Download Chapter 8 PPT

Chapter 3: Patient Care: Medical
and Surgical
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Medical Assistants (cont’d)
• Course Work
–
Patient relations
–
Clinical & diagnostic
procedures
–
Laboratory techniques
–
Administration of
medications
–
Anatomy & physiology
–
Medical terminology
–
Typing & transcription
–
Computer applications
–
Office practices
–
Pharmacology
–
Insurance processing
–
First aid
–
Recordkeeping &
accounting
–
Medical law & ethics
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Medical Assistants (cont’d)
• Professional Organizations
–
American Association of Medical Assistants (AAMA)
–
American Medical Technologists (AMT)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Surgical Technologists (cont’d)
• Course Work
–
Surgical procedures
–
Anatomy & physiology
–
Patient care & safety
–
Medical terminology
–
–
Microbiology
Legal, moral, & ethical
issues
–
Pharmacology
–
Communication skills
–
Physical environment &
safety standards
–
Skills for professional
behavior
–
Sterile techniques
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Surgical Technologists (cont’d)
• Personal Characteristics
–
Accurate listening
–
Strong sense of
responsibility
–
Ability to work well with
others
–
Conscientiousness about
work
–
Calmness during stressful
conditions
–
Organizational skills
–
Manual dexterity
–
Attention to details
–
Good physical condition
–
Accuracy & precision
–
Initiative
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Physician Assistants (cont’d)
• Course Work
–
Biochemistry
–
Pathology
–
Anatomy
–
Physiology
–
Microbiology
–
Pharmacology
–
Physical diagnosis
–
Clinical medicine
–
Geriatric & home health
care
–
Disease prevention
–
Medical ethics
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Physician Assistants (cont’d)
• Work Responsibilities
–
Treating patients’ diseases
–
Prescribing some
medications
–
Ordering & analyzing
–
Taking medical histories
–
Physical exams
–
Interviewing & examining
patients
–
Diagnosing diseases
• X-rays
–
Discussing diagnoses with
patients
• EKGs
• Lab tests
–
Treating minor injuries
• Applying splints
• Applying casts
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Physician Assistants (cont’d)
• Personal Characteristics
–
Diligence
–
Self-discipline
–
Level-headedness
–
Good judgment
–
Interpersonal skills
–
Communication skills
–
Integrity
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Physician Assistants (cont’d)
• Professional Organization
–
American Academy of Physician Assistants (AAPA)
–
Offers:
• Annual conference
• Networking opportunities
• Recognition
• Scholarships
• Continuing education
• Journal & other publications
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
EMTs/Paramedics (cont’d)
• Work Responsibilities
–
Start an IV
–
Recognize hazards
–
Run & read an EKG
–
Assess patient’s breathing
–
–
Do rapid trauma
assessment
Attach a cardiac monitor &
a pulse oximeter
–
Insert an artificial airway
–
Provide oxygen by mask
–
Stabilize impaled objects
–
Suction an airway
–
–
Use an AED
Administer certain
medications
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins