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2. Setting The Scene Risks including the dual role
Your own accountability
5. Have I failed in my duty of care to the patient?
6. The main issues of concern include: Clarification on the role and definition of the First assistant
Legal implications of the Dual role/accountability
Competencies for a First assistant
Availability and access to validated training
Formulation of a local policy to support first assisting within the operating theatre
Job description / specification and clinical grading
Professional Indemnity insurance required
How to implement the role effectively.
7. The Perioperative Care Collaborative September 2003Position Statement
8. POSITION STATEMENT ON THE ROLE OF THE FIRST ASSISTANT (ADVANCED SCRUB PRACTITIONER) IN THE INDEPENDENT SECTOR(August 2003)
9. Definition: Advanced Scrub Practitioner
10. ?A Surgical Practitioner/Assistant is a Perioperative practitioner working both in and out of the operating room, who undertakes specified surgical intervention, either under direct, indirect or proximal supervision?. NASSP 2002
11. Advanced Scrub Practitioner Specification Enhancing communication link between theatre, patient and ward including pre-operative assessment and post- operative care evaluation.
Assisting with patients positioning including tissue viability assessment
Skin preparation prior to surgery
Skin and tissue retraction
Handling of tissue and manipulation of organs for exposure or access
12. Advanced Scrub Practitioner Specification Cutting of sutures and ties
Assisting with haemostasis in order to secure and maintain a clear operating field.
Use of suction
Indirect application of electro-cautery under supervision
Camera holding for minimal invasive access surgery
Use and maintenance of specialised surgical equipment relevant to area of working
Assistance with wound closure
Application of dressing
Transfer of patient to Post Anaesthetic Care Unit
13. The Dual Role
14. Captain of the Ship Doctrine?
15. So what is my key message to you?
16. Pace yourselves for this role
18. Accountability 6.2 To practice competently, you must possess the knowledge, skills and abilities required for lawful, safe and effective practice without direct supervision. You must acknowledge the limits of your professional competence and only undertake practice and accept responsibilities for those activities in which you are competent
NMC Code of Professional Conduct June 2002
19. Competency -How do you achieve this? Greenwich University
John Moores University
20. Employers Responsibility Job Description
21. Strategic Planning