Clean
2. Clean contaminated
3. Contaminated
4. Dirty
12. Demonstrate knowledge of a case conversion.
a. Preserve hold items on the case cart in the event of a high-risk patient.
b. Use critical thinking to request supplies into the field for a case to go ‘open.’
13. Demonstrate postoperative case management during a mock surgical procedure.
a. Complete closing counts.
b. Prepare supplies to remove blood/prep from the patient.
14. Prepare sterile dressings for the patient.
a. Demonstrate when to inquire and prep for surgical dressing application.
b. Apply surgical dressings to a wound.
c. Cover the new dressing until drapes are removed.
15. Demonstrate drape removal and securing the sterile field.
a. Preserve all sterile supplies and instruments until the patient is secure and awake.
b. Remove all cords and light handles.
c. Doff surgical gown and gloves.
d. Wash hands or use sanitizer.
16. Demonstrate how to assist with moving a patient to a stretcher.
a. Secure all tubes or IVs going with a patient to PACU.
17. Break down the sterile field.
a. Don non-sterile gloves.
b. Dispose of all sharps from the field.
c. Place all instruments back into pans.
d. Utilize the policy for preparing items for decontamination.
i. Soaking
ii. Organizing trays
iii. Enzymatic spray
e. Separate any recycle items.
f. Demonstrate safe disposal of sanguineous fluids and materials.
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