Critical Care RN Needs Assessment 2010 - UC …...1 of 18 Critical Care RN Needs Assessment 2010 1....

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Critical Care RN Needs Assessment 2010

1. Identify the area you work on.

Response

Percent

Response

Count

SSDU 17.2% 10

NSDU 3.4% 2

NSCU 13.8% 8

BICU 8.6% 5

SICU 31.0% 18

MICU 12.1% 7

CCU 13.8% 8

answered question 58

skipped question 0

2. Identify the patient population you care for

Response

Percent

Response

Count

Adult 87.9% 51

Pediatric 0.0% 0

Adult & Pediatric 12.1% 7


skipped question 0

OO9d, 2010 Critical Care Needs Assessment Survey Results.pdf

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3. I prefer lectures give in:

Response

Percent

Response

Count

2 hour sessions 19.0% 11



other 5.2% 3

Other (please specify)

3


skipped question 0

4. I would like lectures given by:

Response

Percent

Response

Count

MD's/Residents 58.2% 32

NP's 47.3% 26

CNS/Educators 78.2% 43

Staff from UCIMC 56.4% 31

Staff from outside UCIMC 47.3% 26

Published Speakers 52.7% 29

National recognized speakers 54.5% 30

Other 1.8% 1


4


skipped question 3


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5. I prefer to attend classes on:

Response

Percent

Response

Count

Monday 29.3% 17

Tuesday 25.9% 15

Wednesday 20.7% 12

Thursday 6.9% 4

Friday 17.2% 10


skipped question 0


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6. I would be interested in taking the following verification review courses in the next year:

Response

Percent

Response

Count

CCRN (Critical Care Registered

Nurse)63.0% 34

PCCN (Progressive Care

Registered Nurse)13.0% 7

CMC (Cardiac Medicine

Certification)16.7% 9

CSC (Cardiac Surgery

Certification)14.8% 8

CNRN (Neuro) 11.1% 6

CGRN (Gerontology) 7.4% 4

OCN (orthopedics) 1.9% 1

Certified Rehabilitation 1.9% 1

Certified Oncology Nurse 1.9% 1

Certified Diabetic Educator 13.0% 7

Certified Wound Care Nurse 24.1% 13

Other 5.6% 3


4


skipped question 4


5 of 18

7. The purpose of the annual needs assessment is to determine educational needs for the unit during

the next year.

No

knowledge

or skills

Little

knowledge,

skills and

experience

Knowledgeable,

but lack skill

and experience

Knowledgeable,

but with little

skill and

experience

Knowledgeable

and competent

with skills and

experience

Planning of Care for Critically Ill

Patients and Families0.0% (0) 3.4% (2) 5.2% (3) 24.1% (14) 67.2% (39)

Planning of Care for the Pediatric

Patient35.1% (20) 29.8% (17) 17.5% (10) 12.3% (7) 5.3% (3)

Concepts of Developement

Milestones for Pediatric Patients30.4% (17) 35.7% (20) 14.3% (8) 16.1% (9) 3.6% (2)

Pediatric Safety Interventions 29.8% (17) 31.6% (18) 17.5% (10) 14.0% (8) 7.0% (4)

Pain, Sedation, and Neuromuscular

Blockade Management0.0% (0) 5.3% (3) 5.3% (3) 42.1% (24) 47.4% (27)

Critical Care Pharmacology 0.0% (0) 5.3% (3) 8.8% (5) 36.8% (21) 49.1% (28)

Ethical and Legal Issues in Critical

Care0.0% (0) 6.9% (4) 13.8% (8) 37.9% (22) 41.4% (24)

End-of-Life Issues 0.0% (0) 5.3% (3) 12.3% (7) 36.8% (21) 45.6% (26)

Synergy Model 20.0% (11) 18.2% (10) 14.5% (8) 40.0% (22) 7.3% (4)

High-Risk and Critical Care in

Obstetric Issues12.3% (7) 38.6% (22) 31.6% (18) 14.0% (8) 3.5% (2)

Gerontologic Alterations and

Management3.5% (2) 3.5% (2) 15.8% (9) 50.9% (29) 26.3% (15)

Advanced Cardiac Life Support 0.0% (0) 0.0% (0) 7.0% (4) 33.3% (19) 59.6% (34)

Pediatric Advanced Life Support 43.9% (25) 21.1% (12) 15.8% (9) 10.5% (6) 8.8% (5)

Prevention of Nosocomial

Infections0.0% (0) 0.0% (0) 3.5% (2) 10.5% (6) 86.0% (49)

Medication Safety 0.0% (0) 0.0% (0) 3.4% (2) 6.9% (4) 89.7% (52)

Medication Calculations 0.0% (0) 0.0% (0) 3.6% (2) 23.2% (13) 73.2% (41)

Stress and Critical Illness for Adult

Patient0.0% (0) 0.0% (0) 5.2% (3) 34.5% (20) 60.3% (35)


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Child Abuse 14.0% (8) 26.3% (15) 22.8% (13) 28.1% (16) 8.8% (5)

Healthy Work Environment 0.0% (0) 5.3% (3) 17.5% (10) 22.8% (13) 54.4% (31)

Cardiovascular Anatomy and

Physiology0.0% (0) 0.0% (0) 8.8% (5) 36.8% (21) 54.4% (31)

Cardiovascular Clinical

Assessment and Diagnostic

Procedures

0.0% (0) 1.8% (1) 10.5% (6) 35.1% (20) 52.6% (30)

Cardiovascular Disorders and

Therapeutic Management0.0% (0) 0.0% (0) 13.8% (8) 41.4% (24) 44.8% (26)

Hemodynamic Monitoring 0.0% (0) 1.7% (1) 12.1% (7) 32.8% (19) 53.4% (31)

Interpretation and Management of

Basic Cardiac Rhythms0.0% (0) 0.0% (0) 3.5% (2) 26.3% (15) 70.2% (40)

Pacemakers 0.0% (0) 3.4% (2) 17.2% (10) 48.3% (28) 31.0% (18)

Management of Acute Myocardial

Infarctions0.0% (0) 0.0% (0) 17.2% (10) 34.5% (20) 48.3% (28)

Care and Management of the

Cardiac Surgery Patients3.4% (2) 12.1% (7) 15.5% (9) 39.7% (23) 29.3% (17)

Use and Effects of Vasopressors

and Inotropes0.0% (0) 0.0% (0) 8.6% (5) 34.5% (20) 56.9% (33)

Deep Vein Thrombosis Prophylaxis 0.0% (0) 0.0% (0) 1.7% (1) 25.9% (15) 72.4% (42)

Pulmonary Anatomy and

Physiology0.0% (0) 0.0% (0) 6.9% (4) 32.8% (19) 60.3% (35)

Pulmonary Clinical Assessment

and Diagnostic Procedures0.0% (0) 0.0% (0) 10.3% (6) 39.7% (23) 50.0% (29)

Pulmonary Disorders and


Nitric Oxide 8.6% (5) 10.3% (6) 36.2% (21) 37.9% (22) 6.9% (4)

ETCO2 Monitoring 6.9% (4) 13.8% (8) 22.4% (13) 31.0% (18) 25.9% (15)

Mechanical Ventilation 0.0% (0) 1.8% (1) 17.5% (10) 22.8% (13) 57.9% (33)

Weaning Patients from Mechanical

Ventilation0.0% (0) 8.8% (5) 14.0% (8) 19.3% (11) 57.9% (33)


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Neurologic Anatomy and

Physiology0.0% (0) 1.7% (1) 20.7% (12) 37.9% (22) 39.7% (23)

Neurologic Clinical Assessment and

Diagnostic Procedures0.0% (0) 8.6% (5) 12.1% (7) 39.7% (23) 39.7% (23)

Parkinsons, ALS, Guillian Barre,

Myasthenia Gravis, Alzheimers,

Multiple Sclerosis, Cerebral Palsy

0.0% (0) 13.8% (8) 24.1% (14) 41.4% (24) 20.7% (12)

Eplilepsy & Seizures 1.7% (1) 6.9% (4) 24.1% (14) 36.2% (21) 31.0% (18)

Standards of Care for the

Traumatic Brain Injured Patient0.0% (0) 12.1% (7) 22.4% (13) 32.8% (19) 32.8% (19)

Identification and Treatment of

Vasospasm1.8% (1) 8.8% (5) 21.1% (12) 36.8% (21) 31.6% (18)

Intracranial Pressure Monitoring 1.7% (1) 10.3% (6) 20.7% (12) 27.6% (16) 39.7% (23)

Brain Tissue Oxygen Monitoring 8.6% (5) 5.2% (3) 24.1% (14) 37.9% (22) 24.1% (14)

Cerebral Perfusion Pressure

Management6.9% (4) 6.9% (4) 25.9% (15) 31.0% (18) 29.3% (17)

Care and Management of Stroke 0.0% (0) 5.2% (3) 10.3% (6) 50.0% (29) 34.5% (20)

Traumatic Brain Injuries 3.4% (2) 8.6% (5) 19.0% (11) 36.2% (21) 32.8% (19)

Brain Tumors 1.8% (1) 10.5% (6) 28.1% (16) 35.1% (20) 24.6% (14)

Therapeutic Hypothermia 7.0% (4) 7.0% (4) 26.3% (15) 35.1% (20) 24.6% (14)

Prevention of ICU Delirium/Use of

CAM-ICU6.9% (4) 5.2% (3) 22.4% (13) 29.3% (17) 36.2% (21)

Renal Anatomy and Physiology 0.0% (0) 0.0% (0) 8.6% (5) 44.8% (26) 46.6% (27)

Renal Assessment and Diagnostic

Procedures0.0% (0) 0.0% (0) 12.1% (7) 39.7% (23) 48.3% (28)

Renal Disorders and Therapeutic

Management0.0% (0) 3.4% (2) 8.6% (5) 39.7% (23) 48.3% (28)

Fluid and Electrolyte Balance 0.0% (0) 0.0% (0) 8.6% (5) 27.6% (16) 63.8% (37)

Acute Renal Failure 0.0% (0) 0.0% (0) 8.8% (5) 31.6% (18) 59.6% (34)

Renal Replacement Therapies 0.0% (0) 7.0% (4) 8.8% (5) 40.4% (23) 43.9% (25)

Gastrointestinal Anatomy and 0.0% (0) 0.0% (0) 5.3% (3) 33.3% (19) 61.4% (35)


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Physiology

Care of the Whipple Patient 3.4% (2) 5.2% (3) 13.8% (8) 43.1% (25) 34.5% (20)

Gastrointestinal Clinical

Assessment and Diagnostic

Procedures

0.0% (0) 3.4% (2) 10.3% (6) 29.3% (17) 56.9% (33)

Gastrointestinal Disorders and


Acute Gastrointestinal Bleeding 0.0% (0) 1.7% (1) 12.1% (7) 34.5% (20) 51.7% (30)

Acute Pancreatitis 0.0% (0) 0.0% (0) 15.8% (9) 33.3% (19) 50.9% (29)

Fulminant Hepatic Failure 3.4% (2) 5.2% (3) 17.2% (10) 41.4% (24) 32.8% (19)

Nutrition Support for the Critically

Ill Patient0.0% (0) 1.7% (1) 12.1% (7) 34.5% (20) 51.7% (30)

Endocrine Anatomy and Physiology 0.0% (0) 1.7% (1) 13.8% (8) 43.1% (25) 41.4% (24)

Endocrine Assessment and

Diagnostic Procedures1.8% (1) 5.3% (3) 12.3% (7) 42.1% (24) 38.6% (22)

Endocrine Disorders and


Insulin Management 0.0% (0) 0.0% (0) 8.8% (5) 24.6% (14) 66.7% (38)

Management of the Diabetic Patient 0.0% (0) 0.0% (0) 7.1% (4) 19.6% (11) 73.2% (41)

Diabetic Ketoacidosis 0.0% (0) 0.0% (0) 19.3% (11) 26.3% (15) 54.4% (31)

Hyperglycemic Hyperosmolar

State0.0% (0) 5.5% (3) 16.4% (9) 30.9% (17) 47.3% (26)

Diabetes Insipidus 0.0% (0) 5.4% (3) 14.3% (8) 39.3% (22) 41.1% (23)

Syndrome of Inappropriate Diuretic

Hormone0.0% (0) 7.1% (4) 16.1% (9) 41.1% (23) 35.7% (20)

Care and Management of

Multisystem Problems0.0% (0) 3.5% (2) 10.5% (6) 43.9% (25) 42.1% (24)

Planning of Care for the Criticaly

Injured Trauma Patient1.8% (1) 8.8% (5) 10.5% (6) 33.3% (19) 45.6% (26)

Shock 0.0% (0) 3.5% (2) 12.3% (7) 29.8% (17) 54.4% (31)

Systemic Inflammatory Response

Syndrome and Multiple Organ 1.8% (1) 5.3% (3) 14.0% (8) 36.8% (21) 42.1% (24)


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Dysfunction Syndrome

Burns 3.6% (2) 14.3% (8) 41.1% (23) 28.6% (16) 12.5% (7)

Organ Donation and Transplantation 3.6% (2) 8.9% (5) 21.4% (12) 19.6% (11) 46.4% (26)

Hematologic Disorders and

Oncologic Emergencies1.8% (1) 3.5% (2) 33.3% (19) 40.4% (23) 21.1% (12)

BIS Monitor 7.0% (4) 7.0% (4) 12.3% (7) 26.3% (15) 47.4% (27)

Peripheral Nerve Stimulator 5.4% (3) 7.1% (4) 14.3% (8) 16.1% (9) 57.1% (32)

Curlin Pump 0.0% (0) 0.0% (0) 5.4% (3) 14.3% (8) 80.4% (45)

Collegue Guardian Pump 3.6% (2) 0.0% (0) 5.4% (3) 16.1% (9) 75.0% (42)

Wound V.A.C. 0.0% (0) 1.8% (1) 7.1% (4) 30.4% (17) 60.7% (34)

IABP 17.5% (10) 22.8% (13) 24.6% (14) 19.3% (11) 15.8% (9)

CRRT (Prisma) 14.0% (8) 14.0% (8) 19.3% (11) 28.1% (16) 24.6% (14)

CPS 23.2% (13) 23.2% (13) 28.6% (16) 17.9% (10) 7.1% (4)

Cortrak 14.3% (8) 8.9% (5) 25.0% (14) 21.4% (12) 30.4% (17)

Oscillating ventilator 19.6% (11) 10.7% (6) 21.4% (12) 32.1% (18) 16.1% (9)

Pressure Controlled ventilation 10.5% (6) 8.8% (5) 19.3% (11) 15.8% (9) 45.6% (26)

Care of the PICC lines/Central

Lines0.0% (0) 1.8% (1) 3.6% (2) 10.7% (6) 83.9% (47)

Endotracheal suctioning 0.0% (0) 0.0% (0) 7.1% (4) 7.1% (4) 85.7% (48)

Tracheostomy care 0.0% (0) 0.0% (0) 5.4% (3) 12.5% (7) 82.1% (46)

Chest tube care 0.0% (0) 0.0% (0) 8.9% (5) 14.3% (8) 76.8% (43)

Intraabdominal pressure monitoring 13.0% (7) 13.0% (7) 9.3% (5) 37.0% (20) 27.8% (15)

Blood warming devices (Ranger) 5.5% (3) 12.7% (7) 16.4% (9) 32.7% (18) 32.7% (18)

Rotation therapy (Hill-Rom Total

Sport Care bed)3.6% (2) 10.7% (6) 8.9% (5) 26.8% (15) 50.0% (28)

answered question

skipped question


10 of 18

8. Please list the NEW procedures, policies, equipment, or initiatives that have begun in

your unit and affect you job in the past year.

Response

Count

14


skipped question 44

9. Please list the CHANGES in procedure, policies, equipment, or initiatives that have

occurred during the last year in your unit that affect your job.

Response

Count

13


skipped question 45

10. What are the procedures done in your unit that you consider HIGH RISK?

Response

Count

18


skipped question 40


11 of 18

11. What reference books would you like to see on your unit?

Response

Count

15


skipped question 43

12. What materials for patient/family education would you like on your unit?

Response

Count

10


skipped question 48

13. I would recommend the following speaker(s) to lecture on the following topics:

Response

Count

5

answered question 5

skipped question 53


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Q3. I prefer lectures give in:

1 Depends on the type of lecture and content. May 18, 2010 5:40 AM

2 6 hour sessions May 4, 2010 8:20 PM

3 depending on the topic. the timing can vary May 3, 2010 1:02 PM

Q4. I would like lectures given by:

1 anyone who is an expert on the topic is good enough May 3, 2010 1:02 PM

2 all depending on their expertise Apr 27, 2010 10:13 AM

3 anyone with his/her expertise. Apr 27, 2010 1:56 AM

4 Any good lecturer that is an expert on the topic being presented Apr 26, 2010 2:14 PM

Q6. I would be interested in taking the following verification review courses in the next year:

1 ANCC Board Certification May 3, 2010 1:02 PM

2 hemodynamics, ccrt Apr 28, 2010 3:37 AM

3 pain resourse Apr 27, 2010 10:13 AM

4 More courses on PEDS TRAUMA/peds CCRN Apr 26, 2010 2:14 PM


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Q8. Please list the NEW procedures, policies, equipment, or initiatives that have begun in your unit and affect youjob in the past year.

1 Quest, Curlin Pump Library, Open Unit Visiting, etc. (the list for both thesequestions could go on and on)

May 8, 2010 10:08 PM

2 rhabdo protocol salt wasting protocol tbi protocol dcd protocol May 4, 2010 11:38 AM

3 skin, curlin, new beds, charting, infection control May 3, 2010 3:31 PM

4 CPS - done too infrequently and needs staff re-training more often May 3, 2010 1:02 PM

5 Procedure for Oscillating Ventilator Apr 30, 2010 5:32 PM

6 Curlin pump regulataions. Insulin drips. Restraints policy Apr 30, 2010 3:09 PM

7 clinical pathway of CHF/AMI Apr 29, 2010 6:22 PM

8 double checks of high risk medications Apr 28, 2010 10:49 AM

9 Change in concentrations of PCA medications Apr 28, 2010 3:23 AM

10 Administering code medications Apr 27, 2010 5:46 PM

11 product trials, ett place holder, new et tubes, auto transfuser Apr 27, 2010 11:33 AM

12 use of only CHG wipes to bathe pt. Apr 27, 2010 5:59 AM

13 New Insulin Protocol, Suicide Identification, Devastating brain injury. Apr 27, 2010 4:02 AM

14 CIWA, Apr 26, 2010 2:14 PM


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Q9. Please list the CHANGES in procedure, policies, equipment, or initiatives that have occurred during the lastyear in your unit that affect your job.

1 SBAR, Lack of enough computers and space to write; use of phones in isolationrooms

May 8, 2010 10:08 PM

2 as above May 4, 2010 11:38 AM

3 See above there are so many, are they changes or new things. May 3, 2010 3:31 PM

4 end of life in critical care (one of many) May 3, 2010 1:02 PM

5 Curlin; epidural May 1, 2010 9:55 AM

6 Skin documentation big time change Apr 29, 2010 6:22 PM

7 no ACLS drugs standardized nursing practice,need orders Apr 28, 2010 2:05 PM

8 double checks Apr 28, 2010 10:49 AM

9 Administering code medications, drips Apr 27, 2010 5:46 PM

10 kurlin pump Apr 27, 2010 4:18 PM

11 central line changes Apr 27, 2010 11:33 AM

12 POP, standards of care Apr 26, 2010 2:14 PM

13 The Change of the PCA settings Apr 26, 2010 9:57 AM


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Q10. What are the procedures done in your unit that you consider HIGH RISK?

1 All ICU Units/all procedures are high risk-some more than others. May 8, 2010 10:08 PM

2 central line, swanz Ganz, May 7, 2010 5:40 PM

3 cps May 4, 2010 11:38 AM

4 whipple care, transplant care, cardiothoracic care, cardiovascular critically ill care May 3, 2010 3:31 PM

5 ICP monitoring- done too infrequently May 3, 2010 1:02 PM

6 CPS May 1, 2010 9:55 AM

7 EVD placement Apr 30, 2010 5:32 PM

8 Care of critically ill pt. who is on CPS Apr 29, 2010 6:22 PM

9 line insertion, CPS Apr 28, 2010 10:49 AM

10 Placing intravenous lines in agitated patients with infectious diseases Apr 28, 2010 3:23 AM

11 Administering insulin gtts, propofol gtts Apr 27, 2010 5:46 PM

12 med admin, following complex protocols not frequently seen Apr 27, 2010 11:33 AM

13 Placement of Intracranial monitors. ICP monitoring. Apr 27, 2010 4:02 AM

14 bedside o.r . procedures Apr 26, 2010 9:37 PM

15 EVD placement Apr 26, 2010 9:04 PM

16 Any procedure done by interns Apr 26, 2010 10:40 AM

17 Lumbar drain placement Apr 26, 2010 10:06 AM

18 Bedside Chest tubes Apr 26, 2010 9:57 AM


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Q11. What reference books would you like to see on your unit?

1 AACN, Basic Med/Surg Procedures Text....the list could be pretty long; at leastone set of books in case computers are down for extended periods.

May 8, 2010 10:08 PM

2 Lab diagnostics, PDR May 7, 2010 5:40 PM

3 Lippincott's nursing manual May 3, 2010 3:31 PM

4 none- they become outdated; prefer electronic resources May 3, 2010 1:02 PM

5 Critical care skills and procedures May 1, 2010 9:55 AM

6 critical care textbook Apr 29, 2010 6:22 PM

7 nothing particular Apr 29, 2010 1:46 AM

8 Ravel's clinical laboratory medicine Apr 28, 2010 2:05 PM

9 Drug handbooks in med room Apr 28, 2010 10:49 AM

10 Post-op care for whipple patients Apr 28, 2010 3:23 AM

11 Good critical care book Apr 28, 2010 2:52 AM

12 Mosby's-Pediatric updated version Apr 27, 2010 5:46 PM

13 nursing clinical reference site fully accessible (not blocking articles I look at) Apr 27, 2010 11:33 AM

14 policies and procedures quick reference with table of contents of where to findonline

Apr 27, 2010 5:59 AM

15 acceptable critical care book Apr 26, 2010 11:53 AM


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Q12. What materials for patient/family education would you like on your unit?

1 ? May 8, 2010 10:08 PM

2 bariatric diet, esophogeal ca diet, post-whipple diet, all diet handouts May 3, 2010 3:31 PM

3 anything not available from Micromedex May 3, 2010 1:02 PM

4 Informational brochures r/t diagnosis May 1, 2010 9:55 AM

5 anything that will help in educating pt/family Apr 29, 2010 6:22 PM

6 Diabetic teaching in Spanish/vietnamese Apr 28, 2010 3:23 AM

7 Pain management in children Apr 27, 2010 5:46 PM

8 visitation policy Apr 27, 2010 5:59 AM

9 End of life care materials that adress coping for children who are loosing theirparents

Apr 26, 2010 10:40 AM

10 Visual aids Apr 26, 2010 10:06 AM

Q13. I would recommend the following speaker(s) to lecture on the following topics:

1 ? May 8, 2010 10:08 PM

2 orthopaedic care, whipple care, cardiology/cardiothoracic care May 3, 2010 3:31 PM

3 review topics Apr 27, 2010 11:33 AM

4 Whipple Surgery, prevention of ICU delerium, Apr 27, 2010 5:59 AM

5 denis prager on happiness Apr 26, 2010 11:28 AM


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