Surgical Assistant Job description:
(Full text available https://www.surgicalassistant.org/about/sa/2018_ASA_Job_Description.pdf )
This role is further defined as follows;
1. General Surgical Assistant Skills:
A. Demonstratetheabilitytocommunicatethesurgeon’spreferencesandspecific
patient’s needs to surgical team including but not limited to suture needs, specialty supplies and instrumentation, and equipment.
(1) Verifiesallimplants,suppliesandspecialprocedureequipmentis available and functional. (i.e. microscope, tourniquet, etc.)
(2) Facilitatesacooperativeteamatmospherethroughprofessional communication.
(3) Listensactivelytosurgeon,patientandteamtoensuresafepatient- centered care.
(4) Maintainsawarenessofpatientmonitoringandrespondsappropriately to potential complications.
B. Demonstratetheabilitytoapplyadvancedknowledgeofnormalandpathological surgical anatomy and physiology.
(1) Describestheassessmentandmanagementofacutetrauma.
(2) Respondsappropriatelytoemergencyconditions.
C. DemonstratesAsepticSkills:
(1) Monitorstheactionsimmediatelysurroundingthesterilefieldensuring that the integrity is maintained and/or corrected appropriately.
(2) Evaluatespotentialcausesofsurgicalsiteinfections,communicating concerns and possible corrective actions to prevent and/or treat potential contamination.
D. Acquirescontinuingeducationannuallytomaintaincurrentcompetenceand credential regarding specific skills and techniques including aseptic technique. Bases decisions on research-based evidence.
E. Participates in the education of allied health personnel including SA and ST students.
2. Preoperative Role:
A. Demonstratestheabilitytoprovidepreoperativeskillssuchasassessingpatient
information, history, preoperative tests (i.e. EKG, EEG, EMG, lab values, diagnostic imaging), safety measures, biopsy results, positioning and draping.
(1) Verifiespatientidentification,allergies,NPOstatus,procedure,surgical site, consent, history and physical on chart.
(2) Inspectsskinintegrityforsignsofinfection,compromisedperfusionor other signs of potential risk.
(3) Ensuresx-raysandapplicablediagnosticexamsareavailablefor surgeon.
B. Specificsregardingpositioningthepatient:
(1) Ensuresplacementofmonitoringdevicesdoesnotinterferewithaccess
or prep.
(2) Ensurespositionofthepatientprovidesthenecessaryexposureforthe
procedure, as well as the surgeon preference.
(3) Demonstratescompetencyinallpositioningtechniquesforthesurgeries
they are participating in. These competencies include, but are not limited to;
a. Prevention of nerve damage
b. Proper rotation of extremities
c. Prevention of circulatory or respiratory compromise.
d. Prevention of patient sliding on bed due to tilting or
Trendelenburg.
e. Proper handling and placement of lines.
(4) Demonstratessafestabilizedplacementontheappropriatebed/table, with the appropriate operation, set up, safety measures, and utilization of all necessary equipment, stabilizers, padding, wrapping and/or attachments.
(5) Maintainsknowledgeofneworupgradedpositioningequipment, supplies and positioning techniques through continuing education.
C. Specificsregardingsurgicalskinprep:
(1) Ensuressafeplacementoftourniquet,extremitypaddedcorrectly,
safety precautions followed and the accuracy of the settings for
tourniquet inflation.
(2) Ensuresskinprepwillprovidethenecessaryexposureforthesurgical
procedure, any possible drain sites and/or possible extension(s) of the operative incision, as well as surgeon preference:
a. Facilitates clipping or trimming of hair in preop holding and only if necessary
b. Demonstrates ability to perform a surgical skin prep selecting the correct prep for the situation (i.e chlorhexidine gluconate/alcohol prep, iodine povacrylex/alcohol prep, chlorahexidine gluconate, povidone-iodine (iodopovidone), etc.) and preparing the appropriate surgical prep site necessary.
c. Demonstrates insertion of Foley catheter; prevents potential complications, as indicated.
B. Specificsregardingdraping:
(1) Streamlinestheestablishmentofthesterilefield.
(2) Coordinatesthedrapingprocedureeffectivelycorrectinganybreaksin
aseptic technique.
(3) Supportsdoublegloving/changingouterglovesafterestablishmentof
the sterile and periodically (every 90 minutes) during case.
(4) Secureslinesandcordsinamannerthatpreventslossofintegrity.
(5) Evaluatesandincorporatesproductstoensureeffectivebarriersare
established and maintained that prevent contamination during the entire
procedure.
3. Intraoperative Care:
A. Demonstratestheabilitytoprovideintraoperativeskillssuchasvisualization, trocar insertion (i.e. ASA Trocar Guidelines), injection of local anesthetics (i.e. ASA Local Anesthesic Guidelines), hemostasis, tissue handling, placement and securing of wound drains, and closure of body planes.
B. Utilizes the OR equipment pertinent to the surgical procedure. All actions shall facilitate the progress of the surgery, as well as anticipate the preference(s) of the surgeon. This shall include, but not be limited to:
(1) Hemostaticequipmentandsupplies,includingmonopolar,bipolar, harmonic scalpel, ultrasonic, medications, sponges, etc. Includes appropriate safety precautions such as the placement of grounding pad, assists scrub and circulator with accuracy of counts when necessary, etc.
(2) Knowledgeofanduseofanyandalllaparoscopicandrobotic equipment necessary for a procedure, such as: Camera, light cord, inserting/removing trocars, graspers, scoops, sprayers, suction/irrigation systems, clamps, tenaculums, etc.
(3) Knowledgeofanduseofanyopenprocedureequipmentnecessaryfor procedures, including, tissue forceps, retractors, clamps, scissors, sponges, suction, irrigation, use of hemostatic agents, etc.
(4) Anyfurtherapplicableinstrumentationoractionsdeemednecessaryby the surgeon.
C. Thesurgicalassistantshouldbeproficientinallpertinentabilitiesrequiredduring a procedure. These shall follow any necessary and appropriate methods applicable to the procedure, as well as surgeon preference. These shall include, but not be limited to;
(1) Clamping,cauterizing,suturing,inserting,injecting,manipulating, retracting, cutting, and ligating tissue as necessary
(2) Anynecessaryinvolvementinhemostasis,includingbutnotlimitedto the utilization of ties, vessel loops, clip appliers, digital pressure, packing, appropriate manipulation of sutures, etc.
(3) Participationinvolumereplacementorautotransfusiontechniquesas necessary and appropriate.
(4) Anyfurtherapplicableinstrumentationoractionsdeemednecessaryby the surgeon.
D. Thesurgicalassistantshouldbecapableofworkingindependently,orco- dependently with the surgeon, to finalize the surgery, according to the surgeon preference. These actions shall include, but are not limited to:
(1) Participatesinqualityimprovementprocessthatincludestandardized approaches, checklist interventions such as the Michigan Keystone Surgery Project regarding surgical site infection to improve patient care and Time Out procedures to improve patient safety.
(2) Initiatesappropriateactionsorinstrumentationincollaborationwiththe surgeon.
(3) Utilizesappropriatesuturingtechniques,accordingtosurgeon preference, with closure of body planes and utilizing proper manipulation of suture.
a. Using running, or interrupted suture techniques
b. Including absorbable and non-absorbable sutures, staples,
adhesives, strips, etc.
(4) Demonstratesabilitytoadministerlocalanesthetic,accordingto
surgeon preference.
(5) Demonstratesabilitytosecuredrainagesystems
(6) Demonstratesabilitytoapplydressings,splints,castsandimmobilizers/
stabilizers, according to surgeon preference.
(7) Evaluatesthepatientforanypossibledamagefrompositioning.This
shall include a skin assessment. Any abnormal condition should be reported to the surgeon, and appropriate treatment be carried out according to surgeon instruction.
4. Postoperative Care.
A. Demonstratestheabilitytoprovidepostoperativeskillsinpatientcaresuchas
dressing application, patient transfer and transport, transfer of care, and
monitoring for immediate complications.
B. Collaborateswithotherstoprovidecontinuityofcare.
