Certified Surgical Assistant Skills Checklist

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PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS:

Proficiency

  1. I have never done the stated task.
  2. I have performed the task/skill infrequently; I require more experience/practice to feel comfortable and proficient.
  3. I have performed the task/skill several times and feel moderately comfortable functioning independently but would require a resource person nearby.
  4. I have performed the task/skill frequently and would feel very comfortable and proficient performing it without supervision or practice.

Frequency

  1. 5 or less Annually
  2. 5 or less Quarterly
  3. 3 or less Monthly
  4. 1 - 5 times Daily/Weekly
PATIENT RIGHTS *
SKILLFREQUENCY
Communicate and obtain information while respecting a patients' rights, privacy, and confidentiality of information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Involve the patient and family and respect their role in determining the nature of care to be provided
Comply with nursing staff responsibilities included in the hospital policy related to organ donation
Meet patient and family communication needs
Provide accurate information to patients and families on time
TRANSMISSION-BASED PROTOCOL *
SKILLFREQUENCY
Contact Precaution
Droplet Precaution
Airborne Precaution
MISCELLANEOUS *
SKILLFREQUENCY
Adult respiratory/ cardiac arrest
Autoclave
Automated med dispensing systems
Care of scopes & fiber optic equipment
Cidex soap
Crash cart
Defibrillator
Electronic documentation
Hand-off communication
Isolation precautions
Patient identification
Pediatric respiratory/ cardiac arrest
Standard precautions
Universal protocol
EQUIPMENT *
SKILLFREQUENCY
Robotics
Fracture tables
Video systems
CUSA
Cell saver
PACS Diagnostics
Electrocautery
Drills
Saws
Stapling devices
Cardiac monitors
Position patient per surgeon's orders
Pressure point paddling
Apply tourniquet as ordered
Protect from nerve damage
Thermoregulation
Use of fracture table
Use of head stabilizer
Use of body stabilizer
Use of c-arm extensions
Skin assessment
Use of retractors
Packing with sponges
Digital manipulation of tissue
Suctioning, Irrigation, Sponging
Manipulation of Surgical Materials (Loops, tags)
Clamping/cauterizing vessels or tissues
Tying/ligating clamped vessels or tissues
Apply hemostatic clips
Place local hemostatic agents
Direct digital pressure
Assist in volume replacement
Assist in autotransfusion
Suturing: all wound layers including muscle & fascia
Wound dressing: liquid or spray occlusive
Absorbent immobilizing dressing
Assist to secure drainage system to tissue
Insert/remove Foley
Drape patient
Electrocautery Mono
Electrocautery Bipolar
Cut tissue
Harvest saphenous vein, including skin incision
Dissect common femoral artery and bifurcate
Insert drainage tubes
GENERAL SURGERY *
SKILLFREQUENCY
Abdominal perineal resection
Adrenalectomy
Bowel resection
Cholecystectomy
Colostomy/Ileostomy
Gastrectomy
Hemicolectomy
Hepatic resection
Herniorrhaphy-femoral/Inguinal
Hiatal Herniorrhaphy- Transabdominal
Pancreatectomy
Organ procurement
Radical mastectomy
Saphenous vein ligation and stripping
Splenectomy
Thyroidectomy
Tracheostomy
Whipple procedure
LAPAROSCOPIC PROCEDURES *
SKILLFREQUENCY
Hysterectomy
Cholecystectomy
Appendectomy
Hernia repair
Colon resection
GYNECOLOGY *
SKILLFREQUENCY
Cesarean section
Dilation & Curettage
Hysterectomy - Vaginal
Hysterectomy - Abdominal
Laser surgery
Radium insertion
Salpingo - Oophorectomy
Shirodkar procedure
Termination of pregnancy
Tubal ligation
Vaginectomy
Vaginal reconstruction
GENITOURINARY AND CYSTO *
SKILLFREQUENCY
Circumcision
Cystoscopy/Cystostomy
Cystectomy
Hypospadias repair
Ileal loop
Lithotripsy
Nephrectomy
Orchiectomy
Penile implant
Prostatectomy
Ureterolithotomy
Ureteroscopy
T.U.R.P./T.U.R.B.
Vasectomy
ORTHOPEDIC *
SKILLFREQUENCY
Amputation - Leg/arm
Application of halo traction
Arthroscopy/ Arthrotomy
Closed pinning & reduction of extremities
External compression devices
Insertion of finger prosthesis
Total joint replacement - knee, hip, shoulder
Spinal fusion - Harrington rods
Spica cast application
O.R.I.F. - Shoulder, hip, humerus, etc.
Repair of dislocation
Patellectomy
Tendon implants & reanastomosis
NEUROSURGERY *
SKILLFREQUENCY
Anterior cervical fusion
AV malformation
Burr holes for subdural hematoma
Craniotomy
Discectomy/Laminectomy
Laminectomy
Meningocele repair
Nerve stimulators
Shunt procedures - VP/VA
Spinal procedures/ fusions
PLASTICS *
SKILLFREQUENCY
Abdominoplasty/ abdominal lipectomy
Augmentation mammoplasty
Breast reduction/ reconstruction
Cleft lip/ palate repair
Dermabrasion
Digital flexor tendon repair
Facelift
Liposuction
Otoplasty
Rhinoplasty
Reduction of facial fracture
Scar revisions
Skin grafting
EENT *
SKILLFREQUENCY
Excision of chalazion
Canthotomy
Correction of ectropion/ entropion
Corneal transplant
Enucleation
I.O.I. implants
Lacrimal duct probing
Refractive keratoplasty
Repair of retinal detachment
Vitrectomy
Caldwell-Luc
Ethmoidectomy
Frontal flap sinus procedure
Laryngectomy
Radical neck
Septoplasty
Sinusotomy
Tonsillectomy & adenoidectomy
Tracheostomy
Myringotomy
Mastoidectomy
Tympanoplasty
Stapedectomy
Nasal polypectomy
Laryngoscopy
Bronchoscopy
CARDIOTHORACIC *
SKILLFREQUENCY
Chest tube set-up
Pneumonectomy/ lobectomy
Septal defect repair
Sternal splitting
Thoracotomy
Bronchoscopy
Lung/ wedge resection
Vein harvesting
A-V shunts
Aortic aneurysm, abdominal
Aortofemoral bypass
Graft insertion
Cardiac valve replacement
Coronary artery bypass graft- on pump
Endarterectomy- carotid/ femoral
Femoral - popliteal bypass
External temporary pacemaker
Internal pacemaker insertion
Intra-aortic balloon pump catheter
Patent ductus repair
Pericardial windows
Portosystemic shunt
Repair of septal defects
Thrombectomy
Vena cava ligation
TRANSPLANT *
SKILLFREQUENCY
Bone marrow
Pancreas
Heart
Lung
Liver
Multi-organ
Kidney
Eye
TRAUMA *
SKILLFREQUENCY
Burns
Vehicular accidents
Gun shot wounds
Stab wounds
ELECTRONIC DOCUMENTATION *
SKILLFREQUENCY
Allscripts
Athena
Care360
Cerner
CPSI
eClincalWorks
Eclipsys
EPIC
Greenway Primesuite
MACLAB
McKesson/Paragon
Meditech
PACS
Quadramed
Soarian
AGE SPECIFIC COMPETENCIES *
SKILLFREQUENCY
Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64-79 years)
Elderly adults (80+ years)

Attestation

ATTESTATION: *