Ethical Foundations of the SFA Role

1. Legal, Professional, and Ethical Issues of the SFA Role

The ritualistic observance of ethics is a vital practice in health processes. Ethics will define that which is morally good to everyone within the context of a health centre. It sets a generally accepted code of conduct to everyone involved in the practice of health. As health professionals, it is paramount to uphold respect for our patients while appreciating their diversity concerning beliefs, wishes, and philosophies. It is therefore to uphold the institutionally constructed codes of conduct which may further provide a blueprint of what are the expectations from every stakeholder involved in the health domain.

1.1 Professional Issues

Mastery of professional needs and issues within the healthcare docket is important because it is a basis of displaying exemplary demeanour and acceptable character in the working environment. Professional aspects entail respecting the autonomy of patients and other health practitioners. Additionally, professional issues entail the concept of beneficence; where the health practitioner undertakes operations geared to benefit societal members. Health professionals should work towards not only safeguarding the patients’ interests; but also towards preventing or removing potential threats to healthy wellbeing (Nursing and midwifery council, 2015). Moreover, the principle of maleficence is important in defining how health practitioners should administer their docket. This principle postulates that caregivers should not induce any kind of harm to their patients; but instead strive to improve their current emotional, social wellbeing. The principle of maleficence is thus a definition of the moral duties to look for opportunities deemed to protect the patients at all costs and save their lives and, help them recover from the ailments.

Professional and employment issues

There are various professional and employment issues relating to the Surgical First Assistant. It is important to understand what the roles SFA officer are, alongside the employment and professional issues relating to such roles. According to Nursing and Midwifery Council, 2015, Surgical First Assistant (SFA) refers to a registered healthcare expert whose basic function is to render competent skills and help under the authority of the surgeon on duty in the theatre room, while not engaging in any kind of surgical intervention. Similar to any other innovative role in healthcare; the needs of an SFA in an operation room are called upon by the senior surgeons, relevant stakeholders or the (Rohr, 2017). A clinical governance blueprint which encompasses risk assessment and the implementation of local policies

Accountability and Responsibility

According to the Royal College of Nursing, accountability is defined as the ability to be accountable to the criminal and also civil law courts for the assurance that one’s undertakings achieve legal demands. The concept of accountability also embeds the ability of care providers to be accountable to their employers and as a manner of obtaining the authentic obligation and duty and the fulfilment of the organization’s regulatory arms. The Surgical First Assistant is required to conform to fundamental care when carrying out different duties with the jurisdictions of Surgical First Assistant roles. Documentation and keeping of healthcare records is an integral part in the healthcare organizations. Documentation and clear record keeping ensure that the information concerning the patients is kept appropriately for easier future retrieval. Under the jurisdiction of the Nursing and Medical Council, there are no rigid frameworks governing the data storage; but the framework is well outlined under the Code: Professional Standards and Behavior for Nurses and Midwives (2016). The following concepts are instrumental in governing record keeping;

10.1 fill in all records as per the occurrences of events; thus, update the records immediately as the events happen. 10.2 identify threats arising and the various mechanisms laid in place to counter such threats. 10.3 complete compiling the record accurately and clearly without overstating or exaggerating the content therein. 10.4 give yourself any entries submitted either electronically or written while making sure they make sense concerning clarity, date, and free from spelling mistakes. 10.5 take the necessary steps to ensure all recorded information is secure from tear, or vandalism, or extortions. 10.6 gather, and safeguard all information and research findings accordingly, and appropriately.

According to the Health Care Professional Council (2016); the need for excellent documentation is also supported and it proposes various standards under which such documentation should be founded.

1.2 Governance

When pursuing the Surgical First Assistant functions, it is important to undertake a risk assessment. Risk assessment is carried out to establish the magnitude of risks likely to be encountered by the patient upon the presence of the SFA officer, and also an assessment o what is considered effective and appropriate for the health practitioner. It is crucial that the Surgical First Assistant develop mastery of awareness and understanding, of the following tenets;

First Perioperative Care Collaboration position statement, which aims at ensuring that they get to operate and behave within the boundaries, set by the health organization. The master of such concepts will submit unto them the limits between which they should operate within.

Secondly is the insurance and indemnity requirement for the purposes of personal care.

Thirdly, is the understanding on evidence-based practice as a safe methodology to decision making processes founded on the threshold of realistic research, current pieces of information available from concrete sources which can therefore back up the practice?

Fourthly, is the premise that vicarious liability is questionable to other actions?

Fifth, there ought to be enough preparation and formulation of SFA working hours to ascertain there are effective capacities of staffing in the operation room so as to ensure there no irrelevant help accrued from the SFA.

1.3 Legal Issues

In the quest to grasp the various legal issues linked with the roles of the Surgical First Assistant, it is mandatory that we are able to pinpoint out the distinctions between criminal and civil law. For the purpose of this presentation, the two concepts are distinguished on the premise of their definitions as follows; Criminal law refers to the breach of criminal law, whereby an individual gets convicted n the criminal law courts. In a more precise term, criminal law refers to a subset of law geared to punish off its breakers. In that in its finest nature, it is a law tailored to punish individuals who contravene its doctrines. In the context of healthcare, criminal law is applied in scenarios where there are deliberate inductions of harm to patients, which is therefore punishable accordingly. On the other hand, civil law is a set of laws which spells and safeguard the basic and private rights of citizens. Such laws equally provide for remedies to restore disputes; and such law can provide a definition and order on matters related to contracts, torts, property, and families. The essence of civil law is also to look at the different rights and responsibilities which people have with each other in a particular setting. These rights and responsibilities in Surgical First Assistant are established by the Perioperative Care Collaborative statement of the role.

Key principles of relevant civil and criminal law underpinning SFA practice

According to the Royal College of Surgeons, doctors are encouraged not to operate on mere assumptions while administering prescriptions to patients; but instead, conduct rigorous tests which seek to identify patients’ particular needs. They should be guided by solid procedures is dement while identifying their patient's needs, and strive to initiate relevant therapies for positive outcomes (Wong, 2013).

1.4 Principles of Consent

Consent refers to the permission granted for something to be done, or consensus to do something. In the context of healthcare, consent is an overall ethical and legal principle which must be validated before the commencement of treatment, or physical examination; or provision of healthcare. The principle of concept focuses to safeguard the patients’ rights of determining that which should befall their bodies. Considering the fact that the principle strengthens the patients’ autonomy, it is therefore essential to good healthcare practices. According to the Nursing and Midwifery Council (NMC) nurses are supposed to make sure that they acquire an effectively informed consent before propagating any action upon the patient. The registered nurses who will fall victims of disobeying the principle are prone to legal action

The principles of informed consent

The demand to obtain consent is based on two main reasons. The first reason is for legal purposes, while the second reason is for clinical purposes. According to the legal premise, the intent is to offer the caregivers a defence mechanism from any possible criminal charge or assault or any other possible innuendos made against the person in question. Alternatively, clinical reasons intend to permit the caregiver a warrant to move forth with the conduction of health check-ups or treatments.

Types of consent appropriate to clinical practice

Implied consent

Implies consent arise in the occasions where it is assumed that consent was guaranteed through the mannerisms under which an individual act. Thus, even if a patient has not consented either verbally or orally, the existing situations gives a vivid impression and reason that grant the healthcare giver a point to believe that the patient is inclined towards giving the consent.

Expressed consent

Expressed consent refers to the consent or permission allowed for a particular issue, which is given in form of either written or verbal. This form of consent is a direct contrast of implied consent which is basically deduced through the interpretation of a person’s actions.

Informed consent

Informed consent refers to the process applied to acquire permission prior to conducting a healthcare examination on a patient; or for disclosing individual and private information. The health practitioner gets to interrogate and ask the patient’s permission towards a particular therapy the health care professional intends to give to the patient. Informed consent is acquired based on the established frameworks in the relevant domains; such as medical and research ethics. ‘ Additionally, informed consent is said to be rendered if it is built on a vivid appreciation and comprehending of the existing frameworks, procedures, facts, and repercussions of an action. Informed consent is thus founded on the tenets of respect to the patient’s dignity and autonomy.

Written consent

This refers to a type of consent that is propagated on the lines of written and signed agreements as witnessed by the parties involved, who may at times sign on behalf of the patient. Once this consent is rendered, a health practitioner gets the permission to conduct the examination and therapeutic-aimed practices on the patient. This form of consent is solely inclined towards signatures on a paper as a form of approval to the consent given.

1.5 Ethical Issues

As important players in the health sector, it is important that we uphold senses of respect to our clients, home we are called to serve diligently. To uphold the integrity of the health domain and practice; it is important we abide by the laid foundations governing of codes of conduct and protect our patents while respecting their affective and cognitive aspects. Ethics refers to an agglomeration of moral tenets, and principles which guide a particular practice. (Quick, 2013);

Autonomy

Autonomy constitutes the basic frameworks in clinical practice. Autonomy refers to the ability to be independent-minded in one’s course of duty. It means being able to work without external influences, such that as a caregiver you are able to make sound decisions on your own; for the betterment of patients’ conditions. Additionally, autonomy may also encompass respecting the patient’s mind and perception; as so engaging them in the therapeutic courses. As health practitioners, to effectively respect our clients must respect their stories and perspectives; for this might also form a basis for drawing meaningful pieces of information towards correct prescriptions.

Beneficence

This is referred to the drive to act for the good of others. Beneficence is yet another vital ethic that governs the practice of any sectored affiliations. In that; everyone should be intrinsically motivated to work towards benefiting the ones he/she serves while protecting their rights and privileges. The health practitioners are required to prevent and alleviate any possible threats, or harms that may endanger their clients. The health professionals also need to take responsibility in ensuring no harm is induced by laying foundations to best treatments. The principle of non-maleficence is also important in the healthcare practice, whereby the least possible harm is inflicted to patients while journeying to beneficial health. Harm and its constituent impacts on the patient is an integral part of ethical decision-making process in any particular health practice. Both long-term and short-term harm are granted attention before any particular prescription is rendered.

Professional development plan

Continuous professional development and growth are critical to the area of SFA as it integrates the new skills required in the profession. Developing and updating your professional competencies is important because it keeping relevant and able to adapt to the demands of the office and profession which is always dynamic with technological needs.

Clinical audit

Clinical audit refers to the process by which quality is assured through improvements on the patient care sector and processes within the healthcare domain, as induced by the various structured and systematic review of care to bring about positive change. Clinical audit encompasses the change of irrelevant structures that are deemed outdated while replacing them with new practices.

Research

Research is the most indispensable aspect of any healthcare sector. The essence of the clinical care is built on the basis of constant research that should always be propagated to establish solutions to the patients’ needs. As the world is prone to any ailments, so should there be a relentless need or research as a form of remedy to treat such diseases. Research should be an integral part in any health organization, and therefore such organizations should find a need to highly invest in research, for it is an instrument for finding new cures to the already existing diseases and the newly introduced.

Dissemination of practice

Dissemination of practice entails the attributes or characteristics of possessing the noble mastery of understandings on different aspects related to healthcare practices. Such an understanding gives one the confidence and ability to communicate properly the research finding for the benefit of the organization’s stakeholders for the general betterment of and healthcare practices.

References

Nursing and midwifery council, 2015.The code standards of practice and behavior for nurses and midwives. London: NMC

Quick, J., 2013. The role of the surgical care practitioner within the surgical team. British Journal of Nursing, 22(13), pp.759-765.

Wong, D.H., 2013. Discovering the Right to Criminal Disclosure-Lessons from Civil Procedure. SAcLJ, 25, p.548.

2. Surgical and Clinical Skills Acquisition

2.1 Preparation of the Surgical Patient in Theatre

The importance of the WHO Surgical Safety Checklist

The World Health Organization’s central role is to orient the health and research agenda to monitor and assess trends in the health sector. The organization equally is responsible for setting standards and norms guiding the healthcare practice. The World Health Organization’s main influence on operating departmental practice is the surgical safety checklist. Various worldwide and regional initiatives have been laid to inspire patient safety in the pre-operative state. The checklist is made up of five stages that conducts studies before the application of anaesthesia, skin incisions, and before the patient is released from the theatre. The first three stages are geared to brief the surgical team prior to the commencement of an operation. The last two stages are intended to discuss the presence of emerging issues if indeed there are any. At every stage; the checklist facilitator ought to check in line with the surgical team and ensure that all activities within the stages are completed to ascertain patients’ safety is ensured. The following are the major stages (Sroka et al., 2010);

Sign in which lies before the induction of anaesthesia.

Timeout which is done immediately after the patients are inducted with anaesthesia but yet before the actual surgery is propagated

Sign out which follows after the completion of surgery, but before the patient is set free from operation theatre.

Hair removal

The process of removing hair from the focal area is a normative activity before the actual conduction of surgery. The removal of hair is conducted on the premise that it will lead to reduced chances of contracting post-operative diseases after the surgery due. However, according to the guidelines National Institute of Health and Care Excellence; the removal of hairs is not always mandatory prior before surgery is done. The following are the common application types of hair removal (Sadideen, and Kneebone, 2012);

Shaving; this is done with the help of a blade to alleviate hairs along the area intended for surgery. Shaving may result in micro cuts on the skin surface; which eventually motivate the thriving of bacteria.

Clippers; this is the application of a shiver, having a disposable head which removes hair along the skin with minimal damages caused to the skin. Clippers are recommended shortly before the start of surgery, to minimize the chances of bacterial colonization on the skin surface.

Depilatory Cream; this is the case where hair removal cream is smeared on the skin to wash them away. This technicality may take around 20 minutes and is considered effective in not allowing colonization of bacteria. It is however costly and requires time, alongside causing irritations and skin inflammation to some allergic patients.

Preparation of the operative site for surgery

Sterile surgical drapes are applied during the surgery process to mitigate contacts with unintended surfaces such that sterility of the surgery environment is maintained. In the same course, surgical gowns are worn by the surgeons and other practitioners during the surgical proceedings to induce sterilized medical fields and reduce the chances of pathogen transmission to both the patients and surgical team

Correct draping and skin preparation techniques for surgical procedures

Surgical draping ensures that the environment where surgery is propagated is free from pathogens that may be inducing pre-operational diseases to both the surgery team and the patient. All drapes should be applied with a high observation of hygiene conditions. The aseptic non-touch method can be harnessed to achieve such high hygiene status while covering the non-prepped points.

2.2 Positioning the Surgical Patient

Various positions are advocated for depending on the body area where the surgeon is operating. During robotic surgery, positions such as supine, lithotomy, Trendelenburg and lateral flank are utilized. Every position constitutes of its own implications concerning the body’s ability to effectively allow smooth posture for surgery.

Potential problems associated with positioning patients

Patient positioning has the capacity to affect circulation, hemodynamic, and ventilation of different body mechanisms, which may consequently affect the peripheral nerve endings and pressure-related impacts such as numbness, paraesthesia, and compartment syndrome. Perioperative assessments and cautious attention ought to be rendered to identify which is the best position that can yield positive outcomes concerning the context at hand.

2.3 Handling of Surgical Instruments

Proper handling of surgical instruments is yet another key area of significance in any sector. The guiding principle is laid on a firm foundation which suggests that all staff will make sure that the instrument used to propagate surgery should be handled with optimal safety to reduce self-induced accidental injuries or patients. Additionally, the principle suggests that all surgical instruments should be thoroughly checked before they get to be used in surgery. This can be done by sterilizing the equipment intended to be used. To optimize the levels of equipment security free from contaminations, the following methods can boost such efforts;

Training of all staff embeds in various ways and methodologies for handling safety equipment. The health sector like any other is prone to scientific evolution in terms of technology. In view of this; there should be a regular training intended to update on new methods for sterilizing surgical equipment. Periodic and yet regular training keep on reminding the health practitioners on the need for safety both for them and those of their patients.

Secondly, training is focused on equipping the staff with the organization policy that governs sharp injuries and Accidental Exposure to Bodily Fluids: Guidance Management. Getting acquainted with the organizational policies on safety and handling of equipment is an eminent course line to address cases of mishaps from happening.

Thirdly, the scrub practitioner ought to countercheck every instrument before the actual hour of surgery. The scrub practitioner should redirect efforts to ascertain that there are no missing links such as screws for the surgery to run down smoothly.

Moreover, sharp objects ought to be properly managed in a receptacle, for instance, a receiver to suppress the chances of accidental risk occurrences. Risks related to sharp objects cuttings may contribute to other emerging issues that could compromise on an accurate treatment regimen of a patient at hand. The surgical instruments are required to be kept as clean as possible. For instance, a swab is appropriate in wiping excessive blood and other body fluids from them. Touching the tips of working equipment during the surgery process should be avoided as much as possible. The equipment having ring handles should get held using the shank while the handles face downwards, and be placed on the surgeon’ hand palm lest specified otherwise by the surgeon. Diathermy tools must always be stored in an insulated receptacle; for instance, a quiver especially when the tools are not in application. This essence is meant to cut shot chances of risks occurrences. Scratchpads are utilized in cleaning the edges of monopolar diathermy, so as to make sure there are good contacts between the bleeding vessels and also to avoid sticking. Notably, it is recommendable that scratch pads are not used with bipolar forceps since they are known to alleviate the non-stick characteristic and therefore leave the equipment with no use.

2.4 Assisting with Surgical Haemostasis

Haemostasis refers to the process and mechanism by which blood stops oozing out from an injured vessel. The concept of haemostasis is deemed an alternative therapy practice that can bring ailment situation to normalcy. It is important to reduce or mitigate blood loss to maintain the vital physiological processes in the patient’s body. Prevention of blood loss is also important because it induces an operation field that is clearer. Managing unexpected or uncontrollable blood bleeding from a body tissue is a basic skill in the health profession. Primary bleeding can occur during a surgical process, or as a result of non-iatrogenic traumatic injury. Bleeding prior to the conduction of surgery is considered as reactionary is it happens within 48 hours. Bleeding beyond 48 hours is classified as secondary after quite some days. Mastery of facts and principles underpinning haemostasis and operative surgery are important tenets that inform the surgeon with the relevant position to manage all eventualities ranging from minute bleed to a more complex haemorrhage.

Methods for surgical haemostasis:

Swabs

The use of swabs is one of the most effective ways of handling haemostasis. In its basic form, a swab utilizes various ways to curb haemostasis. Their most common approach is that they suck up blood to make better the surgeon’s view of the area of operation. In making clear the view, the surgeon gets to see where the blood is originating from. Additionally, swabs equally make use of direct pressure to areas of bleeding and also as a tamponade by getting packed into the bleeding point.

Suction

This approach resembles swabs in the sense that it improves the visibility of wound point or centre of surgical operation.

Application of pressure

The application of direct pressure as induced y the surgeon’s compression using the thumb finger onto the area of bleeding may be one of the foremost option available in the surgery room. It is deemed the most reliable method in terms of availability and speed at which it can be propagated on the patient’s scholarly studies and empirical experiments have demonstrated that arterial bleeding is effectively managed and curbed through the exertion of mild pressure directly from the source. Maintaining pressure for about few seconds (15-20) will induce a sort of blood clot at the ends of the blood vessels. In cases where a main vein or artery is hurt, direct pressure should be applied until the distal and proximal ends of the blood vessels are litigated or controlled.

Pharmacological agents

Pharmacological agents refer to the utilization of collagen-related products that are put on the bleeding site to reduce the outflow of blood from the area. The collagen products are known to inspire and activate the blood clotting process which consequently slower the rate at which bleeding takes place, and fastens the healing process of wounds. The application of pharmacological agents lies on the decision of the surgeon’s experience or preference, and if they are readily available in the surgery context.

Surgical haemostasis

Managing haemostasis during a surgical exercise assists in maintaining a vivid view or vision on the area where an operation is executed by the surgeon. Managing blood loss can also cut short the need for blood transfusion as caused by excessive blood loss. As a matter of fact, reduced needs for blood transfusion will consequently reduce the length of period the patient stays in hospital but also reduces the chance of contracting infections and postoperative complications. All these rationales and advantages amount to decreased healthcare budget for patients and healthcare facilities.

Correct use of electrosurgery devices

Electrosurgery refers to the application of high-frequency electrical current and alternating polarity to living tissue as a mannerism to cut, desiccate, coagulate or fulgurate tissue. The primary aim of electrosurgery devices is to create a bloodless spot in an area where surgery is being done (Goh et al., 2012). There are two main types of techniques used in electrosurgery namely, monopolar and bipolar techniques. The two are almost similar, but there is one fundamental distinction between the two. In monopolar electrosurgery; a probe electrode is induced to enact electrosurgical power to the intended area. In bipolar technique; a bipolar gadget, for instance, a set of forceps is harnessed to induce the required effect.

2.5 Male and Female Catheterisation

A safe procedure for urinary catheterisation in both male and female patients

Urethral catheterization constitutes one of the clinical skills which are regularly conducted in healthcare practice. The process is deemed risk-free, and is conducted under the following occasions; when there is a need to monitor the urinary output of surgical patients, to capacitate the bladder functional tests when introducing cytotoxic therapies, and when there is a need to empty the bladder after or before giving birth in women (Levinson, Lesser, and Epstein, 2010).

Indications and contraindications for bladder catheterization

The contraindications of catheterization include (Katsumi et al., 2010);

Pelvic trauma

Urinary tract trauma

Suspected urinary tract infection

2.6 Minimal Access Surgery (MAS) - Camera Operating Skills

Minimal Access Surgery is the application of video camera or thin and minute instruments into the body through small incisions as an aid to surgery. The endovision; or camera applied is used to visualize the whole body area of the application while assisting the surgeon to conduct surgery while looking at the computer screen. In view of this technique; therefore the camera resumes the role of a surgeon's eyes. During the process, the surgeon is advised to hold the camera by himself or herself to prevent obstruction by any other holder. The additional holder should only assist in stabilizing additional laparoscopic equipment for retracting. The following considerations are important during the application of Minimal Access Surgery; The camera holder should make sure the camera is correctly positioned at the beginning to guarantee themselves comfort and wellbeing. The Surgical First Assistant should be inquisitive to ask on related issues such as how to improve the visibility and improve the whole process. The surgeon should be positioned at an angle where he/she catches a clear view. The surgeon should remind the camera holder about their roles and contextual functions in the theatre room. Prior to the start of surgery, the surgeon with the camera holder should build up mutual directional commands geared to ensure the camera gets perform effectively.

References

Goh, A.C., Goldfarb, D.W., Sander, J.C., Miles, B.J. and Dunkin, B.J., 2012. Global evaluative assessment of robotic skills: validation of a clinical assessment tool to measure robotic surgical skills. The Journal of urology, 187(1), pp.247-252.

Katsumi, H.K., Kalisvaart, J.F., Ronningen, L.D. and Hovey, R.M., 2010. Urethral versus suprapubic catheter: choosing the best bladder management for male spinal cord injury patients with indwelling catheters. Spinal cord, 48(4), p.325.

Sadideen, H. and Kneebone, R., 2012. Practical skills teaching in contemporary surgical education: how can educational theory be applied to promote effective learning?. The American Journal of Surgery, 204(3), pp.396-401.

Sroka, G., Feldman, L.S., Vassiliou, M.C., Kaneva, P.A., Fayez, R. and Fried, G.M., 2010. Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room—a randomized controlled trial. The American journal of surgery, 199(1), pp.115-120.

3. Enhancing Communication

3.1 Communication Skills

Communication refers to the process by which human beings interact with each other resulting in the construction of relationships or maintaining the existing ones. Additionally, it is the process by which information is shared verbally or in written form using a particular medium. Effective communication is essential in the context of healthcare. Since it helps to obtain necessary information for the surgery team before and after the surgery is done. Proper communication also helps to establish a rapport between the patients and the healthcare practitioners, which consequently build trust between each other; hence improving the overall experiences after and before the therapies are initiated (Kurtz, Draper, and Silverman, 2016).

Factors required for effective communication and barriers to effective communication

For effective communication to take the course, the involved participants must develop a positive attitude toward each other. There should be mutual respect for each other’s perceptions and listen to each other’s sentiments. Additionally, listening skills are important in the establishment of an effective communication platform. The barrier s to effective communication comprises of factors such as noise, wearing of masks that hampers the ability to project voices, stress and psychological torments; an inferiority complex. Wounds are defined as injuries induced causing breakage on the tissue part of an organ. Wounds can be categorized based on a number of various incidents by which they cause; such as incision, burns, abrasion, tears, or punctures. Additionally, the can be categorized based on how they undergo the healing process; such that we have the primary intention, tertiary intention, and secondary intention. Moreover, wounds are classified on the basis of the duration which they consume to heal, which brings forth chronic, acute and postoperative wounds.

3.2 Patient/Practitioner Relationship

Factors that contribute to establishing a patient/practitioner relationship

In the practice of healthcare, it is recommended that patients are given the rights to contribute actively in medical processes. There are various factors which exemplify and establish the relationship between patients and practitioners; which are; the practitioner’s attitude towards the patient, the patient’s attitude towards the practitioner, time, and other medical practitioners’ attitudes.

Establishing a patient/practitioner relationship in preoperative assessment and postoperative care

Preoperative analysis is conducted prior to the culmination of surgical exercises, where as postoperative care is provided after surgery is completed. In healthcare processes, preoperative assessments are done mainly to make sure patients are fit and legitimate to undergo surgery process. Preoperative assessment seeks to identify issues that need to be dealt with by the healthcare professional team. Postoperative assessments are done to monitor and repeatedly identify possible symptoms of surgical complications for an appropriate course of action.

3.3 Interprofessional Collaboration

Interprofessional collaboration between the surgical and perioperative teams

Cooperation and collaboration between surgical teams and perioperative teams is very essential especially in the achievement of positive surgical incomes. There should be a comprehensive communication strategy common and well understood to all in te the theatre room..

The correct use of WHO Surgical Safety Checklist and documentation as a member of a multidisciplinary team delivering safe surgery

The World Health Organization is an important body in ensuring health standards are achieved, internationally. The Surgical Safety Checklist and documentation helps the practitioners to record the patient’s information sequentially for easier future retrieval. The records should be clear, and legible. Prior to surgery; the surgeon ought to substantiate he/she is operating the correct patient by counterchecking the details.

References

Kurtz, S., Draper, J. and Silverman, J., 2016. Skills for communicating with patients. CRC Press.

Levinson, W., Lesser, C.S. and Epstein, R.M., 2010. Developing physician communication skills for patient-centered care. Health affairs, 29(7), pp.1310-1318.

Silverman, J., Kurtz, S. and Draper, J., 2016. Teaching and learning communication skills in medicine. CRC press.

4. Wound Care

4.1 Physiology of Wound Healing

Factors that contribute to re-establishing the integrity of surgical wounds

The physiological essence of wound healing is founded on the basis of four stages; which are haemostasis, inflammatory, proliferation, and maturation. Haemostasis is the initial stage that encompasses blood clotting, immediately after the injury. In this phase; the platelets get in contact with collagen on the skin surface leading to activation and aggradation. Thrombin enzyme is the key player here, which activates the formation of fibrin mesh that makes stronger the platelet clumps into a stable clot (Knowles et al., 2010). Inflammatory phase focuses on killing bacteria and alleviating debris, which lay the foundation for the growth of new tissues. Proliferative phase is important because it involves the filling and covering of the wound. Maturation stage is where the newly formed tissues obtain flexibility and strength.

4.2 Principles of Wound/ Cavity Drainage

Drain systems are typical components of the postoperative surgical management which intend to remove traces of drainage from a wound bed, to minimize chances of infections or unnecessary delays in healing. The conduction of surgical drains should adhere to lots of hygienically consideration and principles such as observance of hand hygiene, introducing you to the patient, listening and attending to patient’s cues, ascertaining the patient’s confidentiality and privacy are maintained, and confirmation of patient’s ID with the help of many patient identifiers.

Factors that initiate the use of surgical drains, and packs

Wound packing and irrigation refer to the induction of a fluid to a wound with an aim of exuding, bacterial contaminants or necrotic debris; to create favorable conditions suitable for tissue nourishment. Any kind of wound characterized by a cavity or a sinus requires irrigation and packing.

Factors that contribute to developing a positive tissue viability outcome

There are various factors which fasten the healing process of wounds. In a more generalized view, the factors which cause fast healing are grouped into local and systemic. Local factors are those which affects the properties of the wound whereas systemic factors are those which that revolve around the general health conditions of a patient. Examples of local factors include oxygenation, venous, infections and foreign bodies. Systemic factors are such as age and sex, stress, sex hormones, alcoholism and smoking, and obesity.

Physiological interaction to a variety of wound

The careful management of wounds is important because it accelerates the healing process while discouraging the colonization of bacteria. Surface dressing can be applied using ointments such as petroleum jelly to limit the growth of bacteria. The specialist dressing is recommended in case of chronic wounds such as leg ulcers or surgical wound healings.

4.3 Surgical Dressing

Surgical dressing refers to the application of a sterile pad to a wound with an intention to accelerate healing and safeguard the wound from further escalations.

Factors that contribute to developing a positive tissue viability outcome

There are various factors contributing to positive tissue viability; moisture imbalance, infections or inflammation, presence of foreign pathogens, stress and emotional torture, medications, sex and age, alcoholism and nutrition.

The appropriate physiological interaction to a variety of wound dressings

Surface dressings

Surface draining is instrumental because it provides for a faster mechanism for stopping the intensification of wounds. Surface dressing is typically applied in less serious wounds. It also leads to prevention of bacteria growth, which prevents the impending rise in prices.

Specialist dressings

Specialized dressing is propagated by an expert, and is characterized by more complex and serious injuries. Such wound may come as a result of postoperative a damage which then induces huge spaces in the name of wounds, which ought to be managed for the betterment of healing process.

References

Gantwerker, E.A. and Hom, D.B., 2012. Skin: histology and physiology of wound healing. Clinics in plastic surgery, 39(1), pp.85-97.

Guo, S.A. and DiPietro, L.A., 2010. Factors affecting wound healing. Journal of dental research, 89(3), pp.219-229.

Knowles, C.H., De Giorgio, R., Kapur, R.P., Bruder, E., Farrugia, G., Geboes, K., Lindberg, G., Martin, J.E., Meier-Ruge, W.A., Milla, P.J. and Smith, V.V., 2010. The London Classification of gastrointestinal neuromuscular pathology: report on behalf of the Gastro 2009 International Working Group. Gut, 59(7), pp.882-887.

5. Introduction to Microbiology

5.1 Normal Flora

Normal flora is vital to our immune systems due to different reasons. First, normal flora supports the innate immunity and improves its ability to defend the body against foreign disease-causing pathogens. The introduction and exposure to pathogens at times is essential because it helps in the adaptability and ability of the body to induce immunity to fight the future introduction of such pathogens (Høiby et al., 2010). Normal flora can be situated along different body parts, such as the skin, the groin, the respiratory pathway, digestive tract, and the urinary tract. The human body is deemed as a host of many normal flora bacteria, but they do not colonize the areas around the brain.

5.2 Preventing Wound Contamination

The need to prevent wound contamination is important because it accelerates the healing process and spells away invasion of bacteria into the region. Various methods are applied to prevent contamination from endogenous and exogenous environments. In endogenous infections a person is infected with our own bacteria especially when the non-sterile and sterile tissues are broke, allowing the free movement of pathogens. Exogenous infections are induced from outside our bodies, through getting in contact with an infected object or a vector (Murray, Rosenthal, and Pfaller, 2015).

References

Høiby, N., Ciofu, O., Johansen, H.K., Song, Z.J., Moser, C. 2011. The clinical impact of bacterial biofilms. International journal of oral science, 3(2), p.55.

Murray, P.R., Rosenthal, K.S. and Pfaller, M.A., 2015. Medical microbiology. Elsevier Health Sciences.

6: Introduction to Pathology

6.1 Basic Aetiological Classifications of Disease

Clinical pathology is a branch of health practice which deals in the diagnosis of diseases with the consideration of laboratory examination of fluids such as urine and blood as well as tissues with the help of chemistry tools haematology and clinical microbiology (Rose, 2014). In view of etiological diseases, the following groups of diseases are deduced namely; inherited, congenital, familial, infectious, congenital, traumatic, nutritional’ traumatic, degenerative, toxic, idiopathic, metabolic and iatrogenic diseases. Inherited diseases are acquired through hereditary through an individual’s DNA during birth. Congenital refers to the diseases which one was born with which may or may not be inherited. Toxic diseases are those caused due to the concentration of too many substances in the body. Infections are caused by microorganisms which are able to possess a genetic component. Degenerative diseases are caused as a result of tissue disintegration probably due to aging idiopathic have no known causative agents. Iatrogenic is induced in the process of trying to treat a certain condition. Neoplastic are diseases that result in tissue formation.

6.2 Disorders of Tissue Growth

Abnormal tissue growth constitutes of a wide array of conditions ranging from absolute absence of developing tissues (agenesis) to unregulated cells growth (neoplasia) (Ilizarov, 2012).

The basic relationship between microscopic histopathology and clinical effects

Histopathology is the branch of knowledge that seeks to study the body issue for the identification of possible causal factors. Histopathological scrutiny of body tissues commence with biopsy, surgery and autopsy.

Definition and differences between the following basic disorders of tissue growth:

Non-neoplastic changes; refer to diseases or conditions that are not induced by neoplasms.

Neoplastic growths; A neoplasm is a sort of excessive and abnormal growth of mass of tissues; commonly known as, neoplasia. The excessive growth of such a tissue is uncoordinated with normal surrounding tissue and might increasingly insist growing.

Carcinogenesis; Carcinogenesis refers to the process by which normal body cells are changed to become cancer cells.

6.3 Handling of Tissue Specimens

Fresh tissues are highly fragile and prone to autolysis and therefore which begs for careful handling. The tissues ought to be taken for electron microscopy. It is necessary to keep the tissue moist to prevent them from drying up. During the process of cutting the tissues, the blades should be changed frequently to avoid distortion of cells (Rose, 2014). During the surgery process, the surgeon should observe intense care and respect for the tissues, based on the fact that the loss of tissues can bring tragic impacts both to the patient and the surgeon.

References

Ilizarov, G.A., 2012. Transosseous osteosynthesis: theoretical and clinical aspects of the regeneration and growth of tissue. Springer Science & Business Media.

Rose, A.H., 2014. Chemical microbiology: an introduction to microbial physiology. Elsevier.