Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
RN Competency: Pediatric Competence Verification & Learning Guide: Facility Name (learner) Date Initiated Unit ☐RN ☐LPN ☐Recent Graduate ☐Experienced Nurse ☐New to Specialty ☐Traveling Nurse Note: for LPN practice guidelines, see state nursing statutes & regulations The preceptor will initial each competency when he/she, as preceptor and colleague, feels safe in allowing the learner to deliver this aspect of care without direct supervision. Self-Assessment: 1 – Identified Limitation (little or no experience); 2 – Capable (familiar but may need assistance); 3 – Independent - can perform these tasks safely; 4 – Proficient - extensive experience *for further information, see instruction sheet at end of this form. References IA. The learner will incorporate relevant assessment & intervention (A&I) skills in delivery of care to include the following: Initiate life-saving/emergency measures consistent with patient needs and protocols set up for emergency airway implement relevant protocols consistent with patient status Manage chest drainage system describe chambers/normal assess patient and system identify any deviations from the norm Learning Guide # D—Demonstrated; T—Test; M—Module/class; V—Verbalized Preceptor initials Verification method & facility specific requirements Learner initials Required Competencies Main categories followed by associated competencies and critical elements. (Preceptor needs to verify learner capability for these items.) Date all met Self-assessment Learning Guide follows competency pages and contains items for each competency that need to be reviewed based on learner’s experience and unit need, they include reminders of important teaching points that may otherwise be missed. IA 1 IA 2 Apply interventions for sepsis per protocols IA 3 Manage care of child with cerebral deficit IA 4 Integrate developmental and age specific needs in approach to and delivery of care IA 5 Use equipment based on age, weight and need IA 6 Implement measures and precautions to insure patient safety and well-being IA 7 Form based on Dr. Carrie Lenburg’s “Competency Outcomes & Performance Assessment” model. Copyright © May, 2008. Updated May, 2012. Alaska Coalition of Educators—Health Care. All rights reserved. Page 1 RN Competency Form: Pediatric Maintain spinal precautions as ordered check for proper collar fit maintain alignment with turning/transferring IA 8 IB. The learner will incorporate relevant A & I skills in delivery of medications, IV’s & blood to include the following: Apply pediatric protocols to medication management implement safe practice with high risk medication implement the “rights” of med administration state indications, contra-indications and side effects (may use reference) administer IVPB solution administer IV push/bolus med (RN only) Calculate doses correctly based on weight Verify pediatric med doses with pharmacist or another nurse Manage peripheral IV care consistent with protocols verbalize pediatric and volume and dosage precautions obtain IV access per protocol Manage central/PICC line consistent with protocols use correct flush solution and technique apply policy for clotted line assess site for complications NOTE: LPN’s limited to specific training per state regs IB 1 IB 2 complete PICC competency if required IB 3 Administer blood/blood products (RN only) per protocol IB 4 Perform venipuncture on an adult &/or child or infant heel stick as applicable IB 5 Optimize patient comfort with sedation and pain control as indicated (IVP & PCA dose) evaluate patient using age appropriate sedation & pain scales administer sedation per protocols wean medications per protocols and patient tolerance IB6 Administer chemotherapy safely (RN only) IB7 IC. The learner will incorporate relevant A & I skills in performing procedures & utilizing equipment to include: Form based on Dr. Carrie Lenburg’s “Competency Outcomes & Performance Assessment” model. Copyright © May, 2008. Updated May, 2012. Alaska Coalition of Educators—Health Care. All rights reserved. Page 2 RN Competency Form: Pediatric Feed child per protocol position for safety ensure proper placement for tube feeding IC 1 Perform point of care testing per lab and unit protocols by completing all required competencies IC 2 Utilize protocols and other references for unfamiliar or infrequently used procedures and equipment IC 3 Section ID The learner will incorporate teaching skills in delivery of all nursing care to include the following: Educate patients and families with consideration for age, culture, educational background and home environment or setting Provide education to complete a successful patient discharge per policy ID1 ID2 Comments/alternative learning plans: All preceptors are to sign & initial below. Ideally new graduates should have only one to two preceptors for the entire orientation. Preceptor Signature Initials Preceptor Signature Initials Signatures at completion of preceptorship/orientation: Preceptee/orientee Date Primary Preceptor Date Manager Date Form based on Dr. Carrie Lenburg’s “Competency Outcomes & Performance Assessment” model. Copyright © May, 2008. Updated May, 2012. Alaska Coalition of Educators—Health Care. All rights reserved. Page 3 RN Competency Form: Pediatric LEARNER GUIDE: Reference items in right-hand column that needs review. IA. The learner will incorporate relevant assessment & intervention (A&I) skills in delivery of care to include the following: IA 1 Initiate life-saving/emergency measures consistent with Review procedures for: patient needs and protocols -Correct response for all codes -Obtaining/interpreting an ECG -Emergency airways: ETT, cricothyrotomy, tracheostomy -Pediatric equipment size differences, lung volumes, code management -Practice with bulb and Delee suction, peak flow meter and interpretation -Set up/care for patient in croup tent and patient with apnea monitor -Allergic reaction (also latex allergy) -Seizure precautions including patient positioning/padding -Hyper and hypoglycemic episodes -Hyper and hypothermic episodes --Reporting abuse/neglect -Use of emergency equipment --Poison/overdose management IA 2 Manage Chest Drainage System Review the following: -P&P and equipment management Talk through drainage system with preceptor-simulate if no patients with chest tubes IA 3 Apply interventions for sepsis per protocols Review protocols, fever reduction methods, circulatory support IA 4 Manage care of child with cerebral deficit Review policy and pathophysiology and treatment of children with cerebral deficits due to acute or chronic conditions (hemorrhage, trauma, Down’s, etc.) Review radiology and neurology resources Review come scale and interventions IA 5 Integrate developmental and age specific needs in approach to and delivery of care Review the following: -VS parameters -Communication techniques -Physical, developmental, spiritual & emotional needs IA 6 Use equipment based on age, weight and need Review the use of equipment (scales, pumps, restraints, lifts, etc.) in regards to age and weight. IA 7 Implement measures and precautions to insure patient safety and well-being Review the following: -Fall prevention protocols -Patient identification measures --Infection control policy including hand hygiene, personal protective equipment, patient isolation (respiratory, wound, neutropenia, etc.) and contaminated waste policies -Nosocomial risks: catheter infections, central line infections, pressure ulcers, etc. -Review teaching/learning principles for children -Unusual occurrence reports IA 8 Maintain spinal precautions as ordered Review policies and equipment, skin assessment -turning/positioning/transfer, how to “clear patient from precautions Form based on Dr. Carrie Lenburg’s “Competency Outcomes & Performance Assessment” model. Copyright © May, 2008. Updated May, 2012. Alaska Coalition of Educators—Health Care. All rights reserved. Page 4 RN Competency Form: Pediatric LEARNER GUIDE: Reference items in right-hand column that needs review. IB. The learner will incorporate relevant A & I skills in delivery of medications, IV’s & blood to include the following: IB 1 Apply pediatric protocols to medication management. Review medication administration policies and reference materials including med reconciliation and narcotic accounting Introduce to pharmacist and review pharmacy role and availability Must pass unit/hospital medication test if required before allowed to administer meds Review limits to medication administration (formulary, restricted meds, high alert meds) Review weight based dosing and pediatric dosing IB 2 Manage peripheral IV care consistent with protocols Practice with related equipment (syringe pump, IV pump and corresponding supplies) Review policies re: preparing IV meds, approved IV medication list per unit Review pediatric considerations re: volume and dosages Review appropriate IV sites for all ages Review administration of fluids including amount and types of fluids commonly used. IB 3 Manage central/PICC line consistent with protocols NOTE: LPN’s limited to specific training per state statutes Review policies on flushing, drawing blood, declotting, dressing change, removal and general care of all central catheters used in the facility (PICC, triple lumen, groshong, portacath, etc.) Complete any specialty line competencies as required IB 4 Administer blood/blood products (RN only) per protocol Review blood bank and nursing policies and procedure for transfusion of blood products Review actions to take if suspected reaction occurs Review massive transfusion, autologous transfusion and giving uncrossmatched blood policies IB 5 Perform venipuncture on an adult &/or child or infant heel stick as applicable Review lab and nursing policies related to blood sampling Review blood culture protocol IB6 Optimize patient comfort with sedation and pain control Review pediatric sedations and pain scales and interventions Review policy for moderate sedation and complete any facility required training and/or checklists IB7 Administer chemotherapy safely (RN only) Review P&P and complete facility competency if applicable IC. The learner will incorporate relevant A & I skills in performing procedures & utilizing equipment to include the following: IC 1 Feed child per protocol Review feeding policies for breast, bottle and tube feeding, teaching parents, -position for safety I&0 measurement -ensure proper placement for tube feeding Review procedure for tube feeding in children, dietician’s role, type of solutions and tubes IC 2 Perform point of care testing per lab and unit protocols by completing all required competencies Review testing and quality control for the following as apply: rapid strep, glucometer, urine chemistry strip, occult blood, , iStat Form based on Dr. Carrie Lenburg’s “Competency Outcomes & Performance Assessment” model. Copyright © May, 2008. Updated May, 2012. Alaska Coalition of Educators—Health Care. All rights reserved. Page 5 RN Competency Form: Pediatric LEARNER GUIDE: Reference items in right-hand column that needs review. IC 3 Utilize protocols and other references for unfamiliar or Review how and where to access all procedures, manuals and instructions. infrequently used procedures and equipment Infrequent procedures may include post-mortem care, organ donation, and many others Equipment may include heating or cooling devices, fluid warmers, and many others ID The learner will incorporate teaching skills in delivery of all nursing care to include the following: ID1 Educate patients and families with consideration for age, Review teaching principles and local culture and resources culture, educational background and home environment or setting ID2 Provide education to complete a successful patient Identify community resources for the patient discharge per policy Identify parent support and resources Review discharge policy and procedures (pharmacy, standardized teaching materials, etc.) Other facility specific items to cover: Form based on Dr. Carrie Lenburg’s “Competency Outcomes & Performance Assessment” model. Copyright © May, 2008. Updated May, 2012. Alaska Coalition of Educators—Health Care. All rights reserved. Page 6 RN Competency Form: Pediatric REQUIREMENTS: All nurses will complete these competencies upon hire. Some competencies may be reviewed annually. This form follows the Competency Outcomes and Performance Assessment (COPA) model. PRECEPTEE/LEARNER INSTRUCTIONS: Complete self-assessment: Rate your skill in each area to identify the areas where you need additional experience, access to teaching resources, and/or lab practice. Discuss your results with your preceptor to help establish a plan and goals for your learning experience and to aid in choosing patient assignments. Scoring per instructions at the top of page 1. PRECEPTOR INSTRUCTIONS: A. Review self-assessment with preceptee/learner to establish plan. B. Required Competencies: The specialty area competency forms are required for independent practice on this unit. This column represents the Alaska Statewide required competencies per ACE-HC and should not be altered. The preceptor will sign each one off when he/she, as preceptor and colleague, feels safe in allowing the preceptee/learner to deliver this aspect of care without direct supervision. C. Verification Method & Agency Specific. Document comments/check marks for the competency and any agency specific requirements. Verification methods include: 1. Demonstration – Preceptor watches learner perform task/procedure in safe, capable manner in a simulated lab or computer setting or as part of direct care performance. The expectation for new graduates is that they demonstrate as many of the competencies as possible. 2. Test – Learner passes a test provided by the facility to measure competence for this skill. (Minimum passing grade indicated. Initial only after test passed.) 3. Module –Learner has completed a training tool (computerized or written module, class, video, etc.) provided by the facility to measure competence for this skill. 4. Verbalization - Learner explains to the preceptor the process and/or planning that evidences safe, reliable knowledge base. This may include case scenarios, discussion, and/or description of plan. NOTE: some competencies may have the verification method specified per facility guidelines (e.g. “test only”) Record N/A and initials only for items that never apply to this learner’s role or performance. D. Sign-off: Sign and date when all elements of the competency are met. If unable to sign off an area due to patient population issues or learner needs more time, document a plan in the comments section at the end of the form. Discuss alternative ways of meeting the requirement(s) as well as any additional time needed with the nurse manager and/or nurse educator. All preceptors assisting in orientation of a new staff member/intern must sign and initial in the signature chart at the end of this document. E. References: Competencies should be met in accordance with these. Add your facility approved references here. F. Learning Guide: These are memory ticklers. The amount of time spent on each of them depends on the learner’s experience. New graduates will likely need time on almost all of the areas listed. REFERENCES COLUMN: List foundational documents to support the learning experience and to use as the official measure by which the competencies are assessed. The ACE-HC group recognizes the following as sources for evidence based practice that can be included in the reference list along with local policies, procedures and forms: Perry & Potter, Elsevier/Mosby, Lippincott, Kozier & Erb, ANA, nationally recognized hospital related regulatory organizations (CLIA, CDC, CMS, JC, etc.), and specialty nursing organizations’ scope, standards and core curricula. This column’s content may be changed to be facility specific. NOTE: ACE-HC competency forms are intended to be used between facilities within Alaska. Form based on Dr. Carrie Lenburg’s “Competency Outcomes & Performance Assessment” model. Copyright © May, 2008. Updated May, 2012. Alaska Coalition of Educators—Health Care. All rights reserved. Page 7