Surgical Intervention and Facilities Overview

Surgical Intervention Goals

• Primary objective is to restore optimal physical and mental health for patients.
• Diagnostic surgery determines the nature and cause of an illness.
• Palliative surgery alleviates symptoms without curing the underlying disease.
• Prophylactic surgery aims to prevent disease occurrence.
• Restorative (curative) surgery seeks to regain health and enable return to normal activities.

Types of Surgical Facilities

• Nonprofit hospitals are affiliated with religious organizations; patient care costs are financed through charitable donations and income is not taxed.
• Proprietary hospitals are privately owned; income is taxable and profits are shared with investors.
• Tax-supported hospitals receive funding from government bodies at various levels.

Surgical Unit Structures in Hospitals

• Hospital-based units contain surgical suites either adjacent to or inside a hospital.
• Self-contained units provide separate operating rooms for outpatient care from inpatient services.
• Combined units allow outpatients to share operating room facilities with inpatients while having separate preoperative areas.

Types of Surgery Centers

• Satellite surgery centers are hospital-owned facilities located away from the main hospital.
• Office-based surgery centers are equipped within physicians' offices for minor surgical procedures.
• Ambulatory care centers are independent facilities focused on short-term care for non-confined patients.

Hospital Organizational Structure

• Organizational charts depict relationships among all hospital staff and departments, clarifying lines of authority.
• Important roles in the surgical department include Director of Surgical Services, Operating Room Clinical Manager, Surgical Technologists, and Patient Care Assistants.

Continuity of Patient Care Departments

• Direct patient care units include nursing care, diagnostic imaging, pathology, and clinical laboratories.
• Indirect patient care services ensure cleanliness, facility management, supply distribution, and record-keeping.

Surgical Team Composition

• Sterile team members handle sterile items within the operating field, including the surgeon and surgical assistants.
• Unsterile team members maintain sterile techniques externally, such as anesthesia providers and circulators.
• Key members include the surgeon, anesthesia provider, surgical assistants, scrub person, and circulator.

Employment Opportunities for Surgical Technologists

• Career options include being a physician/surgeon’s assistant, medical sales representative, or surgical technology instructor.
• Required programs need CAAHEP accreditation for certification as a surgical technologist.

Job Descriptions and Duties

• Job descriptions outline roles, responsibilities, qualifications, and reporting structure for surgical technologists.
• Preoperative responsibilities include obtaining supplies, preparing the sterile field, and assisting with patient draping.
• Intraoperative tasks involve passing instruments, maintaining aseptic technique, and monitoring patient safety.
• Postoperative functions include assisting with dressings, cleaning, and equipment maintenance.

Limitations of Surgical Technologists

• Surgical technologists cannot administer medications, perform anesthesia, or make patient assessments.
• They must operate only under supervision and are not responsible for final documentation or any actions affecting patient anatomy.

Symptom and Hospice Definition

• A symptom is a subjective indication of a disease identified by the patient.
• Hospice focuses on providing care and support for individuals with terminal illnesses.

Goals and Types of Surgical Intervention

• Primary goal is to restore optimal physical and mental health in patients.
• Diagnostic Surgery: Identifies the nature and cause of an illness.
• Palliative Surgery: Alleviates symptoms without curing the underlying condition.
• Prophylactic Surgery: Prevents the occurrence of a disease or illness.
• Restorative Surgery: Aims to regain health and strength, allowing patients to return to normal activities.

Reasons for Surgical Intervention

• Nonprofit Facilities: Funded by charitable donations, income is not taxed.
• Proprietary Facilities: Privately owned, taxable income, and profits shared with investors.
• Tax-Supported Facilities: Receive funding from government sources.

Types of Hospitals

• Hospital-Based Units: Surgical suites are part of or attached to hospitals.
• Self-Contained Units: Operating rooms separate from inpatient services.
• Combined Units: Shared operating room facilities for inpatients and outpatients, with a designated holding area.

Surgical Facilities

• Satellite Surgery Center: Hospital-owned yet physically separate facility for outpatient surgery.
• Office-Based Surgery Center: Surgery unit within a physician’s office.
• Ambulatory Care Center/Surgicenter: Independent facility for patients not requiring overnight admission.

Organizational Structure

• Medical facilities utilize organizational charts to show department relationships and authority lines.
• Important for maintaining control and accountability within the institution.
• Key personnel include:
  • Director of Surgical Services
  • Operating Room Clinical Manager
  • Post Anesthesia Recovery Unit Manager

Patient Care Departments

• Direct Patient Care: Involves nursing units, diagnostic imaging, pathology, and clinical laboratories.
• Indirect Patient Care: Includes environmental services, facilities management, medical records, biomedical engineering, and administration.

Surgical Team Composition

• Sterile Team Members: Surgeons, surgical assistants, and scrub personnel handle sterile items within the sterile field.
• Unsterile Team Members: Circulators and anesthesia providers maintain sterile technique from outside the sterile field.

Surgical Team Roles and Responsibilities

• Surgeon: Licensed physician who performs procedures and leads the surgical team.
• Assistants: Includes physician first assistants and non-physician first assistants with special training.
• Anesthesia Provider: Administers anesthesia; can be an anesthesiologist or Certified Registered Nurse Anesthetist (CRNA).
• Scrub Role: Prepares the sterile field, passes instruments, and maintains aseptic technique.

Surgical Technologist Training and Employment

• Programs must be CAAHEP accredited to qualify as a Certified Surgical Technologist.
• Training options include career and technical schools, colleges, and the armed forces.

Job Descriptions and Responsibilities

• Job descriptions define the scope, responsibilities, educational and skill requirements for surgical technologists.
• Essential for ensuring safe and efficient operation within surgical teams.

Preoperative, Intraoperative, and Postoperative Responsibilities

• Preoperative: Includes obtaining supplies, patient assessment, and preparing the sterile field.
• Intraoperative: Involves passing instruments, anticipating needs, and maintaining aseptic conditions.
• Postoperative: Assists in applying dressings, cleaning equipment, and preparing instruments for reprocessing.

Limitations of Surgical Technologists

• Cannot administer medications or anesthetics, conduct assessments, or function without supervision.
• Restrictive in roles around patient assessment and documentation finalization.

Understanding Symptoms and Hospice

• Symptom: Subjective indication of disease or change as perceived by the patient.
• Hospice: A specialized form of care focused on providing support and comfort for terminally ill patients.