175 E. Olive Avenue Suite 101, Burbank, CA TEL: FAX: Review Information. Guidelines. Neurological.

Transcription

1 Medical/Surgical Clinical Competency Assessment 175 E. Olive Avenue Suite 101, Burbank, CA TEL: FAX: Your Name: Date: 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. Neurological Anticonvulsant Meds IV Drip Steroids Lumbar Puncture Alzheimer s Disease CNS Infection CVA Seizures Spinal Cord Injury-Fresh Spinal Cord Injury-Long Term Glascow Coma Scale Neuro Evaluation Seizure Precautions Hyper/Hypothermia Blanket Orthopedics Assessment of: Circulation Gait Range of Motion Skin Amputation Page 1 of 9

2 Orthopedics (continued): Arthroscopic Surgery Cast Osteoporosis Pinned Fractures Rheumatic/Arthritic Disease Total Hip Replacement Total Knee Replacement Continuous Passive Motion Traction-Skeletal Traction- Skin Use of Assistive Devices: Cane Cervical Collar Gait Belt Prosthetic Sling Transfer Board Walker Wheelchair Gastrointestinal Administration of tube feedings via flexible tubes: By feeding Pump By Gravity Infusion Assessment of: Abdominal/Bowel Sounds Fluid Balance GI Bleeding Nutritional Status Bowel Prep: Enemas Bowel Training/Bowel Program Colostomy Care: Knowledge of Appliances Knowledge of Irrigation Knowledge of Maintenance Mast Trousers Colostomy Ileostomy Inflammatory Bowel Disease Inserting Nasogastric Tubes Jejunostomy/Gastrotomy/Cecostomy Tubes Nasogastric Tubes Page 2 of 9

3 Gastrointestinal (continued): Nasointestinal Tubes Wound Dehiscence Cardiovascular Antiarrhythmics (Oral) Antihyperetnsives (Oral) Nitrates (Oral, Topical) Assessment: Auscullation (rate, rhythm) Blood Pressure/non-invasive Doppler Heart Sounds/Murmurs Pulses/Circulation Checks Cardiac Monitors Cardiopulmonary Resuscitation (CPR) Cardioversion Abdominal Aortic Bypass Aneurysm Angina Cardiac Arrest Cardiomyopathy Cartoid Endarterectomy Congestive Heart Failure (CHR) Femoral-Popliteal Bypass Myocarditis Permanent Pacemaker Post Acute MI hours Post Angioplasty Post Cardiac Cath Post Cardiac Surgery Temporary Pacemaker Thrombophebitis Defibrillation Performing Basic Rhythm Strip Measurements Pulse Checks Dysrhythmias EKGs 12 Lead BP Cuffs (i.e., Dinamap) Page 3 of 9

4 Endocrine Assessment of: S/S Diabetic Coma S/S Insulin Reaction Blood Glucose Monitoring: Performing Fingersticks Use of Blood Glucose Meter Device Use of Visual Blood Glucose Strips Diabetes Mellitus Disorders of Adrenal Gland (Addison s) Disorders of Pituitary Gland (Diabetes Insipidus) Hyperthyroidism (Grave s Disease) Thyroidectomy Insulin Administration: Insulin Infusion Mixed Insulins Single Type Renal/GU AV Shunt/Fistula Cysto Ideal Conduit/Other Urinary Diversion Surg. Nephrectomy Renal Surgery Transurethral Resection Renal Failure Catheterization: 3-Way Condom Indwelling Irrigations: Continuous Intermittent Nephrostomy Tube Straight Suprapubic Dialysis: Hemodialysis Peritoneal Pre/Post Transplant Care Page 4 of 9

5 Oncology Assessment of: Nutritional Status Pain Control Chemotherapy AIDS/ARC Anemia Bone Marrow Transplant Immuno Compromised Condition Leukemia Pain Management Radiation Therapy Radiation Implant Sickle Cell Disease Interpretation of Lab Work Infectious Disease Assessment and care of patient with: Administration of Chemotherapy AIDS/ARC Anemia Bone Marrow Transplant Hepatitis Immuno Compromised Condition Inpatient Hospice Leukemia Lyme Disease Pain Management Radiation Therapy Radiation Implant Fever Management Interpretation of Lab Results Isolation Disease Specific Blood/Body Fluid Contact Drainage/Secretion Enteric Respiratory Strict Intravenous Therapy Antibiotics Administration Blood: Albumin Page 5 of 9

6 Intravenous Therapy (continued): Packed Plasma Platelets Whole Blood Drawing: Central Implanted CVP Line Measurement Care of implanted Vascular Access Devices (Infusaport,Portcath,Mediport) Discontinuing: Central Peripheral Dose Calculation Flushing Central Peripheral IV Administration: Central Chemotherapy Implanted Peripheral TPN Intralipids Insertion of: Angiocath Butterfly Heparin Lock Intra Cath Mixing PICC Line Insertion Adult Pediatric Site Care: Central (Hickman/Broviac) Implanted Peripheral Infusion Pumps (IVAX, IMED, etc.) Multiple Lumen Catheters PCA/CADD Medication Administration Administers Medication via: Documentation on MAR Dose Calculation IV Drip Medications Page 6 of 9

7 Medication Administration (continued): Antibiotics Chemotherapy Narcotics Drug Actions/Interactions/Side Effects Narcotic Administration: Verification of Wastage Oral Parenteral Intradermal Intramuscular Z-track Intravenous Heparin Lock Hickman-Broviac Catheter Rectal Subcutaneous Sublingual Topical Unit Dose Pain Management Assessment of Pain Level/Tolerance Epidural Anesthesia/Analgesia IV Conscious Sedation Narcotic Analgesia Patient Controlled Analgesia (PCA Pump) Asthma Exacerbation Pulmonary Assessment of Breath Sounds Bronchodilator Adminstration: Inhalers IV Oral Asthma Exacerbation Bronchoscopy Chest Tubes COPD Fresh Tracheostomy Lobectomy Pneumonectomy Pre/Post Thoracic Surgery Pulmonary Embolism Tuberculosis Page 7 of 9

8 Pulmonary (continued): Interpretation Lab Results Blood Chemistry Blood Gases Additional Skills Application and Assessment of Restraints: Extremity Vest Assessment of Skin Assessment of Wound Healing Burn Management ENT Disease GYN Surgery Hemovacs Jackson-Pratt Tubes Penrose Drains Plastic Surgery Skin Graft Staple/Suture Removal Universal Precautions Experience (Indicate Number of Years) Medical Neurology OB/GYN Oncology Orthopedics Pediatrics Psychiatry Rehabilitation Surgical Telemetry Other Signature: Date: Page 8 of 9

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