Tollgate III - Intermediate Clinical Apprentice III: Intermediate Clinical Procedures, EKG and Cardiovascular testing, Phlebotomy, Basic Pharmacology and Medication Administration

1. Identify roles and responsibilities of the medical assistant and other healthcare providers Differentiate between scope of practice and standards of care for medical assistants
2. Discuss licensure and certification as they apply to healthcare staff and providers
3. Demonstrate understanding and use of basic medical terminology a. Common abbreviations, acronyms, and symbols
4. b. Medical word building (prefixes, suffixes, plurals)
5. c. Conditions, procedures, and instruments
6. Demonstrate understanding and use of basic pharmacology a. Commonly prescribed medications and common approved abbreviations
7. b. Forms of medications
8. c. Look alike/sound alike medications
9. d. Routes of administration
10. e. Physicians’ Desk Reference and online resources
11. f. Principals of storage and disposal
12. Define dietary nutrients and their functions
13. Recognize psychological components of patient care

1. Describe structural organization of the human body
2. Identify the anatomical location of major organs in each body system
3. Describe the normal function of each body system across the life span
4. Identify common pathophysiology and disease processes across the lifespan
5. Discuss basic concepts of microbiology

1. Demonstrate ability to measure and record: a. Blood pressure
2. b. Describe normal, pre-hypertension and hypertension
3. c. Temperature
4. d. Pulse
5. e. Respirations
6. f. Intake and output
7. g. Height
8. h. Weight
9. i. Length (infant)
10. j. Head circumference (infant)
11. k. Pulse oximetry
12. l. Pain (using correct scale for children and adults)

1. a. Demonstrates general clinical patient care
2. b. Identify patient using the correct patient identifiers
3. c. Rooming process
4. d. Medication reconciliation
5. e. Effective handoff communication with provider and other staff
6. f. Prepare patient for procedure or treatment
7. g. Assist provider with minor office procedures
8. h. Proper documentation
9. i. After visit summary / discharge
10. j. Demonstrate ability to collect pertinent patient data
11. k. Reason for the visit
12. l. Preferred pharmacy
13. m. Allergies
14. n. Medical and social history
15. o. Domestic violence screening
16. p. Falls risk
17. q. Tobacco, drug, alcohol history
18. r. Travel History
19. s. Proper documentation

1. a. Electrocardiography
2. b. Venipuncture
3. c. Capillary puncture
4. d. Incentive spirometry
5. e. Aseptic and sterile technique
6. f. Bladder scanner
7. g. Urinary catheterization
8. h. Suture and staple removal
9. i. Ear Irrigation
10. j. Eye Irrigation
11. k. Casting and splinting
12. l. Pulmonary Function Testing
13. m. Wound care
14. n. Simple dressing
15. o. Simple wet to dry dressing

1. Demonstrate measurement and conversions for both metric and household measures
2. Calculate proper dosages for medication administration
3. Successfully complete medication dosage calculation test
4. Identify classifications of medications
5. Verify the rules of medication administration: a. Right patient
6. b. Right medication
7. c. Right dose
8. d. Right route
9. e. Right time
10. f. Right documentation
11. g. Right reaction or response
12. Identify landmarks for subcutaneous and intramuscular injections
13. Correctly administer medication via the following routes: a. Oral
14. b. Parenteral (excluding IV) intramuscular and subcutaneous
15. c. Inhalation (nebulizer)
16. d. Rectally
17. e. Eye
18. f. Ear
19. Demonstrate aseptic and sterile technique when preparing and administering medications
20. Understand distinction between single use and multi-dose vials
21. Demonstrate proper disposal of sharps and medication equipment
22. Utilize engineered safety mechanism on devices

1. Perform quality control measures- urinalysis and glucometer machines
2. Obtain specimens and perform: a. CLIA waived hematology test
3. b. CLIA waived chemistry test
4. c. CLIA waived urinalysis
5. d. CLIA waived immunology test
6. e. CLIA waived microbiology test

1. Maintain Basic Life Support Certification for a Healthcare Provider- American Heart Association or American Red Cross
2. Able to locate AED in clinic, i.e. Appropriately place pads and locate power
3. Respond appropriately to medical emergencies within the Medical Assistant scope as they pertain to the ambulatory healthcare setting a. Bleeding
4. b. Hypoglycemia
5. c. Hyperglycemia
6. d. Diabetic coma or insulin shock
7. e. Seizures
8. f. Fainting/syncope
9. g. Shock
10. h. Fracture
11. i. Stroke
12. j. Myocardial Infarction

1. Describe regulations and guidelines related to infection prevention and control
2. Describe the infection control cycle, common infectious agents, medical and surgical asepsis
3. Demonstrates understanding and use of standard precautions
4. Select appropriate barrier/personal protective equipment (PPE)
5. Perform hand hygiene appropriately
6. Prepare items for autoclaving or central processing
7. Perform sterilization procedures
8. Prepare a sterile field for procedure
9. Demonstrates proper disposal of sharps
10. Demonstrate proper disposal of biohazardous material a. Sharps
11. b. Regulated wastes
12. Recognize the implications for failure to comply with Center for Disease Control (CDC) and Occupational Health Safety and Health Association (OSHA) regulations in healthcare settings

1. Define medical assistant scope of practice and demonstrate principles of self-boundaries
2. Use the following communication techniques to obtain patient information: a. Reflection
3. b. Restatement
4. c. Clarification
5. Demonstrate appropriate verbal and nonverbal communication
6. Implement techniques to overcome communication barriers
7. Differentiate between subjective and objective information
8. Use medical terminology correctly and pronounced accurately to communicate information to providers and patients
9. Reinforce education of patients regarding: a. Clinic policies
10. b. Health maintenance
11. c. Disease prevention
12. d. Treatment plan
13. Support patients appropriately considering: a. Cultural diversity
14. b. Developmental life stage
15. c. Communication barriers
16. d. Coping mechanisms
17. Demonstrate professional telephone techniques
18. Document telephone messages accurately
19. Compose professional correspondence utilizing electronic technology
20. Locate current list of community resources related to patients’ healthcare needs
21. Report relevant information concisely and accurately
22. Demonstrate: a. Empathy
23. b. Active listening
24. c. Nonverbal communication
25. d. Values and behaviors of Carolina Care
26. Demonstrate respect for individual diversity including: a. Gender
27. b. Race
28. c. Religion
29. d. Age
30. e. Economic status
31. f. Appearance
32. g. Orientation and/or lifestyle

1. Properly schedules patients based on priorities (new and returning patients)
2. Able to check in and check out patients
3. Schedule patient new and return appointment
4. Schedule a patient procedure
5. Create, organize, and maintain a new patient’s medical record
6. File patient medical records
7. Utilize an electronic medical record to perform basic administrative functions (i.e. Epic)
8. Perform routine maintenance of administrative or clinical equipment
9. Perform an inventory with documentation

1. Identify types of financial information contained in the patient’s billing record.
2. Perform account procedures to include: a. Cash collection
3. b. Credit card charges
4. c. Reconcile adjustments
5. Verbalize understanding of process to make bank deposit
6. Appropriately utilize cash bags and secures monies during shift and at end of shift
7. Inform a patient of financial obligations for services rendered including Site of Service Letter
8. Verbalize understanding of role of financial navigator

1. Interpret information on an insurance card
2. Able to collect demographic information appropriately
3. Verify eligibility for services and documents appropriately
4. Obtain precertification or preauthorization including documentation
5. Understand various payment models including HMO, PPO, ACO, Medicare, Medicaid, Tricare
6. Complete an insurance claim form
7. Differentiate between fraud and abuse

1. Perform procedural coding
2. Perform diagnostic coding
3. Utilize medical necessity guidelines

1. Comply with legal and regulatory requirements
2. Adhere to professional codes of ethics
3. Explain and adhere to the use of medical directives as it relates to: a. Healthcare proxies and agents
4. b. Medical order for life-sustaining treatment
5. Describe components of the Health Insurance Portability & Accountability Act (HIPAA) a. Privacy
6. b. Release of information
7. Summarize the Patient’s Bill of Rights as it relates to: a. Choice of treatment
8. b. General consent for treatment
9. c. Right to information
10. d. Refusal of treatment
11. e. Informed consent for treatment
12. Verbalize understanding of required reporting based on public health statutes a. Domestic violence
13. b. Communicable diseases
14. Verbalize understanding of how to report illegal activity in the healthcare setting
15. Complete an incident report related to an error in patient care (Safety Awareness for Everyone)
16. Protect the integrity of the medical record (logs off when computer not in use, protects protected health information appropriately)
17. Develops a plan for separation of personal and professional ethics

1. Evaluate the work environment to identify unsafe working conditions
2. Discuss fire safety issues and safe evacuation in an ambulatory healthcare setting
3. Identify response measures for an emergency or natural disaster
4. Identify safety techniques that can be used when responding to accidental exposures to: a. Blood or body fluids
5. b. Needle sticks
6. c. Chemical spills
7. Identify and comply with: a. Safety related policies and procedures,
8. b. Safety related signage, symbols, and labels
9. Locate Material Safety Data Sheets (MSDS) and Safety Data Sheets (SDS)
10. Demonstrate proper use of: a. Eyewash equipment
11. b. Fire extinguishers
12. c. Biological chemical materials
13. Demonstrate use of proper body mechanics