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Clinical Skills Assessment Tools: Will help establish competency level of IEN and assist with planning orientation to a facility or unit. Competency Novice Advanced Beginner Competent Admission/Discharge/ Transfer Completes Admission procedure/ policy Transfer/Transport procedure/policy: Within site Across sites External agency Assessment Completes Initial assessment Plan of Care Develops a plan of care Implements a plan of care or clinical pathway Evaluates plan of care or clinical pathway Integumentary Assesses Integumentary system Completes Braden Assessment Scale Performs wound management Completes wound care documentation Performs wound care Cleansing and irrigation Application of bandages/compresses/ Packing Removal of sutures/ staples VAC dressings 1 Proficient Expert N/A Comments Competency Novice Advanced Beginner Competent Integumentary (cont’d) Shortens/Removes drains: Penrose Hemovac Sump Jackson-Pratt Neurological Assesses Neurological System: Using Neurological Assessment Flowsheet Cardiopulmonary Resuscitation Trained in BLS-Health Care Provider Identifies role during a code Checks cardiac arrest cart Respiratory Assesses Respiratory system Administers oxygen therapy Performs suctioning Performs pulse oximetry Cares for patient with Tracheostomy Cares for patient with a chest tube Cardiovascular Assesses Cardiovascular system Cares for patient with telemetry Performs 12 Lead EKGs Performs 15 Lead EKGs Gastrointestinal Assesses Gastrointestinal system Cares for patient with: 2 Proficient Expert N/A Comments Competency Novice Advanced Beginner Competent Gastrointestinal (cont’d) Nasogastric tube Large bore Small bore Nasointestinal tube Gastrostomy tube Percutaneous Endoscopic Gastrostomy (PEG) tube Jejunostomy tube Enterostomy Nutrition Enteral Maintains and regulates flow manually Parenteral Cares for patient receiving parenteral nutrition Reproductive/ Genitourinary Assesses Reproductive/ Genitourinary systems Performs urinary catheterization: Male Female Cares for patient with: Indwelling catheter Suprapubic catheter Continuous/ intermittent bladder irrigation Incontinent urinary diversion (i.e., ileoconduit) Urinary devices (i.e. condom drainage) 3 Proficient Expert N/A Comments Competency Novice Advanced Beginner Competent Musculoskeletal Assesses musculoskeletal Systems Completes neurovascular assessment flow sheet Specimen Collection Collects specimens: Urine Stool Sputum Body fluids Obtains swab from: Wounds Body orifices Obtains blood specimen by: Lancet Venipuncture Tests: Urine by reagents (e.g., pH, glucose, ketones) Blood glucose Stool for occult blood Peri operative Care Cares for patient in preoperative phase Cares for patient in postoperative phase Blood and Blood Products Cares for the patient receiving blood and/or blood products Patient Safety Assesses Fall Risk and implements Risk Protocol Utilizes Alcohol Withdrawal Protocol 4 Proficient Expert N/A Comments Competency Novice Advanced Beginner Competent Patient Safety: (cont’d) Cares for patient requiring mechanical lift Cares for the patient with restraints Cares for the patient requiring seizure precautions Implements surveillance: Standard-routine Close Constant Cluster Implements isolation precautions Assesses and cares for patients with allergy and adverse reactions (i.e., drug/food allergies, Latex allergy) Identifies patients utilizing patient identification policy Bed rails Occupational Health and Safety Reviews Occupational Exposure to Blood and Body Fluids Policy, including Needle Stick Protocol Follows MusculoSkeletal Injury Prevention protocols Maintains Standard Precautions/ Routine Practices 5 Proficient Expert N/A Comments Competency Novice Advanced Beginner Competent Care After Death Provides routine postmortem care Provides postmortem care for: Reportable death Organ donation Autopsy Completes Death Certificate (applicable nursing sections) Venous/Arterial/ Subcutaneous Cares for patient with: Peripheral lines Central lines: Peripherally inserted central catheter (PICC) Tunneled catheter (Hickman/Broviac) Implanted infusion port Hypodermocyclsis Obtains blood cultures Obtains blood from: Peripheral lines Central lines Medication Administration Administers medications as per: facility /professional organization standards General Medication Guidelines/Policy IV Medication Guidelines/Policy Cares for patient receiving PCA 6 Proficient Expert N/A Comments Competency Novice Advanced Beginner Competent Medication Administration (cont’d) Cares for patient receiving epidural medication Cares for patient receiving medication by SQ indwelling needle Utilizes policy for narcotic administration Cares for patient receiving high risk mediations (i.e., potassium) Adheres to Pharmacy Policies Transcription of Orders Transcribes written orders Writes and transcribes telephone orders Writes and transcribes verbal orders Transcribes and initiates Standing Medical Protocols Computer Training Uses Order Entry Uses E-mail Initiates and uses Computer for nursing documentation, checking and ordering patient tests, etc. Communication Gives and obtains shift Report 7 Proficient Expert N/A Comments Competency Novice Advanced Beginner Competent Proficient Expert N/A Comments Novice Advanced Beginner Competent Proficient Expert N/A Comments Communication (cont’d) Arranges referrals, e.g., other disciplines, services, community and long term care Collaborates with other health care members Utilizes appropriate facility and provincial policy manuals / paper and electronic Leadership Follows professional accountability related to: In-charge role Method of assignment Coffee and meal break policy Float Assignment policy Documentation Utilizes appropriate nursing documentation, electronic, hybrid or paper Understands how to complete incident reports Uses approved abbreviations Follows documentation guidelines Adheres to nursing documentation policy Follows guidelines for proper completion of various forms Legal/Ethical Adheres to policies on: Consent Confidentiality Competency Legal/Ethical (cont’d) Advanced Health Care Directives Standards of Care 8 from ARNPEI / LPN Association of PEI Scope of Practice from ARNPEI/ LPN Association of PEI CNA Code of Ethics Do Not Resuscitate Position Statements from CNA, ARNPEI, and the LPN Association of PEI IEN Signature: _____________________________ Date: ___________________________________ Nurse Educator / Manager/ Supervisor Signature: ___________________________ Date: ____________ Please ensure both parties have a copy of this documentation and maintain a copy for both your records Adapted from Office of the Provincial Chief Nurse, Department of Health and Community Services. (2011). Orientation Framework for Internationally Educated Nurses 9