Certified Surgical First Assistant - Duke University Hospital

Duke University Hospital Duke University Hospital is consistently rated as one of the best in the United States and is known around the world for its outstanding care and groundbreaking research. Duke University Hospital has 1,048 licensed inpatient beds and offers comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center; a major surgery suite containing 65 operating rooms; an endo-surgery center; a separate hospital outpatient surgical department with nine operating rooms and an extensive diagnostic and interventional radiology area. For 2021-2022, U.S. News and World Report ranked Duke University Hospital nationally in 11 adult specialties: cancer, cardiology & heart surgery, diabetes & endocrinology, ear, nose & throat, gastroenterology & GI surgery, gynecology, neurology & neurosurgery, ophthalmology, orthopedics, pulmonology & lung surgery, and urology. Duke University Hospital is also ranked first in North Carolina and first in the Raleigh-Durham area. Inaddition to its hospitals, Duke Health has an extensive, geographically dispersed network of outpatient facilities that include primary care offices, urgent care centers, multi-specialty clinics and outpatient surgery centers.

 

 

General Description of the Job Class

The Certified Surgical First Assistant (CSFA) will support the continuity of care for Perioperative patients. The scope of practice includes preoperative patient care management, intraoperative surgical first assisting, and postoperative patient care management. The role will help expedite surgical productivity, support the education of surgical residents, 2nd assist where needed, and first assist the Surgeons when surgical Residents are not available. The CSFA will provide patient care for all ages and provide leadership and direction to the perioperative team where needed. The CSFA in surgery collaborates with the surgeon and the health care team in performing a safe operation with optimal outcomes for the patient. The CSFA practices in collaboration with and at the surgeon's direction during the intra- operative experience.

 

Duties and Responsibilities of this Level

The Certified Surgical First Assistant (CSFA) possesses and demonstrates competencies related to all aspects of perioperative care, including preoperative review of patient history and physical, preoperative tests results, and postoperative transfer of care and monitoring for complications. The CSFA serves as the first assistant in designated surgical procedures under the direct supervision of the operating surgeon/physician; handles all variety of tissue appropriately to reduce the potential for injury or compromised blood supply; uses surgical instruments properly, employs principles of safe tissue handling:

• Provides exposure to the operative site
• Provides and maintains hemostasis
• Performs wound closure
• Demonstrates advanced knowledge of normal and pathological anatomy and physiology
• Safely positions patients for the surgical procedure and assists with transport to and from the operative suite
• Assists surgeon in identifying patient and staff safety hazards
• Surgical prepping and draping of patients for the surgical procedure
• Provides exposure of the operative site by the appropriate use of retractors
• Manipulates equipment and instruments to enhance the visual field
• Suctions and sponges to maintain a dry surgical field resulting in an optimal visualization of the surgical field
• Provides counter-traction of tissue utilizing various instruments
• Assists with maintaining hemostasis to reduce potential for fluid volume deficits by clamping/ligating vessels, using electrocautery to tissue, applying manual direct pressure, assisting with use of pharmaceutical agents (e.g. topical thrombin) and other means as directed by the surgeon/physician
• Ties and cuts sutures
• Skillfully sutures all varieties of tissues/tissue planes with appropriate suture materials and suturing techniques
• Assists in closure of wound or independently closes wound under the direction of the surgeon
• Assists and independently applies dressing and tape at the end of the surgical procedure using proper aseptic/sterile techniques
• Maintains current knowledge of procedures performed
• The Certified Surgical First Assistant may take a scrub role when not needed as a first assistant.

Other Considerations:

• Scope of position does not include dissection down to the area to be repaired, replaced, etc., which is done by the surgeon.
• The CSFA may share a single surgical site with the surgeon being assisted and may not independently perform a procedure on an opposite site except subcutaneous tissue and skin closure.
• Placing a screw or manipulating a tool w