Competency checklist addl

Maintenance of Safe Environment

Performance Criteria (PC) Standard AchievedThe nurse will successfully: Self assessment Evaluator assessment

Yes No Initial & date

M S N

1 Demonstrate bed space safety checks and discuss the implications of each check

2 Demonstrate the correct use of the call bells and when these would be used.

3 Locate spare oxygen cylinders, demonstrate reading cylinder gauge.

4 Discuss the implications of a cluttered bed space and demonstrate an attempt to remove excess equipment from the patient area environment.

5 Demonstrate how to complete safety checks of unit based emergency equipment.

6 Describe how to ensure faulty equipment is reported.

7 Be shown when and how to complete `Risk Pro’

Date completion Assessor’s Name & Signature Designation

Competency Key

Level Of Competency: Abbrev. Level of Competency: Abbrev.Does not meet criteria N Exceeds criteria- area of strength SMeets Criteria M Not observed N/O

BEDSIDE SAFETY



M S N

1 Demonstrate correct set up for a patient admission

2 Demonstrate correctly checking an ambubag and state when you would need a PEEP valve attached.

3 Demonstrate the correct set up for oral suction and state what this should be set at.

4 Demonstrate the correct set up for low-pressure suction for chest drains.

5 Demonstrate the correct use of the call bells and when these would be used.


Competency Key


BEDS


Yes No Initial &

date

M S N

1 Identify the different types of beds available in the ICU/HDU.

2 Locate the brakes and demonstrate their use.3 Demonstrate how to perform a head tilt using the

bed control.4 Demonstrate how to engage the head emergency

release.5 Demonstrate how to raise and lower the bed

using the bed control.6 Demonstrate how to lift and lower the patient’s

legs using the bed control7 Demonstrate how to place the bed in

Trendelenburg and reverse Trendelenburg using the bed control.

8 Demonstrate how to safely place the bed into Trendelenburg and reverse Trendelenburg using the manual control.

9 Demonstrate how to place the applicable beds into the seated position using the bed control.

10 Demonstrate how to lift and lower the side rails.11 Demonstrate how to lift and lower and where

applicable remove the head and footrests.


Competency Key


Nihon Kohden MonitorsPerformance Criteria (PC) Standard AchievedThe nurse will successfully: Self assessment Evaluator assessment

Yes No Initial &

date

M S N

1 Demonstrate how to admit patient data into the monitor, including commencement of the case and correct values for measures eg kg/cm

2 Demonstrate how to transport monitor tram over to the patient monitor when a patient has come back from recovery/OT

3 Demonstrate how to change the screen layouts and turn parameters on/off.

4 Demonstrate how to set alarm levels, arrhythmia levels, and alarm volume.

5 Demonstrate how to silence an alarm.6 Demonstrate how to retrieve an alarm history.7 Demonstrate the correct placement of electrodes

for monitoring of the ECG.8 Demonstrate changing the size of the ECG and the

lead viewed.9 Demonstrate the correct procedure for obtaining

oxygen saturation.10 Demonstrate the correct procedure for obtaining

a NIBP including setting it to record automatically.11 Demonstrate how to zero a transduced line.12 Demonstrate how to retrieve observation history 13 Demonstrate how to discharge a patient off the

monitor.14 Demonstrate how to completely power down the

monitor and then power it up.15 Demonstrate how to switch the monitor to the

standby state.16 Demonstrate correct procedure for cleaning the

equipment.


Competency KeyLevel Of Competency: Abbrev. Level of Competency: Abbrev.

Does not meet criteria N Exceeds criteria- area of strength SMeets Criteria M Not observed N/O

INFUSION DEVICESPerformance Criteria (PC) Standard AchievedThe nurse will successfully: Self assessment Evaluator assessment


M S N

1 Explain the safety checks and precautions to be taken before use of an infusion device

2 State the functions of the soft keys and indicators on the front panel of syringe driver/ volumetric pump.

3 Demonstrate the correct loading and unloading of a syringe (syringe driver) and giving set (volumetric pump)

4 Initiate and commence a prescribed infusion on syringe driver/ volumetric pump.

5 Explain the information on the pump display whilst on use

6 On volumetric pump demonstrate how to set a specified volume to be infused

7 Demonstrate the use of a prescribed drug name8 Explain what KVO is9 Explain what the battery alarm means and what

to do for them


Competency Key


RHYTHM INTERPRETATION and MANAGEMENTPerformance Criteria (PC) Standard AchievedThe nurse will successfully: Self assessment Evaluator assessment


M S N

1 Describe the electrical conduction through the heart

2 Correctly label the ECG complex3 Correctly identify the following rhythms and

discuss treatment options: Sinus rhythm Sinus bradycardia Sinus tachycardia Atrial fibrillation Atrial flutter Ventricular tachycardia Ventricular Fibrillation Asystole

4 Demonstrate taking 12 Lead ECG using the Nihon Kohden monitor


Competency KeyLevel Of Competency: Abbrev. Level of Competency: Abbrev.


MANAGEMENT OF ARTIFICIAL AIRWAY AND POSITIVE PRESSURE VENTILATIONPerformance Criteria (PC) Standard AchievedThe nurse will successfully: Self assessment Evaluator assessment


M S N

1 Demonstrate respiratory examination of intubated patient

2 Identify normal lung structure /ET tube/ Central line and intercostal drains on post op CXR

3 Explain principles of positive pressure ventilation4 Discuss reasons for intubation5 Identify equipment necessary for intubation6 Discuss when a bag valve mask would be used and

demonstrate its use7 Describe potential complications of bagging and

how to avoid them8 Demonstrate the correct procedure for securing

an ET tube9 Demonstrate correct suction procedure for a

patient with an ET tube, including selecting s suitable pressure to prevent barotrauma

10 Demonstrate collection of sputum sample from an intubated patient

11 Discuss 3 preventative methods to prevent nosocomial infections in ventilated patients

12 List 3 signs that would indicate a patient’s ET tube has become dislodged/ blocked

13 Discuss benefits of early extubation14 Explain reasons behind each criteria for weaning

process Eg Temp, bleeding levels15 Demonstrate weaning process on 3 occasions16 Identify signs which would indicate patient not

coping with weaning process17 Discuss appropriate course of actions to take if a

patient is not coping with weaning process18 State parameters that need to be met prior to

extubation19 Demonstrate on 3 occasions planned extubation20 Identify signs that patient not coping with

extubation21 Discuss appropriate course of actions to take if a

patient is not coping with extubation22 Identify and discuss treatment options for ABG

showing Respiratory Acidosis Respiratory Alkalosis Metabolic Acidosis Metabolic Alkalosis


Competency Key


TRACHEOSTOMIES



M S N

1 State the most common indications for tracheostomy

2 Identify the anatomical position of a tracheostomy

3 Identify and rationalise the equipment that must be present in the bedspace of a patient with a tracheostomy

4 Identify 3 complications of a tracheostomy5 State what the humidifier should be set to for a

patient with a tracheostomy6 Discuss how to insert a tracheal dilators7 State the difference between fenestrated and

non- fenestrated tracheostomy tubes8 Identify how often you would suction a patient

with a tracheostomy and the indications for this9 Demonstrate the correct procedure for

suctioning a tracheostomy10 State when an inner tube should be in situ,

discuss the correct procedure for removing and inserting an inner tube.

11 Demonstrate the cleaning procedure for an inner tube stating how often this needs to be done

12 Demonstrate the correct procedure for performing a tracheostomy dressing and changing of tapes

13 Explain how you would prevent and manage an occluded tracheostomy tube, aspiration and an unplanned removal

14 Discuss when cuff inflation and deflation should be done

15 State the process for weaning a patient16 State when oral feeding may commence for a

patient with tracheostomy in situ, the safety considerations and observations required.


Competency Key


TISSUE VIABILITY



M S N

1 Demonstrate the ability to ensure that all hygiene needs are met for/with the patient in an appropriate manner and according to RBP.

Eye and oral care Urinary catheter care Maintenance of patients privacy and

dignity at all times2 Demonstrate accurate and appropriate pressure

area assessments3 Identify factors affecting skin integrity and wound

healing4 Identify appropriate personnel to assist in

choosing wound care products and how to complete accurate and appropriate documentation

5 Demonstrate aseptic technique in caring for patients wounds and invasive sites

6 Demonstrate correct method for taking a wound swab


Competency ChecklistLevel Of Competency: Abbrev. Level of Competency: Abbrev.


PSYCHOLOGICAL ISSUES FOR PATIENTSPerformance Criteria (PC) Standard AchievedThe nurse will successfully: Self assessment Evaluator assessment


M S N

1 Discuss the communication needs of the unconscious and/ or intubated patient

2 Discuss the psychological impact of the critical care environment, both in the short and longer term, for both the patient and relatives.

3 Describe how patients can be prepared for step down to the ward after a prolonged stay in the ICU

4 Identify the common barriers to sleep.5 Demonstrate the ability to create an environment

conducive to achieving sleep6 Discuss some of the problems associated with

intensive care and cardiac surgery in relation to hallucinations and delirium


Competency Key


CARE OF THE DYING PATIENT



M S N

1 Identify the role of the nurse when caring for the dying patient, including the importance of comfort, sedation and analgesia, the importance of privacy and dignity, ways of meeting relative needs, identifying and meeting religious and cultural needs.

2 Discuss with the nurse specialist the legal and ethical requirements when caring for a dying patients, to include treatment withdrawal, Not for Resuscitation orders

3 Demonstrate awareness of correct documentation and disposal of notes, x-rays and property

4 Discuss with members of the bereavement team their role

5 Discuss the availability of debriefing for staff and follow up services that are available for both staff and relatives


Competency Key


TRANSPORT OF THE CRITICALLY ILL



M S N

1 List essential equipment that is needed for Self ventilating patientVentilated patient

2 Set up portable monitor- demonstrate changing alarm limits, zeroing transducers

3 Perform a transport bag check4 Discuss special requirements for MRI scanning5 Demonstrate correct use of portable suction6 Discuss parameters that need to be monitored

during transport7 Discuss risks and preventative measures that can

be taken for patients undergoing transfers8 Discuss emergency procedures to be undertaken

if a patient deteriorates on transfer9 Discuss which personnel should accompany

patient on transfer if- Self ventilating- Ventilated


Competency Key


Central Venous LinesPerformance Criteria (PC) Standard AchievedThe nurse will successfully Self

assessmentEvaluator assessment

Yes No Initial& Date

M S N

1 Give 3 reasons why a patient may require a CVL2 State 3 locations where a CVL may be inserted and

explain where the tip of the CVL resides3 Demonstrate the equipment required for insertion of

a CVL, including the pressure bag and transducing system. Explain your role during a CVL insertion

4 Demonstrate levelling the transducer to the patient's phlebostatic axis and zeroing

5 State how often continuous infusion lines need to be changed

6 State how often intermittent infusion lines need to be changed

7 State how often the CVL dressing needs to be changed8 Demonstrate a CVL dressing9 State how often a CVL needs flushing when it is not in

use10 State how often the 3-way tap needs changing 11 Describe how you would manage a blocked lumen12 State 3 complications of having a CVL insitu13 Demonstrate the correct procedure for taking blood

from a CVL14 Demonstrate the correct procedure for removing a

CVL

Date of Completion Assessor’s Name & Signature Designation

Competency Key

Level of Competency Abbrev Level of Competency AbbrevDoes not meet criteria N Exceeds criteria – area of strength SMeets criteria M Not observed N/O

Chest DrainsPerformance Criteria PC Standard AchievedThe nurse will successfully Self



M S N

1 State the difference between cardiac and thoracic drains

2 Identify the indications for a chest drain3 State how to differentiate between apical and basal

drains 4 Demonstrate setting up the equipment required for a

chest drain insertion5 Discuss the differences between high and a low

pressure units and when these are used6 State the usual range of low pressure suction for

patients post cardiac surgery7 State the usual range of low pressure suction for

patients post thoracic surgery 8 State when a chest drain can be clamped9 State the safety aspects of looking for a patient with a

chest drain10 Demonstrate the correct procedure for securing a

chest drain to the skin surface 11 Demonstrate the correct procedure for taping chest

drain tubing connections12 Demonstrate how to correctly apply suction to a chest

drain13 Demonstrate the correct procedure for changing a

chest drain dressing14 State how often the tubing and the chest drain bottle

needs changing and demonstrate the correct procedure for this

15 State what action you would take if the tubing became disconnected

16 Demonstrate the correct procedure for removal of chest drain

17 State when chest drains are removed


Competency Key


Blood Sugar ManagementPerformance Criteria PC Standard AchievedThe nurse will successfully Self



M S N

1 Explain the rationale for normalization of blood sugar

2 Explain the effects of insulin3 Demonstrate correctly drawing up and labelling an

insulin4 Demonstrate the correct use of insulin protocol5 State your action if the blood sugar level is rapidly

declining6 State your action if you have a patient who is on an

insulin infusion and is having NG feeds and the feed is turned off

7 Demonstrate the correct documentation of blood sugar level results and adjustments to the insulin infusion


Competency Key


Pain ManagementPerformance Criteria PC Standard AchievedThe nurse will successfully Self



M S N

1 Perform a pain assessment2 Identify the appropriate interventions for pain

management3 Demonstrate how you would use the IV Opioid

Protocol4 Correctly document your assessment findings and

interventions5 State how the patients response to intervention and

analgesic medications is monitored and documented


Competency Key


Patient Controlled AnalgesiaPerformance Criteria PC Standard AchievedThe nurse will successfully Self



M S N

1 Locate the RBP for PCA2 Locate the PCA information document3 Locate the Acute Pain Service Resource Manual4 State how to order a pump5 Locate the Prescription chart6 State how to assess the patient’s effective use of

PCA7 Demonstrate checking the prescription8 Demonstrate correct labeling of the tubing9 Demonstrate correct assembly of the tubing10 Demonstrate correct insertion of the cassette into

the pump11 Demonstrate the correct programming of the pump

against the prescription12 State the purpose of the anti-siphon valve13 State the purpose of the anti-reflux valve14 State what drugs and/or fluids can be infused via the

sidearm15 Demonstrate how to find from the history

1. Program2. Shift Totals3. Demands and Delivery Totals

16 Demonstrate locking and unlocking the keypad17 Demonstrate a bag change18 Demonstrate changing dose19 Demonstrate changing modality20 Demonstrate programming extra bolus dose21 Demonstrate battery change22 Demonstrate stopping and removing cassette23 Demonstrate priming remainder of line24 Demonstrate a line change25 Demonstrate starting a pump26 State the frequency of bag and line change27 State how to recognize alarms and trouble shoot

pump: Air in line Change batteries Check batteries Proximal occlusion – cassette “P” Distal occlusion Almost empty Use Help Key

28 State how often observations need to be made29 Identify where Naloxone is kept in the unit30 Explain the following terms:

PCA PCA & Continuous Lockout Dose limit Adjunct therapy

31 State how to return the pump when discontinued


Competency Key


WOUND MANAGEMENT

Performance Criteria PC Standard AchievedThe nurse will successfully Self



M S N

1 Correctly assesses the wound: Type of wound Phase of Healing Correct Tissue Identification Identification of surrounding tissue Amount of exudate Wound measurement Rationale for taking a wound swab Pain Signs and symptoms of infection

2 Correctly choose the appropriate wound product3 State the function of the following wound products:

Films Hydrocolloids Foams Alginates &Hydrofibres Gels Anti-microbials

4 State the contributing factors to wound healing5 Demonstrate aseptic dressing technique6 Demonstrate the correct use of a wound bag7 Demonstrate correct documentation

Competency Key


InotropesPerformance Criteria PC Standard AchievedThe nurse will successfully Self



M S N

1 State the effects and usual dose ranges of:a. Dopamineb. Norepinephrinec. Milrinone

2 Demonstrate how to safely calculate the dose, draw up and label the infusion of an inotrope:

a. Dopamineb. Norepinephrinec. Milrinone

3 Demonstrate how to safely change an infusion of inotrope

4 Demonstrate how to document on the chart the infusion rate

5 State the actions taken if the pump displays an occlusion alarm


Competency Key


Competency checklist addl

Technology

Transcript of Competency checklist addl