Job responsibilities
Overview of tasks and activities
Improving communication between theatre and patient
Involvement in the team completion of the WHO surgical safety checklist for all surgical interventions.
Assistance with patient positioning, including tissue viability assessment.
Skin preparation prior to surgery and draping.
Use and maintenance of specialised surgical equipment relevant to the area of their work.
Handling of tissues and manipulation or organs for exposure or access under direct observation of the operating surgeon.
Superficial and deep tissue retraction (NB: Retractors should not be placed by the SFA but by the operating surgeon.)
Assistance with haemostasis to secure and maintain a clear operating field, including indirect application of surgical diathermy as directed by the operating surgeon (NB: activities such as application of direct electro surgical diathermy to body tissue, applying haemostats or ligaclips to vessels and cast bandaging are the remit of the surgeon, supervised surgical trainee or surgical care practitioners and not the SFA).
Use of suctions guided by the operating surgeon.
Instrument manipulation under the direction of the surgeon during minimal access surgery
Cutting of deep sutures and ligatures.
Simple wound closure and skin suturing (see below*).
Application of dressings.
Assistance with the transfer of patients to the post-operative anaesthetic care unit.
Supervision and Management
Clinical responsibility to the consultant surgeon once trained.
Day to day work under the direction of the operating surgeon and the theatre management team.
Line Management as part of the theatre team.
Autonomy
The surgical first assistant works under the direct supervision of the surgeon who must remain in the theatre until surgery is completed.
(*) SFAs are not allowed to undertake tasks considered to be surgical interventions. However, they are allowed to undertake skin suturing to close simple wounds provided they have received appropriate training and assessment or through demonstrating competence at the same level.
Training
Successful completion of a nationally recognised programme of study:
A university accredited programme, such as the College of Operating Department Practitioners BSc in operating department practice.
Universities that offer accredited modules for the SFAs must ensure that the programme offered follows the recommendations of the Perioperative Care Collaborative.
An alternative approved training package supported by the AfPP SFA Competency Toolkit.
Personal/Professional Development:
In addition to maintaining continued education through attendance at any courses and/or study days necessary to ensure that professional development requirements for revalidation are met, the post-holder will participate in any training programme implemented by the Practice as part of this employment, such training to include:
Participation in an annual individual performance review, including taking responsibility for maintaining a record of own personal and/or professional development.
Attendance at team meetings as and when required, this is in addition to the allocated personal study leave.
Taking responsibility for own development, learning and performance and demonstrating skills and activities to others who are undertaking similar work.
Ensure appropriate revalidation is obtained as required
On some days other clinicians may be covering the practice list for a period of the day. This time could be used for educational activity.
Professional Accountability
Nursing and Midwifery Council, or Health and Care Professionals Council, for their original, non-extended roles.
It is recommended that SFAs follow the AfPP voluntary code of conduct for registered practitioners working in advanced roles, as well as the codes of conduct and performance of their regulatory bodies.
