Chapter 8: Patient Care: Medical and Surgical

1. Chapter 8: Patient Care: Medical and Surgical

2. Medical 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. Medical Assistants (cont’d) • Professional Organizations • American Association of Medical Assistants (AAMA) • American Medical Technologists (AMT)

12. 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

13. Surgical 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. Physician 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.

24. 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

25. 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

26. Physician Assistants (cont’d) • Course Work • Biochemistry • Pathology • Anatomy • Physiology • Microbiology • Pharmacology • Physical diagnosis • Clinical medicine • Geriatric & home health care • Disease prevention • Medical ethics

27. 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

28. Physician Assistants (cont’d) • Personal Characteristics • Diligence • Self-discipline • Level-headedness • Good judgment • Interpersonal skills • Communication skills • Integrity

29. 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

30. Physician Assistants (cont’d) • Professional Organization • American Academy of Physician Assistants (AAPA) • Offers: • Annual conference • Networking opportunities • Recognition • Scholarships • Continuing education • Journal & other publications

31. EMTs/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

32. 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

33. 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.

34. 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

35. 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

36. 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

37. 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