SGT 222 SURGICAL PROCEDURES

SGT 222 SURGICAL PROCEDURES PRESENTED AND APPROVED: AUGUST 9, 2012 EFFECTIVE: FALL 2012-13

Prefix & Number SGT 222 Course Title: Surgical Procedures Purpose of this submission: New Change/Updated Retire If this is a change, what is being changed? Update Prefix Course Description (Check all that apply): Course package has been Title Course Number updated. Program modification was approved on Format Change Credits November 4, 2011. Prerequisite Competencies Textbook/Reviewed Competencies-no changes needed Does this course require additional fees? No Yes If so, please explain. Program Fees Is there a similar course in the course bank? No Yes (Please identify) SGT 102 Articulation: Is this course or an equivalent offered at other two and four-year universities in Arizona? No Yes (Identify the college, subject, prefix, number and title: Is this course identified as a Writing Across the Curriculum course? No Yes Course Textbook, Materials and Equipment Textbook(s) Current edition Textbook(s) Title Surgical Technology for the Surgical Technologist: A Positive Care Approach, 2 nd ed. Author(s) Association of Surgical Technologists Publisher Delmar, 2004 ISBN 1-4018-3848-0 Software Title Alexander s Care of the Patient in Surgery, 12 th ed. Author(s) Meeker, Margaret H. and Rothrock, Jane C. Publisher Mosby Inc., 2003 ISBN 0-323-01622-7 Equipment Other Course Assessments Description of Possible Course Assessments (Essays, multiple choice, etc.) Exams standardized for this course? Midterm Final Other (Please specify): Where can faculty members locate or access the required standardized exams for this course? (Contact Person and Location) Example: NCK Academic Chair Office Multiple choice Are exams required by the department? No Yes If Yes, please specify: Student Outcomes: Identify the general education goals for student learning that is a component of this course.

Check all that apply: 1. Communicate effectively. a. Read and comprehend at a college level. b. Write effectively in a college setting. 2. Demonstrate effective quantitative reasoning and problem solving skills. Method of Assessment Function as a student surgical technologist in the hospital operating room Surgical preceptor and clinical instructor evaluations 3. Demonstrate effective qualitative reasoning skills. 4. Apply effective methods of inquiry. a. Generate research paper by gathering information from varied sources, analyzing data and organizing information into a coherent structure. b. Employ the scientific method. 5. Demonstrate sensitivity to diversity a. Experience the creative products of humanity. b. Describe alternate historical, cultural, global perspectives. Office of Instruction Use only: CIP Code: ONET Code: Minimum Qualifications:

COURSE INFORMATION Initiator: Dr. Robert Goodrich Date of proposal to Curriculum Sub-Committee: August 9, 2012 Effective Semester/Year Fall 2012 Spring Summer Prefix & Number: SGT 222 Full Title: (100 character limit) Surgical Procedures Short Title: (30 character limit) Surgical Procedures Catalog Course Description: This course is designed to provide the Surgical Technology student with introduction to surgical procedure and orientation in the role of primary scrub person on selected procedures. SUN Course Number: Credit Hours: 6 Lecture Hours: 4 Lab Hours: 6 Prerequisite(s) Acceptance into the program, completion of SGT 121, 122, BIO 205, BIO 201 and BIO 202. Co-requisite(s) SGT 221 and SGT 122L. Intended Course Goals By the end of the semester, students will be able to: 1. Define case classification. 2. Analyze difference between major and minor case. 3. List specific types of post-surgical complications, their prevention and treatment. 4. Identify cystoscope, endoscope, laparoscope, ureteroscope, and components and describe care, special procedure and safety precautions for each. 5. Assess abnormal lab values for the surgical patient pre-operative and intra-operative. 6. Incorporate the surgical patient lab values with pre-op, intra-op and post-op care. 7. Apply knowledge of basic surgical instrumentation to specific surgical procedures. 8. Analyze the relationship between instrument type and usage. 9. Plan methods of care, handling, and assembly of basic operating room furniture. 10. Identify the use of various supplies and accessory supplies in the operating room environment. 11. Identify the basic surgical interventions of surgical procedures including: anatomy, physiology, pathophysiology, diagnostic intervention, surgical intervention, equipment, instrumentation, procedural steps, counts, dressing material, specimen care, postoperative destination and patient care considerations, prognosis, complications, wound classification and management. Areas of surgical interventions to include: GI, Ortho, Gu, Gyn/OB, PV and Cv, Neuro, Thoracic, ENT/Eyes, and Endoscopy.

Course Competencies and Objectives By the end of the semester, students will be able to: Competency 1 The student will be able to define the types of diagnostic imaging, laboratory reports, electrodiagnostic studies, endoscopy, plethysmography and phleborheography. Objective 1.1 Apply knowledge of anatomy and physiology to determine which diagnostic examinations will be useful. Objective 1.2 Indicate the sources of patient data. Objective 1.3 Compare and contrast techniques used to establish the diagnosis. Objective 1.4 Determine which diagnostic procedures will require surgical intervention. Objective 1.5 Recognize the major indications for surgical intervention. Objective 1.6 Demonstrate knowledge of the surgical technologist s role in caring for each specific type of specimen. Competency 2 The student will be able to identify the internal and external components of female genitalia and organs and the various types of major and minor OB-GYN conditions, testing, surgical procedures and instruments, supplies and drugs used in treating them. Objective 2.1 Recognize the relevant anatomy and physiology of the female reproductive system. Objective 2.2 Summarize the pathology of the female reproductive system that prompts surgical intervention and the related terminology. Objective 2.3 Determine any special preoperative obstetric and gynecologic diagnostic procedures/tests. Objective 2.4 Define any special preoperative preparation procedures related to obstetric/gynecologic procedures. Objective 2.5 Delineate the names and uses of obstetric and gynecologic instruments, supplies, and drugs. Objective 2.6 List the names and uses of special equipment related to obstetric/gynecologic surgery. Competency 3 The student will be able to describe the composition of the abdominal cavity, general surgery instrumentation, the proper room setup, positioning, draping and incisions used in general surgery, common surgeries of abdominal organs and other commonly performed surgeries. Objective 3.1 Recognize the relevant anatomy and physiology of the abdominal wall, digestive system, hepatic and biliary system, pancreas, spleen, thyroid, and breast. Objective 3.2 Indicate the pathology and related terminology of each system or organ that prompts surgical intervention. Objective 3.3 Evaluate preoperative diagnostic procedures and tests. Objective 3.4 Classify special preoperative preparation procedures related to general surgery procedures. Objective 3.5 Describe the names and uses of general surgery instruments, supplies, and drugs. Objective 3.6 Define the names and uses of special equipment related to general surgery. Objective 3.7 Propose the intraoperative preparations of the patient specific to the illustrative procedures. Objective 3.8 Summarize the surgical steps of the illustrative general surgery procedures in this chapter. Objective 3.9 Identify the purpose and expected outcomes of the illustrative procedures. Competency 4 The student will be able to describe the anatomy of the ear, nose, upper digestive tract, thyroid and parathyroid glands, pathology affecting them, diagnostic procedures, tests and common surgical procedures. Objective 4.1 Recognize the relevant anatomy of the ear, nose, and upper aerodigestive tract. Objective 4.2 Summarize the pathology that prompts otorhinolaryngologic surgical intervention and the related terminology. Objective 4.3 Delineate any otorhinolaryngologic diagnostic procedures/tests. Objective 4.4 Describe any otorhinolaryngologic preoperative and intraoperative preparation procedures. Objective 4.5 List the names and uses of otorhinolaryngologic instruments, supplies, and drugs.

Objective 4.6 Explain the names and uses of special otorhinolaryngologic equipment. Objective 4.7 Summarize the surgical steps of the otorhinolaryngologic procedures. Objective 4.8 Interpret the purpose and expected outcomes of the otorhinolaryngologic procedures. Objective 4.9 Recognize the immediate postoperative care and possible complications of the otorhinolaryngologic procedures. Objective 4.10 Assess any specific variations related to the preoperative, intraoperative, and postoperative care of the otorhinolaryngologic patient. Objective 4.11 Describe the structure and function of the thyroid and parathyroid glands. Objective 4.12 Define some common symptoms and signs of both hyperthyroidism and hypothyroidism. Objective 4.13 Explain the proper procedures for positioning and preparing the patient for thyroid surgery. Competency 5 The student will be able to describe the anatomy of the oral cavity, face and cranium, pathology of the oral cavity, common types of facial fractures and cranial deformities, names and uses of various instruments used in oral and maxillofacial surgery and preparations for both pre-and post-surgery. Objective 5.1 Recognize the anatomy relevant to oral and maxillofacial surgery. Objective 5.2 Summarize the pathology that prompts oral and maxillofacial surgery and the related terminology. Objective 5.3 Define special preoperative diagnostic procedures/tests pertaining to oral and maxillofacial surgery. Objective 5.4 Determine special preoperative preparation procedures related to oral and maxillofacial surgery. Objective 5.5 Indicate the names and uses of oral and maxillofacial instruments, supplies, and drugs. Objective 5.6 Describe the names and uses of special equipment used for oral and maxillofacial surgery. Objective 5.7 Give details of the intraoperative preparations of the patient undergoing an oral or maxillofacial Objective 5.8 Summarize the surgical steps of oral or maxillofacial procedures. Objective 5.9 Interpret the purpose and expected outcomes of oral and maxillofacial procedures. Objective 5.10 Recognize the immediate postoperative care and possible complications of oral and maxillofacial procedures. Objective 5.11 Assess any specific variations related to the preoperative, intraoperative, and postoperative care of the oral and maxillofacial surgical patient. Competency 6 The student will be able to describe the skin and underlying structures and the basic anatomy of the nose, hand, palate, and breasts; some specific pathologies and various congenital deformities and the plastic surgeries necessary to correct them; common diseases and traumas affecting the hand; diagnostic procedures involved in plastic surgery and special instruments, drugs and equipment used in plastic surgery. Objective 6.1 Recognize the relevant anatomy and physiology of the skin and its underlying tissues. Objective 6.2 Summarize the pathology that prompts plastic/reconstructive surgical intervention and the related terminology. Objective 6.3 Describe any special preoperative plastic/reconstructive diagnostic procedures/tests. Objective 6.4 Definee any special preoperative preparation procedures related to plastic/reconstructive surgical procedures. Objective 6.5 Indicate the names and uses of plastic/reconstructive instruments, supplies, and drugs. Objective 6.6 Indicate the names and uses of special equipment related to plastic/reconstructive surgery. Objective 6.7 Outline the intraoperative preparation of the patient undergoing a plastic/reconstructive Objective 6.8 Summarize the surgical steps of the plastic/reconstructive procedures. Objective 6.9 Interpret the purpose and expected outcomes of the plastic/reconstructive procedures. Objective 6.10 Recognize the immediate postoperative care and possible complications of the plastic/reconstructive procedures. Objective 6.11 Assess any specific variations related to the preoperative, intraoperative, and postoperative care of the plastic/reconstructive patient.

Competency 7 The student will be able to describe the anatomy of the chest, operative pathology of the various components of the chest, diagnostic procedures for the thorax, heart, and lungs; special preoperative considerations, instrumentation, supplies, drugs, and equipment, and various common surgical procedures of the chest. Objective 7.1 Recognize the relevant anatomy of the cardiovascular and respiratory systems. Objective 7.2 Summarize the pathology that prompts cardiac or thoracic surgical intervention and the related terminology. Objective 7.3 Describe any special preoperative diagnostic procedures/tests for the patient undergoing cardiac or thoracic surgery. Objective 7.4 Define any special preoperative preparation procedures. Objective 7.5 Indicate the names and uses of cardiovascular and thoracic instruments, supplies, and drugs. Objective 7.6 Indicate the names and uses of special equipment for cardiac and thoracic procedures. Objective 7.7 Explain the intraoperative preparation of the patient undergoing a cardiac or thoracic Objective 7.8 Summarize the surgical steps of the cardiac and thoracic procedures, Objective 7.9 Interpret the purpose and expected outcomes of the cardiac and thoracic procedures. Objective 7.10 Recognize the immediate postoperative care and possible compolications of the cardiac and thoracic procedures. Objective 7.11 Assess any specific variations related to the preoperative, intraoperative, and postoperative care of the patient undergoing a cardiac or thoracic Competency 8 The student will be able to describe the basic anatomy of the peripheral vascular system, including the arterial and venous systems; operative pathology and diagnosis, instrumentation, supplies and sutures used in surgery, and procedures involved in common vascular surgeries. Objective 8.1 Recognize the relevant anatomy of the peripheral vascular system. Objective 8.2 Summarize the pathology that prompts surgical intervention of the peripheral vascular system and the related terminology. Objective 8.3 Describe any special preoperative peripheral vascular diagnostic procedures. Objective 8.4 Define any special preoperative preparation procedures. Objective 8.5 Indicate the names and uses of peripheral vascular instruments, supplies, and drugs. Objective 8.6 Indicate the names and uses of special equipment. Objective 8.7 Determine the intraoperative preparations of the patient undergoing the peripheral vascular procedures. Objective 8.8 Summarize the surgical steps of the peripheral vascular procedures. Objective 8.9 Interpret the purpose and expected outcomes of the peripheral vascular procedures. Competency 9 The student will be able to describe the anatomy of the musculoskeletal system, including the types of bones and joints, and some of the major pathological conditions that affect them as well as common surgical procedures employed to correct them. Objective 9.1 Recognize the relevant anatomy and physiology of the musculoskeletal system. Objective 9.2 Summarize the pathology of the musculoskeletal system that prompts surgical intervention and the related terminology. Objective 9.3 Determine any special preoperative orthopedic diagnostic procedures/tests. Objective 9.4 Describe any special preoperative preparation related to orthopedic procedures. Objective 9.5 Indicate the names and uses of orthopedic instruments, supplies, and drugs. Objective 9.6 Outline the names and uses of special equipment related to orthopedic procedures. Objective 9.7 Determine the intraoperative preparation of the patient undergoing an orthopedic Objective 9.8 Summarize the surgical steps of the orthopedic procedures. Objective 9.9 Interpret the purpose and expected outcomes of the orthopedic procedures. Objective 9.10 Recognize the immediate postoperative care and possible complications of the orthopedic procedures. Objective 9.11 Assess any specific variations related to the preoperative, intraoperative, and postoperative care of the orthopedic patient. Competency 10 The student will be able to describe the anatomy of the urinary system and male reproductive anatomy, pathology affecting the adrenal glands, urinary system, and male reproductive

system, diagnostic procedures and tests for disorders of the genitourinary tract, special equipment, instruments, supplies, and drugs used in genitourinary surgery, preoperative and intraoperative preparation and common surgical procedures. Objective 10.1 Recognize the relevant anatomy of the genitourinary system. Objective 10.2 Give examples of the pathology that prompts genitourinary system surgical intervention and the related terminology. Objective 10.3 Assess any special preoperative genitourinary diagnostic procedures/tests. Objective 10.4 Explain any special preoperative genitourinary preparation procedures. Objective 10.5 Indicate the names and uses of genitourinary instruments, supplies, and drugs. Objective 10.6 Delineate the names and uses of special genitourinary equipment. Objective 10.7 Determine the intraoperative preparation of the patient undergoing the genitourinary Objective 10.8 Summarize the steps of the genitourinary procedures. Objective 10.9 Explain the purpose and expected outcomes of the genitourinary procedures. Objective 10.10 Assess the immediate postoperative care and possible complications of the genitourinary Objective 10.11 Recognize any specific variations related to the preoperative, intraoperative, and postoperative care of the genitourinary patient. Competency 11 The student will be able to describe the anatomy of the eye, ophthalmic surgical pathology, ophthalmic medications and special considerations in ophthalmic surgery and various ophthalmic surgical procedures, surgical anatomy of the nose and sinuses, surgery preparations, instrumentation and equipment used in rhinologic and sinus surgery, and common rhinologic surgery procedures and methods. Objective 11.1 Recognize the anatomy of the eye. Objective 11.2 Summarize the pathology that prompts surgical intervention of the eye and related terminology. Objective 11.3 Outline any special preoperative ophthalmic diagnostic procedures/tests. Objective 11.4 Determine any special preoperative preparation procedures. Objective 11.5 Describe the names and uses of ophthalmic instruments, supplies, and drugs. Objective 11.6 Indicate the names and uses of special equipment. Objective 11.7 Define the intraoperative preparation of the patient undergoing an ophthalmic Objective 11.8 Summarize the surgical steps of ophthalmic procedures Objective 11.9 Interpret the purpose and expected outcomes of the ophthalmic Objective 11.10 Delineate the proper patient positioning for rhinologic and sinus surgery. Objective 11.11 Identify the most commonly utilized anesthesia procedures for rhinologic and sinus surgery. Competency 12 The student will be able to describe the divisions and anatomy and of the neurological system, some common pathologies that require neurosurgical surgery, special instrumentation, supplies, drugs and equipment used in neurosurgical surgery, patient preparation for cranial and spinal procedures, and some advances in neurosurgery such as laser and radio-surgery. Objective 12.1 Recognize the relevant anatomy and physiology of the neurological system. Objective 12.2 Summarize the pathology that prompts surgical intervention of the neurological system and the related terminology. Objective 12.3 Describe any special preoperative neurological diagnostic procedures/tests. Objective 12.4 Define any preoperative preparation procedures related to neurosurgery. Objective 12.5 Indicate the names and uses of neurosurgical instruments, supplies, and drugs. Objective 12.6 List the names and uses of special equipment related to neurosurgery. Objective 12.7 Determine the intraoperative preparation of the patient undergoing a neurosurgical Objective 12.8 Summarize the surgical steps of the neurosurgical procedures. Objective 12.9 Interpret the purpose and expected outcomes of the neurosurgical procedures. Objective 12.10 Recognize the immediate postoperative care and possible complications of the neurosurgical procedures. Objective 12.11 Assess any specific variations related to the preoperative, intraoperative, and

postoperative care of the neurosurgical patient. Objective 12.12 Outline recent advances in neurosurgery. Competency 13 The student will be able to describe advanced instruments and demonstrate proper care and handling of them, identify the types of advanced and/or specialized and accessory equipment used in the OR and their functions, collect and prepare OR supplies and describe their relationship to quality patient care and safety concepts. Objective 13.1 Associate the relationship between instrumentation, equipment, and supplies with quality patient care in the OR. Objective 13.2 Indicate items that require sterilization prior to use in the sterile field. Objective 13.3 Recognize advanced instruments by type, function, and name. Objective 13.4 Demonstrate proper care, handling, and assembly of instruments. Objective 13.5 Differentiate the types of special equipment utilized in OR practice and demonstrate proper care, handling techniques, and safety precautions. Objective 13.6 Cite the names and functions of advanced accessory equipment and demonstrate proper care, handling, and assembly. Objective 13.7 Collect and prepare supplies used in the OR, including less frequently used, advanced and/or specialized instruments. Objective 13.8 Associate the relationship between instruments, equipment, and supplies and the OR environment with safety concepts. Competency 14 The student will be able to identify the types, classifications, finishes and proper care and handling of advanced and/or specialized instruments as well as several methods of learning about them. Objective 14.1 Describe the characteristics of tissue Objective 14.2 Identify classifications of advanced and specialized instruments Objective 14.3 Differentiate types of instruments by their function Objective 14.4 Identify the different types of finishes on advanced and specialized surgical instruments Objective 14.5 Demonstrate the care and handling of instruments Objective 14.6 Cite several methods of learning about instruments Objective 14.7 Develop a personal plan for learning instruments Competency 15 The student will be able to describe procedures for counting sponges, sharps and advanced/specialized instruments and which OR staff members are responsible for doing so. Objective 15.1 Delineate counting procedures for all items Objective 15.2 Explain the procedure to follow when a count is incorrect Objective 15.3 Define the types of sponges Objective 15.4 Cite methods of accounting for sponges Objective 15.5 Summarize the procedure for counting surgical needles Objective 15.6 Depict the methods of accounting for sharps Objective 15.7 Describe who is responsible for counting sharps Objective 15.8 Detail the methods of counting instruments as well as simplifying instrument counts Objective 15.9 Explain the risk factors associated with items being retained inside the patient Objective 15.10 Categorize the procedures for proper care, handling and storage of instruments Competency 16 The student will be able to explain in detail why sponge, sharp and instrument counts are performed and the methods and general policies instituted by hospital ORs designed to ensure that no instruments are left inside patients. Objective 16.1 Describe some different methods of counting sponges and how they should be handled after they are counted Objective 16.2 Cite who is responsible for counting and discarding sponges Objective 16.3 Explain some different methods of counting sharps and how they should be handled after they are counted Objective 16.4 Delineate who is responsible for counting and discarding sharps Objective 16.5 Detail how instrument counts are performed and by whom Objective 16.6 Give examples of who is responsible for counting instruments and what must be done when a count is incorrect Competency 17 The student will be able to give a detailed description of the proper procedures for patient identification, transport, transfer, and positioning and how to minimize the risk of injury to both patient and health-care worker as well as the proper selection and preparation of wound drains and dressings.

Objective 17.1 Identify how to incorporate safe body mechanics into patient transport, transfer, and positioning Objective 17.2 Describe the responsibilities of the surgical technologist in patient transport and transfer Objective 17.3 Use the correct procedure to identify a patient Objective 17.4 Demonstrate how to assist a patient from a bed to a wheelchair Objective 17.5 Explain how to ease a patient to the ground in the event of a fall Objective 17.6 Identify the steps to transport a patient by stretcher safely Objective 17.7 Demonstrate the transfer of a patient from a bed to a stretcher Objective 17.8 Define the proper transport for a pediatric patient Objective 17.9 Detail the transfer of a patient from a stretcher to the operating table Objective 17.10 Cite the use of common operating table accessories Objective 17.11 Describe the transfer of a semiconscious patient from the operating table to a stretcher Objective 17.12 Explain the consequences of nerve and blood vessel compression Objective 17.13 Delineate the principles of safe positioning Objective 17.14 Identify methods to prevent shearing injury Objective 17.15 Describe the stages of decubitus ulcers and how to prevent them Objective 17.16 Participate in commonly used methods of patient positioning Objective 17.17 Define compartment syndrome and how to prevent it Objective 17.18 Detail how to do the following when positioning a patient: Prevent brachial plexus injury Prevent ulnar nerve and cubital tunnel injury Prevent injury to the face, ear, and eye during positioning Prevent injury to the breasts and genitalia in prone position Turn a patient from supine to prone position Objective 17.19 Discuss the selection and preparation of wound drains Objective 17.20 Demonstrate preparation of the surgical wound dressing Objective 17.21 Describe safe techniques for handling tissues Competency 18 The student will be able to describe advanced suture properties, materials and brand names, needle types and their various uses, commonly used stapling devices, uses of surgical adhesives, and endoscopic suturing. Objective 18.1 Recognize suture properties and materials by observing and handling suture Objective 18.2 Identify sutures by package labeling, and select proper sutures Objective 18.3 Distinguish between inert suture materials and those that cause inflammation Objective 18.4 Identify and anticipate the need for specific sutures during a procedure Objective 18.5 Demonstrate proper preparation of sutures for use Objective 18.6 Properly pass suture-needle combinations Objective 18.7 Explain the need to maintain sutures on the sterile field in an orderly manner Objective 18.8 Delineate safety precautions to prevent needle-stick injuries during suture use Objective 18.9 List basic needle types and their applications Objective 18.10 Define the difference between absorbable and nonabsorbable sutures Objective 18.11 Distinguish among different suture sizes Objective 18.12 Recognize commonly used stapling devices Objective 18.13 Identify the uses of surgical adhesives Objective 18.14 Describe the practice of endoscopic suturing and knot tying Competency 19 The student will be able to describe in detail the various types and names of sutures and their composition; methods of hemostasis (bleeding control) and related materials; suturing methods and handling, counting, and storing surgical instruments. Objective 19.1 Define the characteristics of suture material Objective 19.2 Describe the types of suture packaging and identifying marks Objective 19.3 Summarize methods of ligating vessels and equipment used Objective 19.4 Cite other methods of hemostasis including skin staples, skin tapes and surgical adhesives and needles Objective 19.5 Describe the different methods of suturing used

Objective 19.6 Explain the proper methods of handling sutures Objective 19.7 Outline the proper methods for counting and disposing of needles Objective 19.8 Identify the sharps no-touch technique Objective 19.9 List the composition of surgical instruments Objective 19.10 Define the different instrument categories Objective 19.11 Name the instruments used for endoscopic surgery Objective 19.12 Expound on the different types of stapling instruments Objective 19.13 Summarize the method for selecting and preparing instruments for patient use Objective 19.14 Describe how tables are set up with instruments and other supplies Objective 19.15 Detail the care and handling of instruments Objective 19.16 Explain the proper methods for counting and storing instruments. Competency 20 The student will be able to describe the relationship between the operating room staff and central service staff, methods of instrument cleaning, decontamination, and disinfection, the different types of disinfectants and levels and methods of disinfection, and the advantages and disadvantages of using disposable products. Objective 20.1 Describe the steps in decontamination. Objective 20.2 List Spaulding s classifications of patient care items. Objective 20.3 Compare and contrast the three levels of disinfection. Objective 20.4 Discuss how an instrument is rendered safe for handling. Objective 20.5 Identify three safety issues associated with the use of chemical disinfectants.