/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-Clinic-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 Clinic RN

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


DHC GI Clinic
RN Orientation Checklist
Name:_________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs
with
minimal
assist
Performs
independen
tly Comments
0 1 2 Healthlink In Basket & Pool Management
Marks & closes messages correctly and in
timely manner
Manages Team Pool appropriately
Scheduling
Demonstrates ability to schedule for:
New patients & Followup clinic
appointments
Lab & radiology appointments
Endoscopy procedures, including propofol
Procedure at Meriter
Health Psychologist consult
Nutrition consult
Telephone Triage (see Policy 8.20)
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
1

DHC GI Clinic
RN Orientation Checklist
Name:_________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs
with
minimal
assist
Performs
independen
tly CommentsSelf 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
Able to appropriately triage GI patients &
use correct dot phrases for:
General GI disorders
IBD
Swallow Disorders
Pancreas
Liver
Colo-rectal Surgery, including Ostomy pt
Describe role of Provider of the Day &
locates schedule
Demonstrates appropriate follow-up of all
urgent calls (call back w/in 1 hour,
addressed by end of day)
Pre-Appointment & Provider Template
Management
Identifies required information prior to
clinic visit
2

DHC GI Clinic
RN Orientation Checklist
Name:_________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs
with
minimal
assist
Performs
independen
tly CommentsSelf 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
Collaborates with MA effectively to obtain
records as needed
Knowledge & management of provider
schedules (templates)
Documents pertinent diagnosis/comments.
Includes use of appropriate dot phrases
Clinic (see Policy 8.02)
Demonstrates appropriate
assessment/reassessment of patients in
clinic
Reviews/acts on assessment data collected
by MA/Tech
Demonstrates effective time management
of clinic schedule
Demonstrates timely communication to
patient &/or provider of lab and test
results
3

DHC GI Clinic
RN Orientation Checklist
Name:_________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs
with
minimal
assist
Performs
independen
tly CommentsSelf 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
Demonstrates ability to provide patient
education using HFFY, AVS & other
appropriate materials for GI population:
General GI Disorders
IBD
Swallow Disorders
Pancreas
Liver
Colo-Rectal Surgery, including Ostomy
patients
Patient Self-administered medications
Wound Care
Delegation & Collaboration with Team
Effectively/approriately delegates
tasks/interventions to MA
4

DHC GI Clinic
RN Orientation Checklist
Name:_________________________________
Performance Criteria
Method of
Validation
(RD/V/NA)
Requires
assistance/
coaching
Performs
with
minimal
assist
Performs
independen
tly CommentsSelf 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
Effectively partners with RN colleagues to
manage needs of patients
Effectively partners with Clinical Trial staff
as needed
Effectively coordinates care for patients in
Multi-D clinics
Competency will be reviewed during & at end of orientation to GI Clinics. Upon completion, sign/date form and return to manager.
RN Orientee: _________________________________________ Date: _____________
RN Preceptor: ________________________________________ Date: _____________
CNS: ________________________________________________ Date: _____________
Manager: ____________________________________________ Date: _____________
5