1 ASSIST IN THE PREPARATION OF PATIENTS FOR OPERATIVE

Key words and concepts

Additional protective equipment

Includes types of personal protective equipment such as visors, protective eyewear and radiation protective equipment

Contaminated

Includes items ‘contaminated’ with body fluids, chemicals or radionuclides.

Any pack/item opened and not used should be treated as contaminated

Elective Surgery

Surgery which is not needed immediately, i.e. one for a non-life threatening disorder

National Guidelines

Includes current approved national/benchmarked guidelines

Personal protective clothing

Includes items such as plastic aprons, gloves – both clean and sterile, footwear, dresses, trousers and shirts and all in one trouser suits.

These may be single use disposable clothing or reusable clothing

Potential sources of contamination

Includes dirty skin, urine/faeces or other bodily fluids

Sterile field

An area that is aseptic, free from living micro-organisms

Simulation:

• Simulation is NOT permitted for any part of this Unit.

The following forms of evidence are mandatory:

• Direct Observation: Your assessor or an expert witness must observe you in real work activities which provide evidence for a significant amount of the performance criteria for this unit.

• Reflective Account/professional discussion: You describe your actions in a particular situation(s) and reflection on the reason(s) for you practicing in that way.

Competence of performance and knowledge could also be demonstrated using a variety of evidence from the following:

• Questioning/professional discussion: May be used to provide evidence of knowledge, legislation, policies and procedures which cannot be fully evidenced through direct observation or reflective accounts. In addition the assessor/expert witness may also ask questions to clarify aspects of your practice.

• Expert Witness: A designated expert witness (for example nurse, doctor, ODP) may provide direct observation of practice, questioning, professional discussion and feedback on reflective accounts.

• Witness Testimony: Can be a confirmation or authentication of the activities described in your evidence which your assessor has not seen. This could be provided by a work colleague.

• Products: These can be any record that you would normally use within your normal role e.g. policies and procedures and reports and records, etc.

You need not put confidential records in your portfolio, they can remain where they are normally stored and be checked by your assessor and internal verifier. If you do include them in your portfolio all names and identifying information must be removed to ensure confidentiality.

General guidance

• Prior to commencing this unit you should agree and complete an assessment plan with your assessor which details the assessment methods you will be using, and the tasks you will be undertaking to demonstrate your competence.

• Evidence must be provided for ALL of the performance criteria ALL of the knowledge and the parts of the scope that are relevant to your job role.

• The evidence must reflect the policies and procedures of your workplace and be linked to current legislation, values and the principles of best practice within the Perioperative setting. This will include the National Service Standards and/or KSF for your areas of work and the individuals you care for.

• All evidence must relate to your own work practice.

You need to show that you know, understand and can apply in practice:

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Legislation, policy and good practice

1. A factual awareness of the current European and national legislation, national guidelines, local policies and protocols which affect your work practice in relation to preparing patients for surgical procedures

2. A working understanding of your responsibilities and accountability in relation to the current European and national legislation, national guidelines and local policies and protocols within the perioperative care environment

3. A factual awareness of the importance of working within your own sphere of competence and seeking advice when faced with situations outside your sphere of competence

4. A working understanding of the application of standard precautions to the preparation of patients for operative procedures and the potential consequences of poor practice

Clinical materials and equipment

5. A working understanding of the types, purpose and function of surgical instrumentation and supplementary items used in patient preparation for surgery

5. A working understanding of factors which affect the choice of surgical instrumentation and supplementary items for individual patients

5. A working understanding of factors which affect the choice of appropriate sites for attaching instrumentation, e.g. diathermy, during patient preparation

5. A working understanding of common skin preparation agents and their:

1. presentation and nomenclature

2. mode of action

3. precautions required to prevent allergic reactions and diathermy burns

5. A working understanding of the types of surgical drape in common use, and the effectiveness of different types of material as barriers to cross infection

10. A working understanding of the dangers of re-using equipment designed for single use only

You need to show that you know, understand and can apply in practice:

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Operative procedures and techniques

11. A working understanding of the relationships between effective surgical field preparation, prevention of wound contamination and surgical access

11. A working understanding of specific instances where particular, non-routine methods are used to prepare the surgical field (on the ward and in the operating department), and the rationale for this

11. A working understanding of safe and effective methods of applying skin preparation agents and the type and extent of skin preparation needed

Team and organisation structures and systems

14. A working understanding of the specific lines of accountability within the surgical team

Records and documentation

14. A working understanding of the information which should be recorded in relation to the preparation of patients for operative procedures

14. A working understanding of the importance of recording information relating to the preparation of patients for operative procedures

14. A working understanding of the importance of immediately reporting any issues which are outside your own sphere of competence without delay to the relevant member of staff

Performance Criteria

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1. Apply standard precautions for infection control and other relevant health and safety measures

2. Assist in the preparation of the patient in a manner which optimises their dignity, comfort and safety

3. Correctly identify potential sources of contamination and take appropriate action to minimise any risks.

4. Correctly identify the patient’s operative site, and clarify and uncertainties with the registered practitioner before assisting with the preparation

5. Correctly select and handle surgical instrumentation and supplementary items in line with manufacturers’ instructions and in a manner which minimises the risk of harm.

6. Ensure all swabs and items used in the preparation of the operative site are accounted for and recorded in accordance with national guidelines prior to safe disposal

7. Select and appropriate site on the sterile field for attaching surgical instruments and supplementary items

8. Ensure safe and correct disposal of waste associated with surgical preparation