Clinical Procedures

Infection Control

Objectives

  1. Define, spell, and pronounce the key terms related to infection control.
  2. Define and state the critical importance of infection control in the ambulatory care setting.
  3. Outline the six stages in the infection cycle.
  4. Define the five classifications of infectious microorganisms.
  5. Recall and elaborate on the four phases the immune system uses to defend against infectious disease.
  6. State the four stages of infectious diseases.
  7. Recall at least five infectious diseases, their agents of transmission, and their symptoms.
  8. Compare the routes of transmission of AIDS and hepatitis B and C and discuss the risk for infection from needlestick.
  9. Describe the purpose of Standard Precautions and give six examples of ways health care providers should practice Standard Precautions.
  10. Differentiate among the three types of Transmission-Based Precautions, defining what they are and how they are applied.
  11. List eight types of body fluids and give an example of each.
  12. Identify appropriate personal protective equipment for potentially infectious situations.
  13. Recognize five situations in which exposure to a patient’s blood can occur, and discuss why Standard Precautions are important.
  14. Describe proper disposal of infectious waste.
  15. Identify the role of the Centers for Disease Control regulations in health care settings.
  16. List human fluids that may contain HIV, HBV, and HCV.
  17. Define medical asepsis.
  18. Define bioterrorism and describe five agents that could be used in a bioterrorism attack.
  1. Define surgical asepsis and differentiate between surgical asepsis and medical asepsis.
  2. List eight basic rules to follow to protect sterile areas.
  3. State four methods of sterilization.
  4. List supplies and equipment necessary to achieve surgical asepsis when using an autoclave.
  5. Explain competent wrapping and operation of the autoclave.
  6. State storage measures and expiration periods for autoclaved materials.
  7. Demonstrate applying sterile gloves.

Activity Checklist

Completed / Activity / Required
Complete the Infection Control Pre-test. You will only complete this pre-test once. / Yes
Read in your textbook or e-book
Chapters____
  • pages ___
/ Not graded- use to prepare for competency demonstration
View the following skills videos :
  • Universal Precautions
  • Everyday Handwashing
  • Removing Gloves
  • Cold Chemical Sterilization of Instruments
  • Wrapping Instruments for Autoclave
  • Steam Sterilization using the Autoclave
/ Not graded- use to prepare for competency demonstration
Complete the following study quiz as many times as needed to prepare for the content competency evaluation.
  • Infection Control
/ Not graded- use to prepare for competency demonstration
Complete the followingCompetency Theory Examto demonstrate mastery of theoretical competencies”
  • Infection Control
/ Yes
Demonstrate competency of the following skills found in your Competency Manual to your skills evaluator:
Medical Asepsis Hand Wash
  • Removing Contaminated Gloves
  • Transmission-Based Precautions: Donning a Gown, Mask, Gloves, and Cap
  • Sanitation of Instruments
  • Chemical “Cold” Sterilization of Endoscopes
  • Preparing Instruments for Sterilization in an Autoclave
  • Sterilization of Instruments (Autoclave)
/ Yes

Real World Application Activities

The following list of activities contains suggestions to assist you to evaluate how the material learned in this module is applied in the clinic where you work.These are ungraded activities designed to help the student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills to evaluate the experiences.

  • Using observation, evaluate your patient interactions at the clinic. Are standard precautions used appropriately in every instance? Why or why not? Is it ever acceptable to fail to adhere to standard precautions?
  • Identify the clinic’s policy for the steps to be taken by a medical assistant in regard to transmission-based precautions.
  • Evaluate your own proficiency in selecting the correct PPE for different situations. Here are some practice examples. What PPE should be selected for the following:
  1. Performing vital signs on a patient who has tested positive for tuberculosis and who has not yet initiated antimicrobial treatment.
  2. Changing a dressing on a patient with second degree burns.
  3. Performing venipuncture to obtain blood for a CBC and fasting glucose.
  4. Obtaining sample of wound exudate for microbiology
  • Observe other MA staff throughout the day- is the policy upheld in every instance? Evaluate why adherence to the policy may vary.
  • Evaluate your own handwashing technique throughout the day. How does it compare to the procedure you have learned in this module?Do you need to change your habitual procedure?
  • Respond appropriately to a patient who asks why you are wearing PPE.
  • Ask to job shadow the person who performs instrument autoclaving at your clinic, observing for:
  • Sanitization procedures, including the solution used.
  • How the appropriate wrapping material is selected.
  • Strip indicator used?What type? Where is it placed?
  • Autoclave tape – how is it used?
  • Labeling- how is the wrapped package labeled?
  • Loading of the autoclave.
  • Operation of the autoclave- where are the instructions for time, temperature and pressure appropriate for the items being sterilized maintained?
  • Storage practices- what is the policy in your clinic for place and length of time for the storage of sterile items.
  • Does your clinic maintain a log sheet for the operation of the autoclave? How is the log maintained?

Minor Office Surgery

Objectives

  1. Define, spell, and pronounce the key terms as presented in the glossary.
  2. Define surgical asepsis and differentiate between surgical asepsis and medical asepsis.
  3. List eight basic rules to follow to protect sterile areas.
  4. State four methods of sterilization.
  5. List supplies and equipment necessary to achieve surgical asepsis when using an autoclave.
  6. Explain competent wrapping and operation of the autoclave.
  7. State storage measures and expiration periods for autoclaved materials.
  8. Explain the sizing standards of suture material and the criteria used to select the most appropriate type and size.
  9. Given a variety of surgical instruments, be able to identify each and describe its intended use.
  10. Demonstrate the ability to select the most appropriate type of dressings for a given situation.
  11. State advantages and disadvantages of Betadine®, Hibiclens®, isopropyl alcohol, and hydrogen peroxide when each is used as a skin antiseptic.
  12. Define anesthesia, and explain the advantages and disadvantages of epinephrine as an additive to injectable anesthetics.
  13. List five preoperative concerns to be addressed in patient preparation and education.
  14. List five postoperative concerns to be addressed with the patient and the caregiver.
  15. Demonstrate applying sterile gloves.
  16. Demonstrate setting up a surgical tray, including laying the field, applying supplies and instruments, pouring a sterile solution, using transfer forceps, and covering the sterile tray.
  17. Explain what is meant by alternative surgical methods.

Activity checklist

Completed / Activity / Required
Complete the Minor Office Surgery Pre-test. You will only complete this pre-test once. / Yes
Read in your textbook or e-book
Chapters_____:
  • Pages_____
/ Not graded- use to prepare for competency demonstration
View the following skills videos
  • Draping a Sterile Field
  • Applying a scalpel blade
  • Sterile gloves
  • Set up and assist with surgery
  • Removing sutures, staples, applying steri-strips
  • Dressing change, suture removal
  • Preparation of skin before surgery
/ Not graded- use to prepare for competency demonstration
Complete the following study quiz as many times as needed to prepare for the content competency evaluation.
  • Minor Office Surgery
/ Not graded- use to prepare for competency demonstration
Complete the followingCompetency Theory Examto demonstrate mastery of theoretical competencies”
  • Minor Office Surgery
/ Yes
Demonstrate competency of the following skills to your skills evaluator:
  • Applying Sterile Gloves
  • Setting up and covering a sterile field
  • Opening sterile packages of instruments and supplies and applying then to a sterile field
  • Pouring a sterile solution into a cup on a sterile field
  • Assiting with office/ambulatory surgery
  • Dressing change
  • Wound irrigation
  • Preparation of a patients skin before surgery
  • Suturing of laceration or incision repair
  • Sebaceous cyst excision
  • Incision and drainage of localized infection
  • Aspiration of joint fluid
  • Hemorrhoid thrombectomy
  • Suture/Staple removal
  • Application of sterile adhesive skin closure strips
/ Yes

Real World Application Activities

The following list of activities contains suggestions to assist you to learn how the material learned in this module is applied in the clinic where you work. These are ungraded activities designed to help the student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills to evaluate the experiences.

Who assists the physician with office surgeries in your clinic:

  • Prepare the surgical area/ exam room.
  • Evaluate the chart for appropriate consent.
  • Provide patient pre and post-surgical education and information.
  • Prepare the patient; positioning, surgical site preparation, any medications.

Observe and evaluate the preparation for a sterile procedure. Watch and evaluate to yourself whether the following procedures were performed according to the standards you have learned in this module:

  • Sterile gloving and gowning
  • Set up of the sterile field or tray
  • Opening of sterile packages
  • Adding items to the sterile field
  • Pouring sterile solutions
  • Assisting with suturing
  • Application of the wound dressing

Where is the information written, or is it written, identifying the instruments and other items needed for various sterile procedures commonly performed in your clinic?

Who removes sutures or staples in your clinic? What is the appropriate PPE to be worn during the procedure? Are appropriate PPE consistently worn by all staff when performing this procedures? Evaluate to yourself why or why not. When might a medical assistant need to ask a physician to evaluate a surgical wound either prior to or after sutures or staples are removed?

MEDICATION ADMINISTRATION

Objectives

  1. Define, spell, and pronounce the key terms related to medication administration.
  2. Discuss the legal and ethical implications of medication administration.
  3. Describe the medication order.
  4. Identify abbreviations and symbols used in calculating medication dosage.
  5. Describe the parts of a prescription.
  6. Define drug dosage.
  7. State what information is found on a medication label.
  8. Understand ratio and proportion.
  9. Use the metric, household, and apothecary systems of measurement and convert between the metric and apothecary systems.
  10. Understand units of medication dosage.
  11. Correctly calculate dosages for adults and children.
  12. List the guidelines to follow when preparing and administering medications.
  13. Administer oral medications.
  14. Select proper sites for administering parenteral medication.
  15. Describe safe disposal of syringes, needles, and biohazard materials.
  16. Describe site selection for administration of injections.
  17. Administer intramuscular, subcutaneous and intradermal injections.
  18. Understand intravenous therapy.
  19. Understand allergenic extracts.
  20. Describe inhalation medication and its administration.

Activity Checklist

Completed / Activity / Required
Complete the Medication Administration Pre-test. You will only complete this pre-test once. / Yes
Read in your textbook or e-book,
Chapters: ____
  • Pages: _____
/ Not graded- use to prepare for competency demonstration
View the following skills videos:
  • How to Handle a Needlestick
  • Withdrawing From A Vial
  • Withdrawing Medication From An Ampule
  • Administering SQ & IM Injections
  • Administering ID & Z-Track IM Injections
  • Mixing Diluent & Changing Needles
  • Medication Administration Terms
  • Positioning Babies and Children for Injections
  • Immunization Techniques
  • Mantoux Test
  • Tips for Childhood Vaccinations
  • Immunizations
  • Child Profile and Pain Management
/ Not graded- use to prepare for competency demonstration
Complete the following study quiz as many times as needed to prepare for the content competency evaluation.
  • Medication Administration
/ Not graded- use to prepare for competency demonstration
Complete the following Competency Theory Exam to demonstrate mastery of theoretical competencies”
  • Medication Administration
/ Yes
Demonstrate competency of the following skills found in your Competency Manual to your skills evaluator:
  • Withdrawing medication from a vial
  • Withdrawing medical from a ampule
  • Administering a subcutaneous injection
  • Administering an intramuscular injection
  • Administering an intradermal injection of purified protein derivative (PPD)
  • Reconstituting a powder medication for administration
  • Z-track intramuscular injection technique
/ Yes

Real World Application Activities

The following list of activities contains suggestions to assist you to evaluate how the material learned in this module is applied in the clinic where you work. These are ungraded activities designed to help the student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills to evaluate the experiences.

  • Find and read your clinic’s policy for the personnel that can administer medications in your clinic. What will be your role in the administration of medication?
  • What drug references are available to obtain information on medications to be administered?
  • What are the medications most commonly administered in your clinic. Using one of your clinic’s drug references, prepare a drug reference card for the medications/ vaccines you are most likely to administer, for use as quick review prior to medication administration.
  • Find the medication preparation area in your clinic. How is it organized?
  • Are sample medications available for dispensing at your clinic? Where and how are they stored?
  • Following your clinic’s HIPAA guidelines, read and evaluate various health care provider’s medication orders.
  • Practice reading the labels on various medication vials/ ampules in your clinic.
  • Job shadow clinic personnel as they administer injections:
  • How is the medication selected? How many times was the label read?
  • Evaluate the preparation of the medication. Was ii the same as you learned in this module? Why or why not?
  • Was the medication explained to the patient? Would you have said anything additional?
  • Was paperwork (i.e. a VIS form) required prior to administration of the medication or vaccine?
    How was that obtained?
  • Observe the administration of the medication? Was it administered as you learned in this module? Evaluate why the procedure was performed as you observed.
  • How was the medication administration documented?

ELECTROCARDIOGRAPHY

Objectives

  1. Define, spell, and pronounce the key terms related to electrocardiography.
  2. Follow the circulation of blood through the heart starting at the vena cavae.
  3. Describe the electrical conduction system of the heart.
  4. State three reasons why patients may need an electrocardiogram (ECG).
  5. Identify the various positive and negative deflections and describe what each represents in the cardiac cycle.
  6. Explain the purpose of standardization of the ECG.
  7. Identify the 12 leads of an ECG and describe what area of the heart each lead represents.
  8. State the function of ECG graph paper, electrodes (sensors), and electrolyte.
  9. Describe various types of ECGs and their capabilities.
  10. Explain each type of artifact and how each can be eliminated.
  11. Name and describe the purposes of the various cardiac diagnostic tests and procedures as outlined in this chapter.
  12. Identify the placement of Holter monitor electrodes.
  13. Describe the reason for a patient activity diary during ambulatory electrocardiography.
  14. Identify six arrhythmias and explain the cause of each.
  15. Explain how to calculate heart rates from an ECG tracing.
  16. Identify a common coding system used to code each lead on an ECG tracing.
  17. Describe the procedure for mounting an ECG tracing.
  18. Perform an ECG.

Activity Checklist

Completed / Activity / Required
Complete the ECG Pre-test. You will only complete this pre-test once. / Yes
Read in your textbook or e-book
Chapter:____
  • Pages ____
/ Not graded- use to prepare for competency demonstration
View the following skills videos:
  • EKG and Holter Monitor
/ Not graded- use to prepare for competency demonstration
Complete the following study quiz as many times as needed to prepare for the content competency evaluation.
  • ECG
/ Not graded- use to prepare for competency demonstration
Complete the following Competency Theory Exam to demonstrate mastery of theoretical competencies”
  • ECG
/ Yes
Demonstrate competency of the following skills found in your Competency Manual to your skills evaluator:
  • Perform a multi-channel electorcardiogram
/ Yes

Real World Application Activities

The following list of activities contains suggestions to assist you to evaluate how the material learned in this module is applied in the clinic where you work. These are ungraded activities designed to help the student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills to evaluate the experiences.

  • Ask to job shadow the person who performs ECG’s at your clinic, observing for:
  • Where to obtain the supplies and equipment needed and what needs to be gathered. Is it all on one cart, or must additional supplies be obtained?
  • How is the procedure explained to the patient? Would you add or delete anything you heard? Did the explanation put the patient at ease with the procedure?
  • Does your clinic have a policy for shaving the chest for males with an abundance of hair? If shaving is necessary, is the necessity explained? Is the patient required to sign a consent form agreeing to be shaved?
  • In your observation, were the leads places as you learned in the module? If not, why not?
  • Did the person placing the leads palpate for landmarks, or just place the leads in a general area? Was the patient’s modesty protected?
  • Was the ECG tracing examined for artifacts upon completion? Were any artifacts noted? If artifacts were present, what may have caused the failed recording?
  • Look at the ECG tracings obtained at your clinic in a given day, making sure to abide by any HIPAA regulations at your clinic. Can you identify the difference between normal and abnormal tracings?

PHLEBOTOMY

Objectives