1. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 3: Patient Care: Medical and Surgical

2. 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

3. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Assistants (cont’d) History of the Profession –Early 20 th 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

4. 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

5. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Assistants (cont’d) Course Work –Anatomy & physiology –Medical terminology –Typing & transcription –Computer applications –Office practices –Insurance processing –Recordkeeping & accounting –Patient relations –Clinical & diagnostic procedures –Laboratory techniques –Administration of medications –Pharmacology –First aid –Medical law & ethics

6. 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

7. 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

8. 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

9. 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

10. 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

11. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Assistants (cont’d) Professional Organizations –American Association of Medical Assistants (AAMA) –American Medical Technologists (AMT)

12. 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

13. 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

14. 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

15. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Surgical Technologists (cont’d) Course Work –Anatomy & physiology –Medical terminology –Microbiology –Pharmacology –Physical environment & safety standards –Sterile techniques –Surgical procedures –Patient care & safety –Legal, moral, & ethical issues –Communication skills –Skills for professional behavior

16. 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

17. 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

18. 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

19. 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

20. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Surgical Technologists (cont’d) Personal Characteristics –Strong sense of responsibility –Conscientiousness about work –Organizational skills –Attention to details –Accuracy & precision –Initiative –Accurate listening –Ability to work well with others –Calmness during stressful conditions –Manual dexterity –Good physical condition

21. 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

22. 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

23. 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.

24. 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

25. 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

26. 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

27. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Physician Assistants (cont’d) Work Responsibilities –Taking medical histories –Physical exams –Interviewing & examining patients –Diagnosing diseases –Discussing diagnoses with patients –Treating patients’ diseases –Prescribing some medications –Ordering & analyzing Lab tests X-rays EKGs –Treating minor injuries Applying splints Applying casts

28. 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

29. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Physician Assistants (cont’d) Employment Opportunities and Trends –7 th -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

30. 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

31. 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

32. 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

33. 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.

34. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins EMTs/Paramedics (cont’d) Work Responsibilities –Recognize hazards –Assess patient’s breathing –Do rapid trauma assessment –Provide oxygen by mask –Suction an airway –Use an AED –Start an IV –Run & read an EKG –Attach a cardiac monitor & a pulse oximeter –Insert an artificial airway –Stabilize impaled objects –Administer certain medications

35. 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

36. 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

37. 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