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At the conclusion of this course, the student should be able to:
1. Demonstrate proper handwashing and proper use of personal protective equipment
2. Demonstrate proper sterilization and disinfection techniques, including surgical instruments
and autoclaving
3. Obtain and document patient vital signs including: oral, axillary, and aural temperatures;
apical, radial, and brachial pulses; respiration; blood pressure; and pain level
4. Obtain and document patient height and weight
5. Transfer patients safely in and out of wheelchairs and on and off exam tables and chairs
6. Room patients including reviewing patient and family history, demographics, chief
complaint, review of body systems, and medication review
7. Prepare patients for examination by the provider including proper positioning and draping
8. Assist provider with minor office procedures
9. Demonstrate medical and surgical aseptic techniques including sterile gloving, sterile field
preparation, and sterile dressing change
10. Demonstrate proper body mechanics
11. Apply physical agents to promote tissue healing
12. Instruct patients regarding ambulatory aids and cast care
13. Document all patient care performed
14. Communicate effectively during all skill performances
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I. Medical Asepsis and the Occupational Safety and Health (OSHA) Standard
A. Microorganisms and Medical Asepsis
1. Growth requirements for microorganisms
2. Infection process cycle
3. Protective mechanisms of the body
4. Medical asepsis in the medical office
B. OSHA Bloodborne Pathogens Standard
1. Purpose of the standard
2. Needle stick safety and prevention act
3. OSHA terminology
4. Components of the OSHA standard
5. Control measures
C. Regulated Medical Waste
1. Handling regulated medical waste
2. Disposal of regulated medical waste
D. Bloodborne Diseases
1. Hepatitis B
2. Hepatitis C
3. Other forms of viral hepatitis
4. Acquired immune deficiency syndrome
E. Competencies*
1. Handwashing*
2. Applying an alcohol based hand rub*
3. Application and removal of clean, disposable gloves*
4. Adhere to the OSHA bloodborne pathogen standard*
5. Prepare regulated waste for pick up by an infectious waste service*
II. Sterilization and Disinfection
A. Hazard communication standard
1. Hazard communication program
2. Inventory of hazardous chemicals
3. Labeling of hazardous chemicals
4. Safety data sheets (SDS)
5. Employee information and training
B. Sanitization
1. Sanitizing instruments
2. Guidelines for sanitizing instruments
C. Disinfection
1. Levels of disinfection
2. Types of disinfectants
3. Guidelines for disinfection
D. Sterilization
1. Sterilization methods
2. Autoclave
3. Other sterilization methods
E. Competencies*
1. Read and interpret an SDS*
2. Sanitize instruments*
3. Chemically disinfect articles*
4. Wrap articles to be autoclaved*
5. Sterilize articles in the autoclave
6. Maintain the autoclave
III. Vital Signs
A. Temperature
1. Regulation of body temperature
2. Body temperature range
3. Assessment of body temperature
B. Pulse
1. Mechanism of the pulse
2. Assessment of the pulse
C. Respiration
1. Mechanism of respiration
2. Assessment of respiration
3. Assessment of oxygen saturation
D. Blood pressure
1. Mechanism of blood pressure
2. Assessment of blood pressure: Manual method
3. Assessment of blood pressure: Automatic method
E. Competencies*
1. Measure oral body temperature*
2. Measure axillary body temperature*
3. Measure rectal body temperature*
4. Measure aural body temperature*
5. Measure temporal artery body temperature*
6. Measure radial pulse*
7. Measure apical pulse*
8. Measure respiration*
9. Perform pulse oximetry*
10. Measure blood pressure*
11. Determine systolic blood pressure by palpation*
IV. The Physical Examination
A. Preparation of the examining room
B. Preparation of the patient
C. Measuring weight and height
D. Body mechanics
1. Principles
2. Application of body mechanics
E. Positioning and draping
F. Wheelchair transfer
G. Assessment of the patient
1. Inspection
2. Palpation
3. Percussion
4. Auscultation
H. Assisting the provider
I. Competencies*
1. Prepare the examining room*
2. Operate and care for equipment and instruments used during the physical exam*
3. Prepare a patient for physical exam*
4. Measure height and weight*
5. Demonstrate proper body mechanics when standing, sitting and lifting*
6. Position and drape a patient in each of the following positions:*
a. sitting*
b. supine*
c. prone*
d. dorsal recumbent*
e. lithotomy*
f. sims*
g. knee-chest*
h. fowler's*
7. Transfer a patient from a wheelchair to the exam table, and back again*
8. Assist the provider during the physical exam of the patient*
V. Physical Agents to Promote Tissue Healing
A. Local application of heat and cold
B. Casts
1. Synthetic casts
2. Cast application
3. Precautions
4. Guidelines for cast care
5. Symptoms to report
6. Cast removal
C. Splints and braces
D. Ambulatory aids
1. Crutches
2. Canes
3. Walkers
E. Competencies*
1. Apply each of the following heat treatments:*
a. heating pad*
b. hot soak*
c. hot compress*
d. chemical hot pack*
2. Apply each of the following cold treatments:*
a. ice bag*
b. cold compress*
c. chemical cold pack*
3. Assist with the application of a cast*
4. Assist with the removal of a cast*
5. Instruct a patient in proper cast care*
6. Apply a splint*
7. Apply a brace*
8. Measure a patient for axillary crutches*
9. Instruct a patient in the proper use of crutches*
10. Instruct a patient in the proper procedure for each of the following crutch gates:*
a. four-point*
b. two-point*
c. three-point*
d. swing-to*
e. swing-through*
11. Instruct a patient in the use of a cane*
12. Instruct a patient in the use of a walker*
VI. Minor Office Surgery
A. Surgical asepsis
B. Instruments used in minor office surgery
1. Scalpels
2. Scissors
3. Forceps
4. Miscellaneous instruments
5. Gynecologic instruments
6. Care of surgical instruments
C. Commercially prepared sterile packages
D. Wound healing
E. Sterile dressing change
F. Sutures
1. Types of sutures
2. Suture size and packaging
3. Suture needles
4. Insertion of sutures
5. Suture removal
6. Surgical skin staples
7. Adhesive skin closures
G. Assisting with minor office surgery
1. Tray set up
2. Skin preparation
3. Local anesthetic
4. Assisting the provider
H. Medical office surgical procedures
1. Sebaceous cyst removal
2. Surgical incision and drainage of localized infections
3. Mole removal
4. Laser mole surgery
5. Needle biopsy
6. Ingrown toenail removal
7. Colposcopy
8. Cervical punch biopsy
9. Cryosurgery
I. Bandaging
1. Guidelines for application
2. Types of bandages
3. Bandage turns
4. Tubular gauze bandages
J. Competencies*
1. Apply and remove sterile gloves*
2. Open a sterile package*
3. Add an article to a sterile field*
4. Pour a sterile solution*
5. Change a sterile dressing*
6. Remove sutures*
7. Remove surgical staples*
8. Apply and remove adhesive skin closures*
9. Set up a tray for each of the following procedures:*
a. suture insertion*
b. sebaceous cyst removal*
c. incision and drainage of a localized infection*
d. mole removal*
e. needle biopsy*
f. ingrown toenail removal*
g. colposcopy*
h. cervical punch biopsy*
i. cryosurgery*
10. Assist the provider with minor office surgery*
11. Apply each of the following bandage turns:*
a. circular*
b. spiral*
c. spiral-reverse*
d. figure-eight*
e. recurrent*
12. Apply a tubular gauze bandage*
*These items are introduced in lecture, and the related skills are performed in the lab. Communication skills are included with every skill performance.