Chapter 8: Patient Care: Medical and Surgical
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Transcript of Chapter 8: Patient Care: Medical and Surgical
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 8: Patient Care: Medical and Surgical
Chapter 8: Patient Care: Medical and Surgical
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Medical AssistantsMedical Assistants
• Overview
– Administrative tasks (office procedures)
– Clinical tasks
• Examining patients
• Helping treat them
– Work settings: doctors’ offices, imaging centers, laboratories, research facilities
– More limited role that that of physician assistant
– No authority to diagnose or treat patients
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• History of the Profession
– Early 20th century: office assistants or nurses trained on job
– 1924: M. M. Mandl opened first school to train assistants
– 1956: American Association of Medical Assistants (AAMA) founded
– 1963: AAMA’s certification exam first administered
– Early 1990s: Commission on Accreditation of Allied Health Education Programs (CAAHEP) forms
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Education
– On-job training (HS diploma required)
– 1- to 2-year programs in vocational schools, community colleges
– Nearly 600 accredited programs
– Internship usually included in program
– Additional training for advanced procedures (x-rays, injections)
– Continuing education required for recertification
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Course Work
– Anatomy & physiology
– Medical terminology
– Typing & transcription
– Computer applications
– Office practices
– Insurance processing
– Recordkeeping & accounting
– Patient relations
– Clinical & diagnostic procedures
– Laboratory techniques
– Administration of medications
– Pharmacology
– First aid
– Medical law & ethics
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Professional Certification
– Not required, but offers advantages
– CMA: certified medical assistant
– RMA: registered medical assistant
– Requires graduation from accredited program & passing an exam
– Certification in specialty areas:
• Ophthalmology
• Optometry
• Podiatry
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Clinical Duties
– Obtaining medical histories
– Assisting with physical examinations
– Preparing & administering medications
– Drawing blood samples
– Assisting with or performing diagnostic or basic lab tests
– Preparing & sterilizing instruments
– Collecting & preparing lab specimens
– Recognizing & treating medical emergencies
– Educating patients
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Clinical Procedures
– Measuring blood pressure
– Collecting a throat specimen
– Administering eye medications
– Performing blood glucose testing
– Assisting with therapeutic soaks
– Completing an EKG
– Changing dressings & removing sutures
– Disposing of biohazardous materials
– Measuring a patient for crutches
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Personal Characteristics of Medical Assistants
– Communication skills
– Organization skills
– Time management
– Multitasking
– Interpersonal skills
– Attention to detail
– Ability to remain calm during stressful situations
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Employment Opportunities and Trends
– 34% growth from 2008 to 2018
– In demand due to:
• Rising # of group practices, clinics, etc.
• Dual administrative & clinical skills of medical assistants
• Aging of population
• Prevalence of obesity & diabetes
• Increased # of patients seen by physicians
• Lower-cost alternative to higher-wage workers
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Professional Organizations
– American Association of Medical Assistants (AAMA)
– American Medical Technologists (AMT)
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Medical Assistants (cont’d)Medical Assistants (cont’d)
• Professional Organizations: Benefits of Membership
– Access to educational seminars
– Access to continuing education units
– Subscription to professional journals
– Access to annual conventions
– Group insurance plans
– Networking opportunities
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Surgical TechnologistsSurgical Technologists
• History of the Profession
– Emerged after World War II
– Evolved from technicians trained by military during war
– 1969: Association of Operating Room Technicians formed
– Renamed as Association of Surgical Technologists (AST)
– 1972:
• AMA approved educational standards
• Accreditation review committee established
– AST established certification program, code of ethics, & standards of practice
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Education
– HS diploma or GED + completion of training program required
– Training program:
• 9 mo to 2 yr
• Certificate, diploma, or associate’s degree
• Community/junior college, vocational school, university, hospital, or military
• Classroom instruction, mock surgery, supervised work
– 455 accredited programs in U.S.
– Continuing ed. or passing an exam required for recertification
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Course Work
– Anatomy & physiology
– Medical terminology
– Microbiology
– Pharmacology
– Physical environment & safety standards
– Sterile techniques
– Surgical procedures
– Patient care & safety
– Legal, moral, & ethical issues
– Communication skills
– Skills for professional behavior
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Professional Certification
– Not licensed
– Certification not required, but preferred
– CST: certified surgical technologist
• Awarded by National Board of Surgical Technology and Surgical Assisting
• Requires graduation from accredited school & passing an exam
– TS-C: tech in surgery-certified
• Awarded by National Center for Competency Testing (NCCT)
• Requires completing training program or work experience
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Work Responsibilities: Before an Operation
– Prepares operating room
– Checks all equipment & places instruments
– Counts sponges, needles, & instruments
– Provides emotional support to patient
– Checks patient charts & vital signs
– Transports patient to OR & positions on operating table
– Washes, shaves, & disinfects surgery site
– Creates & maintains sterile field
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Work Responsibilities: During an Operation
– Passes instruments, equipment, & supplies to surgeon
– Holds retractors
– Uses sponges or suction to clear fluids
– Monitors vital signs
– Operates equipment
– Manages specimens collected
– Prepares dressings & applies them to incision site
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Work Responsibilities: After an Operation
– Takes patient to recovery room
– Removes used instruments, equipment, & supplies
– Sets up operating room for next patient
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Personal Characteristics
– Strong sense of responsibility
– Conscientiousness about work
– Organizational skills
– Attention to details
– Accuracy & precision
– Initiative
– Accurate listening
– Ability to work well with others
– Calmness during stressful conditions
– Manual dexterity
– Good physical condition
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Employment Opportunities and Trend
– Rapidly growing occupation: 25% between 2008 & 2018
– In demand due to:
• Increase in # of surgeries due to population growth & aging of population
• Technological advances, leading to new surgical procedures
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Surgical Technologists (cont’d)Surgical Technologists (cont’d)
• Professional Organization
– Association of Surgical Technologists (AST)
– Ensures surgical technologists have knowledge & skills required
– Works to advance profession by
• Setting accrediting standards & lobbying
– Membership benefits
• Free & discounted continuing education
• Career center
• Subscription to The Surgical Technologist
• Annual conference
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Physician AssistantsPhysician Assistants
• Overview
– Examine patients, diagnose illnesses, arrange treatment
– Must work under supervision of a physician
– Provide primary care in areas that lack physicians:
• Rural settings
• Inner-city clinics
– Free up physicians by assuming responsibility for routine tasks
– Ranked as one of the best careers in U.S.
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Physician Assistants (cont’d)Physician Assistants (cont’d)
• History of the Profession
– Began in 1960s
– First members were corpsmen, trained by military
– Created to address shortage of primary care physicians
– 1964: MEDEX (medical extension) training program begun
– 1965: First students enrolled in a program
– 1969: American Association of Physician Assistants (AAPA) formed
– 1973: First national certifying exam was administered
– Fast-growing profession
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Physician Assistants (cont’d)Physician Assistants (cont’d)
• Education
– License required in every state
– Licensure requires:
• Graduation from accredited school
• Passing a national exam
– Programs
• Require ≥2 years of college + work experience of applicants
• Last about 2 years
• Most offer master’s degree; some offer bachelor’s
• Continuing education required for recertification
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Physician Assistants (cont’d)Physician Assistants (cont’d)
• Course Work
– Biochemistry
– Pathology
– Anatomy
– Physiology
– Microbiology
– Pharmacology
– Physical diagnosis
– Clinical medicine
– Geriatric & home health care
– Disease prevention
– Medical ethics
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Physician Assistants (cont’d)Physician Assistants (cont’d)
• Work Responsibilities
– Taking medical histories
– Physical exams
– Interviewing & examining patients
– Diagnosing diseases
– Discussing diagnoses with patients
– Treating patients’ diseases
– Prescribing some medications
– Ordering & analyzing
• Lab tests
• X-rays
• EKGs
– Treating minor injuries
• Applying splints
• Applying casts
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Physician Assistants (cont’d)Physician Assistants (cont’d)
• Personal Characteristics
– Diligence
– Self-discipline
– Level-headedness
– Good judgment
– Interpersonal skills
– Communication skills
– Integrity
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Physician Assistants (cont’d)Physician Assistants (cont’d)
• Employment Opportunities and Trends
– 7th-fastest growing occupation in U.S.
– 39% growth between 2008 & 2018
– In demand due to:
• Continued growth of health care industries
• Drive to control costs
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Physician Assistants (cont’d)Physician Assistants (cont’d)
• Professional Organization
– American Academy of Physician Assistants (AAPA)
– Offers:
• Annual conference
• Networking opportunities
• Recognition
• Scholarships
• Continuing education
• Journal & other publications
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EMTs/ParamedicsEMTs/Paramedics
• Overview
– Provide emergency medical treatment at:
• Homes
• Scenes of accidents
• Other locations
– Transport patients to hospitals
– Care for patients during transport
– Services depend on level of training
– Paramedic is highest level of training
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EMTs/Paramedics (cont’d)EMTs/Paramedics (cont’d)
• History of the Profession
– Began in 1960s
– 1964: Report calling for establishment of standards
– 1966: National Highway Safety Act passed
– 1970: National registry of EMTs formed
– Initial resistance from states, doctors, & nurses
– 1973: Emergency Medical Services Act
– 1980s: EMS management handed over to states
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EMTs/Paramedics (cont’d)EMTs/Paramedics (cont’d)
• Education, Training, and Legal Requirements
– HS diploma or GED & formal training program required
– Three levels of training:
• EMT-Basic: 110 hours
• EMT-Intermediate: 30 to 350 hours beyond basic
• EMT-Paramedic: 1- to 2-yr programs
– Certification or registration provided by NREMT
– Recertification every 2-3 yr, requiring exam & continuing ed.
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EMTs/Paramedics (cont’d)EMTs/Paramedics (cont’d)
• Work Responsibilities
– Recognize hazards
– Assess patient’s breathing
– Do rapid trauma assessment
– Provide oxygen by mask
– Suction an airway
– Use an AED
– Start an IV
– Run & read an EKG
– Attach a cardiac monitor & a pulse oximeter
– Insert an artificial airway
– Stabilize impaled objects
– Administer certain medications
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EMTs/Paramedics (cont’d)EMTs/Paramedics (cont’d)
• Personal Characteristics
– Emotional steadiness
– Ability to make quick decisions
– Level-headedness
– Communication skills
– Independent & team work skills
– Leadership skills
– Good physical condition
– Willingness & ability to improve knowledge & skills
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EMTs/Paramedics (cont’d)EMTs/Paramedics (cont’d)
• Employment Opportunities and Trends
– 9% growth between 2008 & 2018
– Factors prompting growth:
• Aging of population
• Overcrowding of ERs
• Increased transfers of patients between hospitals
• Turnover, as EMTs change occupations for better pay or benefits
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EMTs/Paramedics (cont’d)EMTs/Paramedics (cont’d)
• Professional Organization
– National Association of Emergency Medical Technicians (NAEMT)
– Advocates for paramedics & EMTs on national level
– Provides three major courses throughout country:
• PreHospital Trauma Life Support
• Advanced Medical Life Support
• Emergency Pediatric Care
– Membership benefits: networking opportunities, free & discounted courses, conference & journal discounts