Official Course Description: MCCCD Approval: 11/25/97
PON290 19982-99999	L+L	2 Credit(s)	4 Period(s)
Certified Nurse Midwife First Assistant
Expansion of the Certified Nurse Midwife role and responsibilities. Emphasis on the intraoperative periods for Cesarean Sections, Hysterectomies and Tubal Ligation. Includes tissue handling, providing tissue exposure, using instruments, suturing and providing hemostasis. Prerequisites: Current RN(Registered Nurse) license and current certification as a Nurse Midwife and permission of the instructor.

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MCCCD Official Course Competencies:
PON290   19982-99999	Certified Nurse Midwife First Assistant

1.	Explain liability considerations in relation to specific Operating Room (OR) situations. (I)
2.	Describe principles of wound healing and specific infection control practices. (II)
3.	List anatomic and physiologic considerations related to Cesarean section, hysterectomies and tubal ligations. (III)
4.	Demonstrate appropriate scrubbing, gowning and gloving techniques for the sterile field. (IV)
5.	Describe and demonstrate surgical techniques related to tissue handling within Certified Nurse Midwife First Assistant guidelines. (V, XIII)
6.	Evaluate and describe techniques for maintaining hemostasis through the use of electrosurgery, clamps, pressure/sponging and other specific methods. (VI, XIII)
7.	Demonstrate suturing skills including proper tying techniques and ligation of vessels. (VII, XIII)
8.	Explain and demonstrate wound closure including approximation of wound layer and securing of drains. (VIII, XIII)
9.	Describe the selection of body tissue and retract being consistent with individual anatomy and physiology. (IX, XIII)
10.	Explain and utilize proper suctioning techniques. (X, XIII)
11.	Given specific surgical patients, identify problems and determine alternative solutions and/or appropriate emergency measures. (XI)
12.	Synthesize and document the data collected for specific preoperative assessment and discharge planning. (XII, XIII)

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MCCCD Official Course Outline:
PON290   19982-99999	Certified Nurse Midwife First Assistant

I. Scope of practice A. Inside B. Outside C. Liability II. Wound healing and surveillance A. Wound classification system B. Principles of wound healing C. Complications of wound healing D. Role in infection control III. Anatomic and physiologic considerations A. Cesarean section B. Hysterectomy C. Tubal ligation IV. Scrubbing, gowning and gloving A. Principles B. Techniques V. Tissue handling A. Types of tissue B. Techniques VI. Hemostasis A. Electrosurgery B. Clamps C. Pressure/sponging D. Chemical E. Manual VII. Suturing A. Typing B. Ligation of vessels C. Other VIII. Wound closure A. Approximation of wound layers B. Subcuticular closure C. Skin closure D. Staples E. Drains IX. Retraction techniques A. Body tissue B. Individual anatomy and physiology X. Suctioning techniques XI. Decision-making behavior A. Patient assessment 1. Needs 2. General health and age 3. Pre-existing problems B. Nursing diagnosis C. Medical diagnosis D. Technique-related considerations E. Alternatives F. Complications 1. Hemodynamic 2. Metabolic 3. Cardiac 4. Potential injury - chemical, physical, electrical and mechanical G. Emergency measures XII. Assessment A. Preoperative assessment B. Discharge planning C. Integrating the nursing process XIII. First assisting responsibilities A. Performance B. Evaluation C. Documentation

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