Supervision and Procedures: Brenner, Elisabeth "Cydnie" (MD)

The Residency Supervision Area is designed to assist hospitals and clinics with the protocols outlined for specific duties residents and fellows can perform. These guidelines are determined by the faculty of the University of Tennessee College of Medicine Chattanooga, Department of OB/GYN. Any questions about certain procedures not listed should be addressed to the faculty and not decided by the resident or fellow.

A credentialed and privileged attending physician ultimately provides supervision or oversight of each Resident's patient care activities. Direct supervision by a qualified attending physician (or a more senior Resident with Indirect Supervision immediately available) is required in the OR/Delivery Room or for non-routine invasive procedures like Cardiac Cath, Endoscopy, and Interventional Radiology.

Elisabeth "Cydnie" Brenner, MD 听

PGY-4 Chief Resident听

Obstetrics and Gynecology

Resident Supervision will consist of four categories/levels:

Direct Supervision听- the supervising physician is physically present with the resident and patient.
Indirect Supervision with Direct Supervision IMMEDIATELY available听- the supervising physician is physically within the hospital or other sites of patient care, and is IMMEDIATELY available to provide Direct Supervision.
Indirect Supervision with Direct Supervision available听- the supervising physician is not physically present within the hospital or other sites of patient care, but is IMMEDIATELY available by means of telephone or other electronic means, and can be available if required for Direct Supervision
翱惫别谤蝉颈驳丑迟听- Supervising Physician is available to provide a review of procedures or the encounter with feedback after the care is provided but the procedure or care does not warrant the physical presence of the attending.
In particular, PGY-1 residents should be supervised either directly or indirectly with direct supervision immediately available as described in the levels of supervision, unless denoted as听Oversight听in the list that follows.
In an emergency, defined as a situation where immediate care is necessary to preserve life or prevent serious impairment, residents are permitted to initiate whatever care is necessary and reasonable to save a patient from serious harm even if an attending physician is not immediately available to supervise. 听The appropriate Medical Staff member should be notified as soon as possible.听听
Supervising physicians may be more advanced residents or fellows.听

Certifications current when the resident entered training at the UTCOMC.听听听听听听听听听听

Basic Life Support (BLS)

Advanced Cardiac Life Support (ACLS)

Neonatal Resuscitation Program (NRP)听听

As a 4th Year Obstetrics and Gynecology Resident (PGY-4 level), the Resident can perform any obstetrical or gynecological physician skill or procedure deemed appropriate by his/her attending physician or specialty physician skill or procedure deemed appropriate by an attending physician in a department in which the Resident is assigned for rotation (e.g., Emergency Medicine, Trauma Surgery, Surgical Critical Care, PICU, etc.). 听Residents are expected to progressively assume more responsibility throughout each level of training and demonstrate competence in skills/procedures requiring less Direct Supervision. 听The supervising physician may make adjustments in the level of supervision required for that specific procedure.

Patient Care Skills or Procedures that do not require Direct or Indirect Supervision presence of a supervising physician (i.e., Oversight/General Supervision) are listed below.听 Anything not specifically listed requires either Direct Supervision, Indirect Supervision with Direct Supervision Immediately Available, or Indirect Supervision with Direct Supervision available by phone or other electronic media, at the discretion of the supervising physician.听听听听听听听听听听听听听听听听听听听听听听听听听听

PGY-1 Obstetrics and Gynecology Residents are supervised either directly or indirectly with the supervising attending or more senior resident available to provide direct supervision. PGY-1 Obstetrics and Gynecology Residents can perform the skills or procedures listed below under Indirect Supervision or Oversight highlighted in yellow.

PGY-2 Obstetrics and Gynecology Residents can perform the procedures listed below under Indirect Supervision or Oversight highlighted in red.

PGY-3 Obstetrics and Gynecology Residents can perform the procedures listed below听under Indirect Supervision or Oversight highlighted in green.

PGY-4 Obstetrics and Gynecology Chief Residents can perform the procedures listed below under Indirect Supervision or Oversight highlighted in blue.

The physical presence of a supervising physician is not required when performing the skills and procedures listed below (by level):

听

听Differential Diagnosis, Treatment, and Patient Care Skills	PGY-1听	PGY-2听	PGY-3听	PGY-4 Chief Resident
听听听 Active rupture of membranes	听X	听X	X	X
听听听 Amniocentesis	听	听	听	X
听听听 Antepartum management of obstetrical patients	听	听	X	X
听听听 Antepartum management of high-risk obstetrical patients	听	听	X	X
听听听 Application of internal fetal scalp monitor	听	听	X	X
听听听 Bimanual and speculum pelvic exam	听X	听X	X	X
听听听 Bladder catheterization	听	听	X	X
听听听 C-Section delivery	听	听	X	X
听听听 Cervical biopsy	听	听	X	X
听听听 Chief Resident supervisory and administrative responsibilities	听	听	听	X
听听听 Circumcision	听	听X	X	X
听听 Clinical and Social History	听X	听X	听X	听X
听听 Communicate with patients and family members	听X	听X	听X	听X听
听听听 Culdocentesis	听	听	X	X
听听 EKG - perform and interpret	听X	听X	听X	听X
听听听 Endometrial biospy	听	听	X	X
听听 Formulate diagnostic and treatment plans	听X听	听X	听X	听X
听听 Formulate pre-and post-operative treatment plans	听X	听X	听X	听X听
听听听 Incision & Drainage of Bartholin / Vulvular abscess	听	听	X	X
听听 Initial Emergency Department consults	听X	听X	听X	X
听听听 Initial evaluation / triage of Labor & Delivery patients	听X	听X	听X	X
听听听 Initial evaluation of fetal heart tracings	听X	听X	听X	X
听听听 Initial evaluation of post-operative complications	听	听X	听X	X
听听听 Initial gynecology consult	听X	听X	听X	X
听听听 Initial obstetrical consult	听X	听X	听X	X
听听听 Insertion of central venous pressure catheter	听	听	听X	X
听听听 Insertion of internal uterine pressure catheter	听	听	听X	X
听听 Interpret basic x-rays and imaging studies	听X	听X	听X	听X
听听听 Interpret fetal monitor strip	听	听X	听X	X
听听 Interpret laboratory and diagnostic studies and tests (including arterial blood gases)	听X	听X	听X	听X
听听听 Intravenous line	听X	听X	听X	X
听听听 Laparoscopy	听	听	听X	X
听听 Mark surgical procedures on patients	听X	听X	听X	听X
听听听 Normal vaginal delivery	听	听X	听X	X
听听 Order radiologic, laboratory, or other diagnostic tests	听X	听X	听X	听X
听听听 Pap smear	听X	听X	听X	X
听听 Participate in and supervise a code (adults)	听X	听X	听X	听X
听听 Participate in neonatal resuscitation	听	X	X	听X
听听 Paracentesis	听	听	听X	听X
听听听 Perform as primary surgeon	听	听	听	X
听听听 Perform lesser major gynecologic procedures	听	听	听X	X
听听听 Perform minor gynecologic procedures	听	听	听X	X
听听听 Perform ultrasounds (fetal and gynecologic)	听	听	听	X
听听 Peripheral Intravenous Access	听	X	X	听X
听听 Physical Examination	听X	听X	听X	听X
听听听 Placement of cervical ripening agent	听X	听X	听X	X
听听 Request specialty and subspecialty consults	听X	听X	听X	听X
听听 Roll with patient to surgery when staff is notified the attending is "on the way to the OR"听	X	X	X	X
听听 See patients and write patient orders	听X	听X	听X	听X
听听 Supervise Medical Students	听X	听X	听X	听X
听听听 Supervise minor surgeries and C-Sections	听	听	听X	X
听听听 Supervise more junior Residents	听	X	X	X
听听听 Suture repair of vulvar / vaginal lacerations	听X	听X	听X	X
听听听 Suture simple wounds and other lacerations	听X	听X	听X	X
听听听 Thoracentesis	听	听	听X	X
听听 Venipuncture	X	X	X	听X
听听听 Vulvar biopsy	听X	听X	听X	X
听听听 Wet prep analysis	听X	听X	听X	X
听听 Wound debridement	X	X	X	听X
听听 Write admission, treatment orders, and notes in the Electronic Health Record	X	X	X	X
听	听	听	听	听
听Cardiopulmonary Resuscitation and Airway Maintenance	听	听	听听	听
听听Perform Basic CPR and related procedures (airway management, emergency drug therapy, rhythm strip interpretation, intravenous catheterization, closed chest massage, electrocardioversion & defibrillation, and venous cut-down)听	听X	听X	听X	听X
听听Adult Resuscitation	X	X	X	听X
听听 Neonatal Resuscitation	听X	听X	听X	听X

听听听听听听听听听听听听听听听听听听

All听other procedures not listed should be performed under the direct supervision of a faculty member or more senior resident.听听

含羞草传媒