The Role of the Surgical First Assistant

Introduction

A Surgical First Assistant (SFA) can be defined as a highly skilled and appropriately educated professional who plays a pivotal role in supporting surgical procedures in the hospital. The presence of a suitably educated SFA in the operating room is associated with several critical factors that positively impact surgical performance. According to Quick (2013), the evolution of the surgical workforce and ongoing advancements in health policy have contributed to the persistent need for novel perioperative professions that equip them with the knowledge and skills necessary to assist the surgical team effectively (Myint, 2018). The current body of literature examining the significance of surgical team inclusion is minimal, thus resulting in a lack of empirical evidence about the benefits associated with their participation. Consequently, Quick et al. (2014) have put in their research that the perceived advantages are primarily based on anecdotal accounts. Moreover, SFAs serve as patient advocates, ensuring that consent is obtained, patient dignity is maintained, and teamwork within the surgical and perioperative teams is optimized (Stott, 2016). Their comprehensive understanding of normal anatomy and physiology enables them to comprehend better and address abnormalities that align with regulatory expectations and contribute to harm prevention.

Aims

This assignment aims to critically analyze and discuss the validity of this statement by delving into the education, ethical responsibilities, patient safety contributions, and overall significance of SFAs within the surgical environment.

Education and Ethical Responsibilities of Surgical First Assistants (SFAs):

Surgical First Assistants are required to undergo rigorous education and training to perform their roles effectively to equip them with a deep understanding of surgical procedures, anatomy, and patient care. This knowledge base is essential for ensuring that they can respond efficiently to the dynamic nature of surgical operations (Favre et al., 2016). Furthermore, SFAs are held to high ethical standards, as they often assume extended and expanded roles in the operating room by upholding principles such as patient confidentiality, informed consent, and maintaining patient dignity (Myint, 2018). This education and ethical foundation provide a strong framework for SFAs to operate and contribute significantly to the enhancement of surgical performance.

Patient Safety and the Role of SFAs

SFAs play a crucial role in ensuring patient safety in the surgical setting by being actively involved in tasks such as patient positioning, ensuring a sterile environment, and adhering to safety protocols to prevent surgical site infections and complications that could compromise patient well-being (Wang, 2014). Moreover, SFAs are instrumental in addressing human factors, such as effective communication within the surgical team and minimizing errors. Their presence and education contribute to a safer surgical environment, ultimately enhancing the overall quality of surgical care and patient outcomes (Stoddart, 2015). Therefore, the critical role of SFAs in maintaining patient safety aligns with the statement that surgical performance is indeed improved with their presence.

Patient Advocacy and Teamwork:

Patient advocacy is an integral part of the SFA role that encompasses aspects like obtaining informed consent and safeguarding patient dignity. SFAs are tasked with ensuring that patients are well informed and that their rights are respected throughout the surgical process (Stott, 2016). Moreover, they are essential team members who collaborate with the perioperative and extended surgical teams. Effective teamwork within these teams is a prerequisite for successful surgical outcomes, and SFAs contribute to this by facilitating communication and coordination (Myint, 2018). The symbiotic relationship between SFAs and the broader surgical team reinforces the notion that the presence of suitably educated SFAs enhances surgical performance.

Understanding Anatomy and Physiology:

SFAs are expected to have a comprehensive understanding of normal anatomy and physiology, which serves as the foundation for recognizing and addressing abnormalities. Their knowledge of the structure of the human body and function is vital in assisting surgeons, anticipating potential complications, and aiding in decision-making during Surgery by aligning with the expectations of regulatory bodies and contributing to the perfection of harm (Favre et al., 2016). It ensures that SFAs can adapt to various surgical scenarios and act swiftly in critical situations. By knowing the normal, they can better navigate the abnormal while bolstering surgical performance and patient care (Stoddart, 2015). Hence, the ability of SFAs to bridge the gap between theoretical knowledge and practical application is a valuable asset in the operating room.

Accountability and the SFA Role:

Accountability is a fundamental aspect of the Surgical First Assistant (SFA) role by ensuring that they perform their duties with the highest level of responsibility and professionalism. SFAs are accountable for their actions and decisions within the operating room and to their surgical team. Wang (2014) stated that this accountability extends to the ethical dimensions of their role, such as respecting patient autonomy, obtaining informed consent, and preserving patient dignity (Stoddart, 2015). To fulfill these accountabilities, SFAs must work within a clearly defined framework that outlines their scope of practice and ethical guidelines that contribute to the enhancement of surgical performance through their commitment to accountability.

Corporate, Trust, and Departmental Frameworks for SFAs:

Based on Summer Bryant (2021), SFAs operate within various frameworks, including corporate, trust, and departmental structures. At the corporate level, healthcare institutions set policies and guidelines that govern the SFA role by defining the relationship of SFA with the larger organization and its mission while ensuring that they align with institutional values and goals (Favre et al., 2016). Trust-level frameworks further delineate the responsibilities of SFAs within specific medical trusts or healthcare systems while considering regional variations and specific healthcare needs. Furthermore, Departmental frameworks provide even more focused guidance, addressing the role of SFAs within surgical departments by outlining surgical protocols, team dynamics, and specific roles and responsibilities (Myint, 2018). The alignment of SFAs within these diverse frameworks reinforces their accountability, fosters standardization of practice, and ultimately enhances surgical performance by ensuring the SFA’s role is well-integrated into the broader healthcare system.

Clinical Governance

Clinical governance is a critical component of ensuring the quality and safety of healthcare services, and it holds particular relevance in the context of Surgical First Assistants (SFAs). Their role involves hands-on support during surgical procedures and the continuous assessment and improvement of their skills. SFAs maintain logbooks that track their experiences, further contributing to clinical governance efforts (Favre et al., 2016). Moreover, it is essential to establish parity of expectations between surgical trainees and SFAs while working closely together in the operating room. This alignment ensures that both groups share similar performance standards, enhancing teamwork and, consequently, surgical outcomes while strengthening the overall framework of clinical governance.

Conclusion

The multifaceted role of suitably educated Surgical First Assistants (SFAs) undeniably enhances surgical performance on multiple fronts with their extensive education and ethical responsibilities. These roles provide a robust foundation for effective practice and the overall quality of care in the operating room. SFAs play a vital role in ensuring patient safety by actively participating in tasks related to infection prevention, patient positioning, and addressing human factors. Their advocacy for patients and their adept teamwork with perioperative and extended surgical teams further strengthen the surgical environment. In essence, the presence of SFAs elevates surgical performance through accountability, standardized frameworks, clinical governance, assessment of skills, and alignment of expectations, ultimately delivering safer and more efficient surgical outcomes.

Reference

Quick, J., 2013. The role of the surgical care practitioner within the surgical team. British Journal of Nursing, 22(13), pp.759–765.

Quick, J., Hall, S. and Jones, A., 2014. Surgical first assistants: fit for purpose? J Perioper Pract, 24, p.188.

Myint, F., 2018. Kirk’s Basic Surgical Techniques E-Book. Elsevier Health Sciences.

Stoddart, K., 2015. Providing holistic perioperative care. Kai Tiaki: Nursing New Zealand, 21(9), p.32.

Favre, A., Huberlant, S., Carbonnel, M., Goetgheluck, J., Revaux, A. and Ayoubi, J.M., 2016. Pedagogic approach in surgical learning: The first period of “assistant surgeon” may improve the learning curve for laparoscopic robotic-assisted hysterectomy. Frontiers in Surgery, 3, p.58.

Wang, K., 2014. Nursing as a first surgical assistant. Kai Tiaki: Nursing New Zealand, 20(6), p.26.

Stott, D., 2016. A vital part of the surgical team. Nursing Standard, 30(24).

Summer Bryant, D.N.P., 2021. The Medical-Surgical Unit: A High-Performing Team. Medsurg Nursing, 30(1), pp.5–6.