SURGICAL SERVICES *

Effective Date: 
Sun, 09/01/1996
Reviewed: 
Thu, 09/02/2021
Revised: 
Tue, 11/09/2021
Policy: 

The Student Health Center performs minor surgical procedures. Examples include; laceration repair, superficial abscess incision and drainage, removal of skin tags, simple superficial excisions, and skin biopsies.  In addition, intrauterine device insertion and removal, colposcopic examination with cervical biopsy and endometrial sampling is performed on site as well, by appropriately credentialed and privileged health care providers. These procedures are performed under local or topical anesthesia. No conscious sedation is performed on site.

Procedure: 

Clinicians must be appropriately credentialed prior to being granted specific privileges to perform surgical procedures.

The Student Health Center clinician performing the procedure assesses the patient, explains the need and appropriateness of the procedure, offers any appropriate alternative treatments, and obtains the patient’s informed written consent prior to performing the procedure.

The clinician performing a procedure that involves removal of skin lesion will verbally verify and confirm with the patient the location of the lesion to be removed and then mark the site with surgical pen if practical. Clinicians are encouraged to use the patient's camera to record a digital image of the skin lesion prior to removal.

The clinician will pause for a time out prior to commencing the procedure to confirm correct location of lesion and that all needed supplies are present to safely perform the procedure.

Appropriate aseptic technique is observed for all surgical procedures, which includes pre-procedural site antiseptic preparation and or isolation of the site, where indicated. Procedures are documented in the electronic medical record.

Patients are provided verbal education on wound care and instructions on after-hours care and follow-up as clinically appropriate. Patients are routinely provided an appropriate electronic handout detailing post procedure instructions and after hours care options. Alternatively, patients are sent an electronic message with the post procedure instructions and after hours care options.

With the exception of dystrophic nails, or normal skin removed incidental to other procedures, all tissues removed during surgical procedures are submitted for examination by an off site pathologist at the reference laboratory, whose signed report is made part of the medical record and acknowledged by the ordering health care provider.

All patients are notified electronically via health e messenger of their pathology results and follow up recommendations. It is the responsibility of the provider to check that patients with abnormal results have read their secure message. Providers are encouraged to create reminders for these referrals to prevent patients with significant pathology from being lost to follow up. Patients with significantly abnormal pathology results will be referred for speciality care to assume management.

 

Key Points: 
  • The Student Health Center performs only minor surgical procedures.
  • Informed consent is documented for surgical procedures.
  • Removed tissues are routinely sent for pathology evaluation and patients are notified of results and recommended follow up.
  • Post procedure instructions are routinely provided that include after hours care options.