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/depts/uwhealth/ambulatory-education/ambulatory-orientation/checklists/resources/Specialty_Cardiology.pdf

20170367

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UWMF,

Learning and Development,

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

Cardiology

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


1

CARDIOLOGY CLINICAL TRAINING CHECKLIST ----- This is due three months from hire date------

Employee Name: __________________________________ Employee Credentials:________ Hire Date: ____________

Clinic Location/ number: _______________________ Employee Number ________________________


*Refer to appropriate UWMF policy *** N/A on checklist indicates that it is not indicated for the employee***
***Each area should either be discussed or observed by preceptor***
AREA OF ORIENTATION Discuss Observe Preceptor’s Signature Completed date
Employee is able to gather data relevant to the following:
Patient’s personal and family health history
Patient’s perception of current problem
Onset of precipitating factors, to worsening symptoms or alleviating
factors and timing

Accompanying factors to patient’s conditions(ie: SOB to chest pain )
Obtains vital signs, smoking history and EKG when indicted

Employee is able to gather data relevant to the following:
S/S ANGINA - pain or pressure in chest, arms back or jaw comes w/ exertion,
relieved w/rest

S/S UNSTABLE ANGINA - chest pain or discomfort along with weakness,
feeling sick to stomach or fainting, feeling of impending doom
Unrelieved
with 3 nitro’s tabs

S/S CHF - SOB, swelling legs and stomach, Wt gain, fatigue, nausea or
Anorexia or sleeping on 2 or more pillows

S/S ATRIAL FIBRILLATION – SOB, Racing heart, palpitation, fatigue
dizziness and chest pain

S/S DYSRHYTHMIA – syncope, palpitations, skipped or fast heart rate


Employee is able to gather data relevant to the following:
Patient’s expectations in medical care
Patient’s knowledge level/deficit and ability to understand
Cultural practices related to care
Relationships with significant others



2
AREA OF ORIENTATION Discuss Observe Preceptor’s Signature Completed date
Patient Education- Employee participates in patient/family teaching:
Anticoagulant therapy and INR levels
Coumadin teaching Vitamin K monitoring INR levels
Cholesterol levels – appropriate levels, modifiable risk factors
Hypertension Meds, bulk, folic acid, niacin, antioxidants, statins
Hypertension – controllable risk factors: weight, sodium intake
Diuretics, beta blockers, calcium channel blockers, ace inhibitors,
nitrates

SBE Prophylaxis – Risk w/ valve replacement/stenosis/regurg,
post CABG/stent

SESTAMIBI – treadmill, dipyridimole, dobutamine mini
(diet, meds to hold)

Heart cath/PTCA/STENT/ (pre and post cath)
Puncture site assessment
Enoxaparin injection –dose/technique for appropriate administration

Employee is able to appropriately care for a patient with the following:
Pacer/defibrillator (ICO) – teaching RE: magnetic fields
Anticoagulation Initiative
RN only - Complete LDS course “Anticoagulation Management with Warfarin
Guidelines”

RN only - Attend live training program “Anticoagulation Management with
Warfarin Guidelines” offered quarterly (optional)

RN only - Develop warfarin management plan for a minimum of 5 patients
requiring dose adjustments – cases must be reviewed and approved by
anticoagulation champion or responsible physician.

RN only - Case 1. 2. 3. 4. 5.
Consults/referrals to other departments:
Nutritional Specialists
Smoking Cessation
Exercise prescription – referral to exercise Physiologist

Be able to speak with drug representatives

Demonstrate competence in counseling and provide appropriate resources
Diet, Smoking, Exercise


Demonstrate competence in Equipment/ Supplies
Equipment/supplies are available based on patient needs
Equipment functions before use – IMED, EKG, TM, Pulse Ox Doppler
Emergency equipment/supplies are current and available at all times
Demonstrate competence in the care of 1st line drugs, defibrillator

3
AREA OF ORIENTATION Discuss Observe Preceptor’s Signature Completed date
Procedures- Demonstrate competence to assist/set-up/patient care/follow-
up

Phlebotomy/Labs from IV’s already in place
IV initiate, IV push meds, (Dipy, Atropine, Metoprolol, Compazine) *
IV piggyback – Aminophylline *
Titrate Dobutamine
AREA OF ORIENTATION Discuss Observe Preceptor’s Signature Completed date
Diagnostic/therapeutic tests –
Demonstrate competence to assist/set-up/patient care/follow-up

EKG *
Catheterization: puncture site, activity level
Treadmill Test
Nuclear Stress Test: dipyridimole, dobutamine
Echo: Administer Definity (contrast materials)


Provides URGENT Patient Care – Employee is able to:
Initiates EKG monitoring (when indicted)
Initiates Defibrillation (if indicted)
Appropriately care for patient requiring an EKG interpretation
Appropriately care for patient requiring anti-arrhythmic medication
Initiate Chest Pain Protocol (Emergency Procedures Manual)
Appropriately care for patient requiring anit-anginal medication
Appropriately care for patient with cardiopulmonary arrest
Understands and can appropriately set-up the crash cart
Stocks crash cart appropriately
Performs appropriate crash cart ‘checks’


Administration of Medications Understands the following drug
compatibility’s

Verbalizes the appropriate dose, mechanism, side effects of medications:
Thrombolytics thin the blood - streptokinase, urokinase, heparin
NEEDED???

Beta-blockers – lowers HR and contractions- lopressor, tenormin, proranolol
Nitrates – to treat angina & lower workload – nitroglycerine
ACE Inhibitors – lessen afterload/work on heart – captopril, vasotec,
lisinopril

Anti-arrhythmics – regulates rhythm – atropine, lidocaine





4
AREA OF ORIENTATION Discuss Observe Preceptor’s Signature Completed date
Administration of Medications Understands the following drug
compatibility’s

Anti-anxiety – keeps patient calm – diazepam/valium, lorazepam,xanax
Digoxin/Lanoxin
Calcium Channel Blockers – lessens afterload/work on heart – nifedipine,
diltiazen, verapimil



Administration of Medications Understands the following drug
compatibility’s -- Continued

Enoxaparin dose and administration – patient teaching on SQ injection
Verbalizes the appropriate dose, mechanism, side effects of drugs used in
chemical MIBI tests: Dobutamine, Atropine, Metroprolol, Dipyridimole, and
Aminophylline

Administer IM adult, SQ adult, ID, and sublingual medications


Administer IV medications:
DEA Procedures/Controlled Substances Log and Controlled Substances
Abuse


I, _________________________________________ (employee name) have completed the CARDIOLOGY CLINICAL TRAINING CHECKLIST and attest the
information is true and valid. I have demonstrated or discussed these skills and I am responsible for performing medical care as a Certified Medical Assistant /
Licensed Practical Nurse / Registered Nurse (circle one).
__________________________________________________ ___________________ Additional Preceptor Signatures/initials:

Preceptor Date _____________________________
__________________________________________________ ___________________ _____________________________
Supervisor Date
______________________________
__________________________________________________ ___________________
Provider Date
Status/Recommendations/Comments: _____________________________________________________________________________________

____________________________________________________________________________________________________________________
Initially Completed 8-8-02 Updated 05/03, 08/04, 07/07, 2/11, 9/11, 3/12, 11/15, 3/17

 Send the original signed Clinical Training Checklist to Clinical Staff Education - 1035.
 One copy of the signed Clinical Training Checklist should be placed in the clinic’s staff employee’s file, and a copy given to the employee.

References:
Brener, T., Doyle, R.M. (Ed.). (2008). Nursing 2008 drug handbook. Philadelphia, PA: Lippincott Williams & Wilkins.
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby Elsevier.