/depts/,/depts/uwhealth/,/depts/uwhealth/ambulatory-education/,/depts/uwhealth/ambulatory-education/ambulatory-orientation/,/depts/uwhealth/ambulatory-education/ambulatory-orientation/checklists/,/depts/uwhealth/ambulatory-education/ambulatory-orientation/checklists/resources/,

/depts/uwhealth/ambulatory-education/ambulatory-orientation/checklists/resources/DHC-Endoscopy-RN-Checklist-182018.pdf

20180116

page

100

UWHC,UWMF,

Learning and Development,

Departments & Programs,UW Health,Ambulatory Education,Ambulatory Orientation,Checklists - Core and Department Specific,Resources

DHC Endoscopy RN

DHC Endoscopy RN - Departments & Programs, UW Health, Ambulatory Education, Ambulatory Orientation, Checklists - Core and Department Specific, Resources


Digestive Health Center
Endoscopy RN Orientation Checklist Name:________________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs w/
minimal
assist
Performs
independen
tly Comments & Examples
0 1 2 Environment & Equipment
Reviews Policy # 4.09 for Emergency
Response/verbalizes understanding of
roles
Utilizes checklist of "open/close" duties
Demonstrates correct utilization of staff
phones
Demonstrates correct utilization of
Responder 5 system every shift
Demonstrates correct use of Accudose
Medication device for dispensing,
returning and waste of meds
Demonstrates ability to use patient
monitoring equipment to
admit/discharge patients
Demonstrates ability to correctly
apply/use ECG, NIBP, SpO2, including
patient specific alarm adjustments,
trouble shooting
Demonstrates ability to use Central
monitor to assess arrythmias, alarms and
run strips
Self Assessment
2 = Knowledgable/has
experience 1 = Limited
knowledge/experience 0 =
no knowledge/experience
RD = Return demonstration/Documentation
review V = Verbalizes understanding NA = Not
applicable
Validation of Competency Preceptor Initial/Date
Page 1 JLH/6-2016

Digestive Health Center
Endoscopy RN Orientation Checklist Name:________________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs w/
minimal
assist
Performs
independen
tly Comments & ExamplesSelf Assessment
Demonstrates ability to navigate
Healthlink for documentation & patient
information
General Patient Care
Demonstrates appropriate assessments
for patients based on clinical condition,
history & procedures (esp: pulmonary,
cardiovascular, GI)
Demonstrates appropriate use and
oxygen devices. * Titrates & intervenes
according to clinical condition
Demonstrates ability to assess &
intervene appropriately for
hemodynamic instability
Demonstrates ability to recognize, assess
& intervene for cardiac dysrrhthmias
Demonstrates ability to assess &
intervene appropriately for
hypoventilation, respiratory distress
Identifies priority items to be included in
hand off report for each phase of care
Documents completely/thoroughly in HL
for each phase of care
Prepping the Patient
Follows Workflow checklist for every
patient during Prep phase of care
Page 2 JLH/6-2016

Digestive Health Center
Endoscopy RN Orientation Checklist Name:________________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs w/
minimal
assist
Performs
independen
tly Comments & ExamplesSelf Assessment
Demonstrates ability to complete prep
calls. Identifies "red flags" and
intervenes appropriately.
Reviews pertinent patient instructions,
pre-procedure orders & assesses patient
understanding
Verbalizes knowledge of & rationale for
specific "red flags" that require
consulting MD before continuing prep
States rationale for driver-requirement
for all patients receiving sedation
Demonstrates ability to initiate
peripheral IVs, using methods to reduce
pain & preferred site for procedures
Demonstrates ability to safely use central
access devices (ports, PICCs)
Providing Procedural Care
Follows Workflow Checklist for every
patient during Procedure phase
States rationale for resuscitative &
suction equipment in procedure room.
Ensures all equipment in place for every
pt
Checks medications prior to start of each
case for correct medications, amounts
and expirations dates
Page 3 JLH/6-2016

Digestive Health Center
Endoscopy RN Orientation Checklist Name:________________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs w/
minimal
assist
Performs
independen
tly Comments & ExamplesSelf Assessment
Safely administers sedating meds
according to policy 8.38
States common complications of
sedating meds & appropriate
interventions
Demonstrates appropriate set up for
various GI procedures
Uses TWO PATIENT IDENTIFIERS for each
and every procedure
Demonstrates proper positioning of
patient for various procedures
Validates that H&P and consent are
present prior to beginning sedation
Reviews chart for current medications,
allergies and PMH. Identifies any "red
flags" and states rationale.
Ensures that Time Out(Universal
Protocol) is completed correctly prior to
every procedure
Demonstrates & documents VS, patient
assessments and interventions during
sedation per policy 8.38
Follows procedure for double checking
specimens with Tech (correct patient,
label, documentation)
Demonstrates correct/timely
documentation for charges in HL
Page 4 JLH/6-2016

Digestive Health Center
Endoscopy RN Orientation Checklist Name:________________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs w/
minimal
assist
Performs
independen
tly Comments & ExamplesSelf Assessment
Recovery the Patient
Follows Recovery Workflow checklist for
every patient during Recovery phase of
care
Demonstrates appropriate assessments
for Phase I & Phase II recovery.
Describes criteria for removal of
monitoring equipment/IV
States potential post-procedure
complications & initiates
interventions/seeks assistance as needed
Demonstrates appropriate airway
management techniques (jaw thrust,
head tilt, artificial airway devices)
Demonstrates ability to assess &
intervene appropriately for pain, nausea
Identifies priority topics to include in
discharge instructions to patient AND
caregiver/driver
identifies key items in post-procedure
calls
Competency will be reviewed during and at end of orientation in Endoscopy. Upon completion, sign/date form and return to manager.
RN Orientee: _________________________________________ Date: _____________
RN Preceptor: ________________________________________ Date: _____________
CNS: ________________________________________________ Date: _____________
Manager: ____________________________________________ Date: _____________
Page 5 JLH/6-2016