175 E. Olive Ave. Suite 101 Burbank, CA TEL: FAX: Review Information. Guidelines. Charting.

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1 Telemetry Clinical Competency Assessment Your Name: Date: 175 E. Olive Ave. Suite 101 Burbank, CA TEL: FAX: Review Information Guidelines Complete this review, using the following scale: 0 = No experience 1 = Infrequent experience 2 = 1 Year consistent experience 3 = 2 years consistent experience 4 = Able to teach and supervise Please check the column that best describes your level of experience with each skill. Charting Computerized DARE APIE SOAPIE FOCUS Computer order entry Discharge planning Utilization review/case management Chart review/audit Cardiovascular 12-lead EKG interpretation Assessment of heart sounds basic dysrhythmia interpretation Angina Aneurysm MI Hypertensive crisis Page 1 of 9

2 Cardiovascular (continued) Open heart surgery (pre-post) Congestive heart failure Cardiac cath (pre-post) Cardiac surgery (pre-post) Stent placement (pre-post) Cardiac monitors: Datascope General electric Hewlett Packard Lifecare MDE Marquette Mennen Nihon-koder Siemens Spacelabs medical Lead placement Permanent pacemakers Emergency Management Emergency response using: Administration of emergency drugs Ambubag technique Assisting with intubation/extubation Cardiac arrest/cpr Cardioversion, assisting with Established protocols Establish an airway Use of defibrillator Gastro-Intestinal Insertion and verification of feeding tubes Administration of feeding with: Feeding pump (continues) Flexible (corpak, dobhoff) Gravity drainage (bolus) Assessment of bowel sounds Appendicitis Bowel obstruction Page 2 of 9

3 Gastro-Intestinal: (continued) Colostomy GERD Esophageal bleeding G.I.bleed (upper-lower) Hepatitis Liver failure (cirrhosis) Liver transplant Laparoscopic abdominal procedures Open abdominal procedure Pancreatitis Paralytic ileus Whipple procedure Gastro-intestinal tubes: Insertion Removal Blakemore-balloon/traction Enterostomal care EWAL Gastrostomy (PEG) Jejunostomy Kaslow (kantor) Miller-abbott Nasogastric suction0levine tube Nasogastic suction-sump tube T-tube Gynecology Abdominalplasty Ectopic pregnancy Hysterectomy Mastectomy Reconstructive breast surgery Removal of cysts Tubal ligation Medication Administration Antihypertensives Page 3 of 9

4 Medication Administration (continued) Atropine Bretylium (bretylol) Cardizem (diltiazem hydrochloride) Coumadin Digoxin (lanoxin) Dobutamine (dobutrex) Dopamine (intropin) Epidural pumps Epinephrine (adrenalin) Heparin drip IM Vassopressin Inderol Infusion pumps Insulin administration Intramuscular injections Intradermal injections IV push IV additive & piggybacks Medications Lidocaine (xylocaine) Nipride (nitroprusside) Nitroglycerin (tridil) Nontitrated cardiac drugs Oral anticoagulants Oral hypoglycemics Steroids Subcutaneous injections Topical Nitrates Unit dose Verapamil Blood glucose monitoring/accuchecks Adrenal gland disorders Adrenal gland surgery Diabetes insipidus Diabetes mellitus Thyroid disorders Metabolic Page 4 of 9

5 Metabolic (continued) Thyroid surgery Diabetic patient teaching Medication Administration Assist with lumbar puncture AV-shunt placement Cranial hemorrhage CVA/TIA Head injury/trauma Hemiplegia Neuro surgery (pre/post) Paraplegia/quadriplegia Seizure activity Spinal cord injury/trauma Glascow coma scale Halo traction Neuron assessment Seizure precautions Neurological Amputation Arthroscopic Surgery (pre/post) Bucks extension Cast care Laminectomy Orthopedic trauma Passive ROM exercises Pin site care Skeletal traction Total joint replacement (pre/post) Orthopedic Assessment of pain level/tolerance IV sedation Narcotic analgesia Patient controlled analgesia (PCA) Pain Management Page 5 of 9

6 Pain Management (continued) Anesthesia and analgesia Renal/GU Chronic/acute renal failure Hemodialysis Nephrectomy Peritoneal dialysis Radical prostectomy Renal calculi Renal transplant Renal trauma T.U.R.P GU electrolyte imbalance replacement Irrigants (set up and maintenance) nephrostomy tube Suprapubic catheters Urinary catheter insertion-male Urinary catheter insertion-female ABG interpretation Assessment of breath sounds ARDS Asthma Chest tubes (emerson/pleuravac) COPD Hemovac drains Inhalation injuries Pneumonia Pulmonary edema Pulmonary embolism Thoracic surgery (pre/post) Tracheostomy Oxygen therapy Incentive spirometry Nasal cannula Rebreather/nonrebreather mask Ventimask Respiratory Page 6 of 9

7 Respiratory (continued) Nasotracheal suctioning Oral sputum collection Oral suctioning Pulse oximetry Administration of blood & blood products Assist physician with insertion of central line Anaphylaxis Ateriovenous shunt Cellulitis Deep vein thrombosis Gortex graft Septic shock Cell anemia Transfusion reaction Groshong catheters Herparin/salin lock Hickman/broviac catheters IV access device Needleless IV systems Peripheral pulses Quinton/permacaths TPN/hyperalimentation/lipids Ultrasound dopplers venipuncture Vascular Other AIDS/HIV Antibiotic resistant infections Burns DTs, alcohol detox Diabetic teaching Drug overdose Drug and alcohol withdrawals Chemotherapy Oncology patient management Fall assessment Page 7 of 9

8 Other (continued) Hemovac drains Isolation techniques Knowledge of normal lab values Nutritional teaching Patient/family teaching Restraints Assessment Informed consent Posey Soft Skin assessment Sterile dressing changes: Simple complex Complex wounds Restraints Check the box under each age group that you have experience with and are comfortable with for each skill. Understands the different communication needs for the age group & changes communication methods and terminology accordingly. Newborn (birth to 30 days) Infant (30 days 1 year) Toddler (1-3 years) Preschooler (3-5 years) School Age (5-12 years) Adolescents (12-18 years) Young Adults (18-39 years) Middle Adults (39-64 years) Older Adults (64+ years) Understands the different medications, dosages and possible side effects for the age group and administers medications appropriately. Newborn (birth to 30 days) Infant (30 days 1 year) Toddler (1-3 years) Preschooler (3-5 years) Page 8 of 9

9 School Age (5-12 years) Adolescents (12-18 years) Young Adults (18-39 years) Middle Adults (39-64 years) Older Adults (64+ years) Understands the different safety risks for the age group and alters the environment accordingly. Newborn (birth to 30 days) Infant (30 days 1 year) Toddler (1-3 years) Preschooler (3-5 years) School Age (5-12 years) Adolescents (12-18 years) Young Adults (18-39 years) Middle Adults (39-64 years) Older Adults (64+ years) Understands the normal growth and development for the age group and adapts care accordingly. Newborn (birth to 30 days) Infant (30 days 1 year) Toddler (1-3 years) Preschooler (3-5 years) School Age (5-12 years) Adolescents (12-18 years) Young Adults (18-39 years) Middle Adults (39-64 years) Older Adults (64+ years) Signature: Date: Page 9 of 9

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