SGT 122 SURGICAL TECHNIQUES

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SGT 122 SURGICAL TECHNIQUES PRESENTED AND APPROVED: AUGUST 9, 2012 EFFECTIVE: FALL 2012-13

Prefix & Number SGT 122 Course Title: Surgical Techniques 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 was Title Course Number updated in order to account for the approved Format Change Credits program modification on 11/4/11. 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) Title Surgical Technology for The Surgical Technologist: A Positive Care Approach and accompanying study guide Author(s) Association of Surgical Technologists Publisher Delmar, 2008 ISBN 1-4180-5168-6 Title Berry & Kohn s Operating Room Technique Author(s) Fortunato, Nancymarie Publisher Mosby Inc. 2004 ISBN 0-323-04483-7 Title Surgical Technology Principles and Practice, 4 th Ed. & accompanying workbook Author(s) Fuller, Joanna Publisher Elsevier Saunders, 2005 ISBN 0-7216-9693-7 Title Differentiating Surgical Instruments Author(s) Rutherford, Colleen J. Publisher F.A. Davis Co. 2005 ISBN 0-8036-1224-9 Software Title Alexander s Care of the Patient in Surgery Author(s) Meeker, Margaret H. and Rothrock, Jane C. Publisher Mosby Inc. 2007 ISBN 0-323-03927-7 Preoperative Surgical Procedures, Interactive CD-ROM 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 122 Full Title: (100 character limit) Surgical Techniques Short Title: (30 character limit) Surgical Techniques Catalog Course Description: Provides students with fundamentals in aseptic technique, safe patient care and knowledge to identify, select and safely use equipment and supplies in the operating room. SUN Course Number: Credit Hours: 4 Lecture Hours: 3 Lab Hours: 3 Prerequisite(s) Admission to Surgical Technology program Co-requisite(s) SGT 121 Intended Course Goals By the end of the semester, students will be able to: 1. Define the principles of asepsis. 2. Describe safe patient care. 3. Explain the purpose of surgical scrub. 4. Identify proper positioning and draping of the surgical patient for various types of surgical procedures. 5. List the needs of the surgical patient. 6. Classify the case-appropriate instruments. 7. Delineate the case-appropriate supplies and equipment. 8. Define a sterile field. 9. Explain the components of bringing a patient to the operating room. LAB: 1. Demonstrate aseptic technique. 2. Show the surgical scrub. 3. Outline gowning and gloving technique. 4. Delineate instrument selection. 5. Demonstrate knowledge of instrument names. 6. Outline supplies/equipment selection. 7. Establish a sterile field. 8. Demonstrate safe transportation of a surgical patient.

9. Explain infection control. 10. Demonstrate proper positioning and draping of the surgical patient. 11. Delineate correct usage for various types of sterilization used in the operating room.

Course Competencies and Objectives By the end of the semester, students will be able to: Competency 1 The student will be able to identify the areas of the OR, the physical components of the operative suite, the different hospital departments that support the surgical process and basic safety considerations. Objective 1.1 Recognize the hazards to the patient in the operative environment. Objective 1.2 Distinguish among the support services that work with the OR team in the care of the patient. Objective 1.3 Review the type of air-handling system required in the OR and the temperature and humidity required to maintain a sterile field. Objective 1.4 Indicate cleaning procedures, traffic patterns, and routines required in the operative environment. Objective 1.5 Analyze the role of the surgical technologist in the protection of self, patients, and others from hazards in the operative environment. Objective 1.6 Recognize the design types of the OR. Objective 1.7 Classify hospital departments that relate to surgical services. Objective 1.8 Recognize the working environment of the OR. Objective 1.9 Determine the physical components of the OR. Competency 2 The student will be able to identify the physical layout of the typical OR suite and its components. Objective 2.1 Identify specific areas within the surgical suite wherein attire and behaviors affect the manner of care delivery. Objective 2.2 Discuss methods of environmental controls that contribute to an aseptic environment. Objective 2.3 Discuss how environmental layout contributes to aseptic technique. Objective 2.4 Illustrate the specialty rooms used for endoscopy, minimally invasive procedures, and urology. Competency 3 The student will be able to identify environmental, physical, chemical and biologic hazards and how to minimize their danger through the implementation of safeguards. Objective 3.1 Identify potential environmental sources of injury to patients and personnel in the perioperative environment. Objective 3.2 Discuss the prevention of injury through proper testing and use of equipment in the operating room. Objective 3.3 Explain the importance of fire and disaster drills. Competency 4 The student will be able to describe the items comprising appropriate operating room clothing and accessories as well as the correct methods of both donning and removing them. Objective 4.1 Identify the components of appropriate operating room attire worn in specific areas of the surgical suite. Objective 4.2 Delineate the components of personal protective equipment (PPE) donned before performing surgical hand cleansing. Objective 4.3 Describe the sterile parameters of a surgical gown. Objective 4.4 Demonstrate the correct method of gowning and gloving before establishing the sterile field. Objective 4.5 Show the appropriate method of changing a contaminated glove during a surgical procedure. Objective 4.6 Identify the proper method for removing a contaminated gown and gloves. Competency 5 The student will be able to describe the differences between sterile, nonsterile and aseptic, the rules of aseptic technique, a proper surgical hand scrub and the proper procedure for donning and removing operating room clothing and accessories and assisting others in doing so. Objective 5.1 Describe the rationale for practicing aseptic technique Objective 5.2 Clearly distinguish among sterile, nonsterile, and aseptic Objective 5.3 Explain surgical conscience. Objective 5.4 Explain the concept of barriers

Objective 5.5 Practice the rules of aseptic technique Objective 5.6 Explain the relationship between personal hygiene and aseptic technique. Objective 5.7 Perform the surgical hand scrub correctly Objective 5.8 Demonstrate aseptic technique by donning gown and gloves Objective 5.9 Don sterile gloves using proper open gloving technique. Objective 5.10 Remove gown and gloves using aseptic technique Objective 5.11 Remove contaminated gloves from another person Objective 5.12 Discuss reasons why personnel might not follow the rules of asepsis. Competency 6 The student will be able to describe basic instruments and demonstrate proper care and handling of them, identify the types of special 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 6.1 Associate the relationship between instrumentation, equipment, and supplies and with quality patient care in the OR. Objective 6.2 Indicate items that require sterilization prior to use in the sterile field. Objective 6.3 Recognize basic instruments by type, function, and name. Objective 6.4 Demonstrate proper care, handling, and assembly of instruments. Objective 6.5 Differentiate the types of special equipment utilized in OR practice and demonstrate proper care, handling techniques, and safety precautions. Objective 6.6 Cite the names and functions of accessory equipment and demonstrate proper care, handling, and assembly. Objective 6.7 Collect and prepare supplies used in the OR. Objective 6.8 Associate the relationship between instruments, equipment, and supplies and the OR environment with safety concepts. Competency 7 The student will be able to identify the types, classifications, finishes and proper care and handling of instruments as well as several methods of learning about them. Objective 7.1 Define the characteristics of tissue Objective 7.2 Identify classifications of instruments Objective 7.3 Differentiate types of instruments by their function Objective 7.4 Identify the different types of finishes on surgical instruments Objective 7.5 Describe the care and handling of instruments Objective 7.6 Illustrate several methods of learning about instruments Objective 7.7 Develop a personal plan for learning instruments Competency 8 The student will be able to describe procedures for counting sponges, sharps and instruments and which OR staff members are responsible for doing so. Objective 8.1 Delineate counting procedures for all items Objective 8.2 Explain the procedure to follow when a count is incorrect Objective 8.3 Define the types of sponges Objective 8.4 Outline the methods of accounting for sponges Objective 8.5 Describe the procedure for counting surgical needles Objective 8.6 Delineate the methods of accounting for sharps Objective 8.7 Identify who is responsible for counting sharps Objective 8.8 Illustrate the methods of counting instruments as well as simplifying instrument counts Objective 8.9 Depict the risk factors associated with items being retained inside the patient Objective 8.10 Define the procedures for proper care, handling and storage of instruments Competency 9 The student will be able to explain 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 9.1 Explain some different methods of counting sponges and how they should be handled after they are counted Objective 9.2 Identify who is responsible for counting and discarding sponges Objective 9.3 Illustrate some different methods of counting sharps and how they should be handled after they are counted Objective 9.4 Describe who is responsible for counting and discarding sharps Objective 9.5 Depict how instrument counts are performed and by whom

Objective 9.6 Outline who is responsible for counting instruments and what must be done when a count is incorrect Competency 10 The student will be able to describe the methods of hemostasis (stopping blood loss) and blood replacement as well as procedures for emergency situations. Objective 10.1 Compare and contrast methods of hemostasis and blood replacement and demonstrate the preparation and use of appropriate agents or devices. Objective 10.2 Recognize developing emergency situations, initiate appropriate action, and assist in the treatment of the patient. Objective 10.3 Apply knowledge of radiological and chemical injuries and biological warfare to the treatment of the patient. Competency 11 The student will be able to describe the various ways of minimizing the risk of fire, disease transmission, hazardous waste, smoke plume, latex allergy, radiation, toxic chemicals and musculoskeletal injury. The student will also be able to describe what the vital signs are and how to measure them on both adults and children. Objective 11.1 Describe toxic substances in smoke plumes Objective 11.2 Identify safe use of the smoke evacuator Objective 11.3 Recognize international hazard communication signs Objective 11.4 Differentiate between latex allergy and nonallergic dermatitis Objective 11.5 Explain the symptoms of true latex allergy Objective 11.6 Identify necessary precautions to prevent latex reaction in allergic patients Objective 11.7 Discuss fuels and sources of ignition commonly found in the operating room Objective 11.8 Describe methods associated with preventing fires in the operating room Objective 11.8 Illustrate how to respond appropriately to a patient fire Objective 11.9 Explain how to respond appropriately to a structural fire Objective 11.10 Delineate the practice of standard precautions Objective 11.11 Identify the practice for transmission-based precautions Objective 11.12 Define proper body mechanics for lifting, pulling, and pushing objects Objective 11.13 Discuss various techniques to prevent sharps injuries Objective 11.14 Describe measures to safely store, transport, and use compressed gas cylinders Objective 11.15 Identify methods to properly handle and dispose of hazardous waste in the operating room Objective 11.16 Explain precautions to prevent exposure to ionizing radiation Objective 11.17 Delineate precautions to prevent patient burns resulting from electrical equipment Objective 11.18 Describe methods to avoid chemical injury Objective 11.19 Analyze a chemical label Objective 11.20 Explain what the vital signs are, what the normal range is, and how to measure them on both adults and children and the differences between the two. Competency 12 The student will be able to describe the three phases of case management for a Surgical Technologist and the duties associated with each phase. Objective 12.1 Analyze the role of the STSR in caring for the surgical patient. Objective 12.2 Verify the preoperative routines that must be completed. Objective 12.3 Demonstrate the transportation of the surgical patient. Objective 12.4 Apply the principles of surgical positioning. Objective 12.5 Describe techniques of opening and preparing supplies and instruments. Objective 12.6 Summarize the methods of preparation of the operative site for surgery. Objective 12.7 Delineate the application of thermoregulatory devices. Objective 12.8 Interpret the principles and demonstrate the taking and recording of vital signs. Objective 12.9 Explain the principles of urinary catheterization and demonstrate the procedure. Objective 12.10 Analyze how the principles of operative site preparation and urinary catheterization are related both to patient care and to the principles of asepsis. Objective 12.11 Describe the proper techniques for the surgical hand scrub, gowning, gloving, and assisting team members. Objective 12.12 Demonstrate the proper technique for preparing supplies and instruments on a sterile field.

Objective 12.13 Give a detailed explanation of the procedure for counting instruments, sponges, needles, and other items on the sterile field. Objective 12.14 Demonstrate the initial steps for starting a procedure. Objective 12.15 Show intraoperative handling of sterile equipment and supplies. Objective 12.16 Summarize and demonstrate postoperative routines. Competency 13 The student will be able to describe the proper procedures for surgical preparation and draping including common cleansing agents and the proper method for catheterization, and the proper draping techniques for different areas of the body. Objective 13.1 List the characteristics of common surgical prep solutions Objective 13.2 Identify necessary precautions to prevent injury associated with skin preparation Objective 13.3 Detail the use of a no-touch preparation technique Objective 13.4 Explain the concepts of body hair management prior to surgery Objective 13.5 Define the proper procedure to perform the surgical skin preparation for all areas of the body Objective 13.6 Describe the proper aseptic technique to catheterize male and female patients Objective 13.7 Demonstrate the proper technique for draping the patient for torso, limb, and lithotomy procedures Competency 14 The student will be able to describe how to minimize the safety hazards involved with moving a patient from one surface to another, the correct body positioning for different procedures, proper patient skin preparation and draping procedures using sterile technique. Objective 14.1 Identify the safety hazards associated with moving a patient from one surface to another. Objective 14.2 List the anatomic considerations for positioning. Objective 14.3 Describe the effects of positioning on the patient s body systems. Objective 14.4 Define key elements of preoperative skin preparation of patients. Objective 14.5 Discuss the implications of chemical and mechanical actions of prepping the patient. Objective 14.6 Recount how a patient is draped using sterile technique. Competency 15 The student will be able to describe 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 15.1 Illustrate how to incorporate safe body mechanics into patient transport, transfer, and positioning Objective 15.2 Describe the responsibilities of the surgical technologist in patient transport and transfer Objective 15.3 Use the correct procedure to identify a patient Objective 14.4 Describe how to assist a patient from a bed to a wheelchair Objective 15.5 Explain how to ease a patient to the ground in the event of a fall Objective 15.6 Identify the steps to transport a patient by stretcher safely Objective 15.7 Demonstrate the transfer of a patient from a bed to a stretcher Objective 15.8 Analyze the proper transport for a pediatric patient Objective 15.9 Illustrate the transfer of a patient from a stretcher to the operating table Objective 15.10 Describe the use of common operating table accessories Objective 15.11 Depict the transfer of a semiconscious patient from the operating table to a stretcher Objective 15.12 Define the consequences of nerve and blood vessel compression Objective 15.13 Explain the principles of safe positioning Objective 15.14 Identify methods to prevent shearing injury Objective 15.15 Portray the stages of decubitus ulcers and how to prevent them Objective 15.16 Participate in commonly used methods of patient positioning Objective 15.17 Cite compartment syndrome and how to prevent it Objective 15.18 Explain 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 15.19 Discuss the selection and preparation of wound drains Objective 15.20 Demonstrate preparation of the surgical wound dressing Objective 15.21 Delineate safe techniques for handling tissues Competency 16 The student will be able to describe the proper procedures for preparing, transferring and transporting the patient to the operating room, positioning the patient for various types of surgical procedures, different types of drains and dressings and their applications and uses. Objective 16.1 Identify the proper check-in procedures for admitting a patient to the surgical suite Objective 16.2 Analyze steps involved in transferring a patient to the operating room Objective 16.3 Explain the standard patient positioning for a variety of different surgical procedures Objective 16.4 Define which types of drains are used to drain various fluids and the point at which they are used Objective 16.5 Interpret the different types of dressings, their composition and uses and their application process Competency 17 The student will be able to describe the classifications of surgical wounds, suture materials, surgical needles and stapling devices, and name the stages and phases of wound healing. Objective 17.1 Indicate terms relevant to wound healing. Objective 17.2 Summarize the possible complications of wound healing. Objective 17.3 Recognize the classifications of surgical wounds. Objective 17.4 Indicate and give examples of types of traumatic wounds. Objective 17.5 Analyze the factors that influence healing and recognize the manner in which they affect the healing process. Objective 17.6 Recognize the characteristics of inflammation. Objective 17.7 Cite and interpret common suture terms. Objective 17.8 Classify and differentiate suture materials and stapling devices and their usage. Objective 17.9 Recognize the types, characteristics, and uses of natural and synthetic absorbable suture materials. Objective 17.10 Compare and recognize the common natural and synthetic nonabsorbable sutures, stating their sources, common trade names, and uses. Objective 17.11 Demonstrate application of recommended preparation and handling techniques for suturing and stapling devices and provide rationale for choice. Objective 17.12 Cite and interpret common suture techniques. Objective 17.13 Summarize the basic uses and advantages of stapling instruments. Objective 17.14 Distinguish, describe the use of, and demonstrate proper handling of the various types of surgical needles. Objective 17.15 Assess the types of injury that cause damage to tissues. Objective 17.16 Elucidate the characteristics of the types of healing. Objective 17.17 Relate the stages/phases of wound healing. Competency 18 The student will be able to describe 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 Annotate safety precautions to prevent needle-stick injuries during suture use Objective 18.9 Identify basic needle types and their applications Objective 18.10 Distinguish between absorbable and nonabsorbable sutures Objective 18.11 Distinguish among different suture sizes Objective 18.12 Recognize commonly used stapling devices Objective 18.13 Elucidate 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 the general process of wound healing, types of wounds, wound management and factors influencing healing, complications and postsurgical infections and basic wound care. Objective 19.1 Identify tissue layers specific to the anatomic site of a wound. Objective 19.2 List several factors that affect wound healing. Objective 19.3 Illustrate the process of wound healing. Objective 19.4 List three wound healing complications. Objective 19.5 Exemplify three dressing materials and their application. Competency 20 The student will be able to describe 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 20.1 Describe the characteristics of suture material Objective 20.2 Identify the types of suture packaging and identifying marks Objective 20.3 Explain methods of ligating vessels and equipment used Objective 20.4 Illustrate other methods of hemostasis including skin staples, skin tapes and surgical adhesives and needles Objective 20.5 Detail the different methods of suturing used Objective 20.6 Relate the proper methods of handling sutures Objective 20.7 Recite the proper methods for counting and disposing of needles Objective 20.8 Demonstrate the sharps no-touch technique Objective 20.9 Define the composition of surgical instruments Objective 20.10 Illustrate the different instrument categories Objective 20.11 Describe the instruments used for endoscopic surgery Objective 20.12 Identify the different types of stapling instruments Objective 20.13 Explain the method for selecting and preparing instruments for patient use Objective 20.14 Demonstrate how tables are set up with instruments and other supplies Objective 20.15 Illustrate the care and handling of instruments Objective 20.16 Elucidate the proper methods for counting and storing instruments. Competency 21 The student will be able to identify the pathogens associated with surgical site infections, methods of transmission, factors that increase risk of surgical site infection, define surgical conscience, describe the history of sterilization and the principles and processes that must be taken to create and maintain a sterile field, identify disinfectant compounds and decontamination practices, and describe how instruments are to be wrapped for sterilization and which sterilization methods are employed. Objective 21.1 Discuss the relationship between the principles of asepsis and practice of sterile technique and surgical patient care. Objective 21.2 Define and discuss the concept of surgical conscience. Objective 21.3 Recount the principles of asepsis. Objective 21.4 Define the terms related to asepsis. Objective 21.5 Discuss the sterile practices related to the principles of asepsis. Objective 21.6 Identify the principles and procedures related to disinfection and sterilization. Objective 21.7 Demonstrate competency related to the practice of sterile technique. Objective 21.8 Delineate competency in the procedures related to disinfection and sterilization. Objective 21.9 Discuss the surgical environment and the application of the principles of asepsis to the environment. Competency 22 The student will be able to describe various disinfectant chemicals, decontamination of the surgical suite as well as furniture, fixed equipment, and other areas that must be cleaned daily and surgical instruments, the different methods of sterilization and their operation, storage and handling of sterile supplies, and prevention of transmission of disease from medical equipment. Objective 22.1 Explain the rationale for practicing aseptic technique Objective 22.2 Clearly distinguish among sterile, nonsterile, and aseptic Objective 22.3 Define surgical conscience Objective 22.4 Illustrate the concept of barriers Objective 22.5 Practice the rules of aseptic technique Objective 22.6 Compare and contrast the relationship between personal hygiene and aseptic technique Objective 22.7 Perform the surgical hand scrub correctly

Objective 22.8 Demonstrate the aseptic technique by donning gown and gloves Objective 22.9 Don sterile gloves using proper open gloving technique Objective 22.10 Remove gown and gloves using aseptic technique Objective 22.11 Remove contaminated gloves from another person Objective 22.12 Discuss reasons why personnel might not follow the rules of asepsis Competency 23 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 23.1 Illustrate the steps in decontamination. Objective 23.2 List Spaulding s classifications of patient care items. Objective 23.3 Compare and contrast the three levels of disinfection. Objective 23.4 Explain how an instrument is rendered safe for handling. Objective 23.5 Give examples of three safety issues associated with the use of chemical disinfectants. Competency 24 The student will be able to describe the difference between sterilization and disinfection, how instruments and other items are packaged for sterilization, types of sterilizers and the advantages and disadvantages of each, control measures, and how sterilized items are transported to the operating room. Objective 24.1 Define the term sterilization. Objective 24.2 List three methods of sterilization. Objective 24.3 Describe the process for preparing an item for sterilization. Objective 24.4 Relate the primary hazards associated with each type of sterilization. Objective 24.5 Discuss sterilization process monitors. Objective discuss the use of a case cart system. Competency 25 The student will be able to describe the causes of infection including microorganisms, infection control practices, methods of sterilization and types of disinfectants, surgical aseptic principles, proper surgical attire and surgical hand antisepsis, gowning and gloving methods, types of drapes and drape configurations, and types of diseases used in biological warfare. Objective 25.1 List the major microorganisms that cause infection. Objective 25.2 List the microorganisms that have become drug resistant. Objective 25.3 Define the universal, standard, and transmission-based precautions. Objective 25.4 Explain the eight surgical aseptic principles. Objective 25.5 Describe proper surgical attire. Objective 25.6 Demonstrate the proper surgical hand scrub procedure. Objective 25.7 Explain both a self-gowning procedure and an assisted-gown procedure as well as the proper procedure for removing gown and gloves. Objective 25.8 Illustrate proper patient skin disinfection and preparation. Objective 25.9 Demonstrate creating the sterile field with surgical drapes Objective 25.10 Identify the major diseases used in biological warfare.