Professional Documents
Culture Documents
Name: ________________________________
Instructions: Place a C and/or an S in each box to indicate level of proficiency in the circulating (C) and scrub (S) roles. Rate your skills from 1 to 4 using the following scale.
1. 2. 3.
You have never done the stated task/skill. You have performed the task/skill infrequently. You can perform the task/skill independently with help of resource person.
4.
Extensive experience
TASKS/SKILLS Perioperative Patient Assessment Patient interview Develop nursing diagnosis and care plan
Monitoring Ventilation, Circulation, Intake, Output, and Temperature Assist anesthesia professional during induction
TASKS/SKILLS Application of cardiac monitor electrodes Application of antiembolitic compression units Sequential compression boots Ace wrap TED hose Defibrillator operation Interpret cardiac monitors Use of intra-aortic balloon pump Use of automatic blood pressure monitor Use of oxygen saturation monitor Administration of blood and blood products Urinary bladder catheterization Aseptic connection of drainage devices Monitoring patient under conscious sedation/local anesthetic
TASKS/SKILLS Gowning and gloving Closed gloving self Open gloving self and others Creating and maintaining a sterile field Preoperative skin preparation Standard and universal precautions Decontaminating instructions Wrapping and packaging items for sterilization Verification of the sterilization process
Handling Equipment Electrosurgical units Monopolar (indicate types) Bipolar Argon beam coagulator Microscopes Steam sterilizers Low temperature hydrogen peroxide gas plasma sterilizer
TASKS/SKILLS Peracetic gas sterilizer Ethylene oxide gas sterilizer EKG monitor Lasers CO2 KTP Argon YAG Others Laparoscopes Pneumatic tourniquet Powered surgical instruments Arthroscope Irrigation and aspiration units Occutome Vitrectomy unit Cell saver Hypo/Hyperthermia units
TASKS/SKILLS Fiberoptic light sources and cords Chest drainage units (indicate types) Stereotactic units Sternal saw Fracture table Midas Rex OR beds Positioning devices (indicate types)
Colectomy Colostomy Sigmoid resection Low anterior resection Cholecystectomy (open) Colon interposition
Esophageal resection Esophagoscopy Gastrectomy Gastroplasty Gastroscopy Hemorrhoidectomy Laparoscopic cholecystectomy Liver Biopsy Resection
TASKS/SKILLS
Transplantation
TASKS/SKILLS
Genitourinary System Surgical Procedures Artificial urinary sphincter insertion Cystoscopy Cystectomy Cystotomy Hydrocelectomy Ileal loop Marshall Marchetti Krantz Nephrectomy Penile prosthesis insertion Rigid Flexible
TASKS/SKILLS
Inflatable Prostatectomy Perineal Suprapubic Transurethral resection RAZ procedure Renal procurement Cadaver donor Homograft Ureterolithotomy
Reproductive System Surgical Procedures Abdominal hysterectomy Anterior/Posterior repair Augmentation mammoplasty Breast biopsy Breast reconstruction
TASKS/SKILLS
Latissimus flap Rectus abdominis D&C Laser laparoscopy Mastectomy Microscopic tubal reanastomosis Pelvic exenteration Peritoneoscopy/Laparoscopy Reduction mammoplasty Tubal irrigation, microscopic Tubal ligation Vaginal hysterectomy Vasectomy Vas reanastomosis, microscopic Vaginal sling
TASKS/SKILLS
Coronary artery bypass graft Mitral valve replacement Aortic valve replacement Atrial septal defect (adult) repair Atrial septal defect (peds) repair Heart recovery (procurement) Heart transplantation Heart/lung transplantation Insert left ventricular assist device PDA (infant patient ductus arteriosus)
Respiratory System Surgical Procedures Bronchoscopy First rib resection Laryngoscopy Mediastinscopy Pericardial window
TASKS/SKILLS
Peripheral Vascular System Surgical Procedures Abdominal aortic aneurysm (AAA) repair Aorta-femoral bypass Axillary-femoral bypass Carotid endarterectomy Embolectomy Femoral-popliteal bypass graft Insertion vena caval filter Saphenous vein ligation/stripping AAA repair using stent graft
TASKS/SKILLS
Burr holes Subdural hematoma Shunt insertion Craniotomy Aneurysm Tumor A-V malformation Anterior cervical fusion Postcervical fusion Laminectomy Cervical Lumbar Thoracic Percutaneous rhizotomy Stereotactic procedures Transphenoida hypophysectomy Ventriculo-peritoneal shunt insertion
TASKS/SKILLS
Sensory System Surgical Procedures Acoustic neuroma excision Blepharoplasty Cataract extraction Corneal transplant Enucleation Facial nerve decompression Glomus tumor excision Intraocular lens implant Labyrinthectomy Mastoidectomy Myringotomy with ear tube insertion Rhytidectomy Scleral buckle Stapedectomy Strabismus repair
TASKS/SKILLS
Musculoskeletal System Procedures/Equipment Amputation Arthroscopy Ankle Elbow Knee Shoulder Bunionectomy Carpal tunnel release Closed reduction nasal fracture Compression hip nailing External fixation devices
TASKS/SKILLS
Fred Thompson prosthesis Harrington rod insertion Hip reconstruction With cement Without cement Intermedullary nailing Jewitt hip nailing Knee reconstruction Knowles pins insertion Ligament reconstruction Mandibular osteotomy Maxillary osteotomy ORIF of fractures Shoulder reconstruction Silastic implants Skeletal traction Tendon repair
TASKS/SKILLS
Endocrine/Lymphatic System Surgical Procedures Adrenalectomy Axillary node dissection Parathyroidectomy Radical neck dissection Staging laparotomy Thyroidectomy