/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/Cardiothoracic.pdf

201409252

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UWMF,

Learning and Development,

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

Cardiothoracic

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


CORE COMPETENCIES

CARDIO-THORACIC SURGERY CLINICAL TRAINING CHECKLIST ACIC SURGERY CLINICAL TRAINING CHECKLIST

Employee Name: __________________________________ Employee Title:________ Hire Date: ____________ Employee Name: __________________________________ Employee Title:________ Hire Date: ____________
Clinic Location: _______________________ Employee Number _______________________ Clinic Location: _______________________ Employee Number _______________________

Checklist to be filled out by preceptor/trainer/manager/coordinator/provider. * n/a on checklist indicates that it is not needed. Checklist to be filled out by preceptor/trainer/manager/coordinator/provider. * n/a on checklist indicates that it is not needed.
Checklist also to be filled out by orientee, using appropriate columns below Checklist also to be filled out by orientee, using appropriate columns below
Shaded areas under the (RN, LPN and CMA columns indicate not applicable) Shaded areas under the (RN, LPN and CMA columns indicate not applicable)

Preceptor/trainer/manager/coordinator/providers sign back page. Preceptor/trainer/manager/coordinator/providers sign back page.
{orientee's initials} {preceptor's checks & initials} {orientee's initials} {preceptor's checks & initials}

AREA OF ORIENTATION AREA OF ORIENTATION RN RN LPN LPN CMACMA
DiscussDiscuss ObservedObserved
Date Date Comments Comments
Employee is able to gather data relevant to the following: (per Ref # 3) ********************** ************* ********************
Review of systems IE: Cardiac, Respiratory, Digestive, Urinary, Nervous, Skeletal\Muscular:

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 (such as SOB to chest pain )
Vital signs, pulse ox, weight, height, smoking history, EKG (when indicted)


Able to elicit patient’s expectations in medical care
Able to determine patient’s knowledge level/deficit and ability to understand
Able to identify cultural practices related to care
Able to elicit information regarding relationships with significant others



1

AREA OF ORIENTATION RN LPN CMA
Discuss Observed
Date Comments
Patient Education- Employee participates in patient/family teaching (per Ref # 3) ********************** ************** *******************
Health Education - Employee demonstrates knowledge & can discuss with patient: ********************** ************** *******************
Pre-operative cardiac surgery teaching with “Preparing for Heart Surgery” Brochure
Discontinuing medications (ie: Plavix, Coumadin, asaprin)

Post Operative - Sternal precautions
When to drive, return to work, resume normal activities, resume sex
Wound Care, Pain Management




Employee is able to appropriately care for a patient with the following: (per Ref # 3) ************************* ************** ********************
I. Valve Replacement (per Ref # 3)
- Tissue
- Mechanical
* Need for anticoagulative therapy
* Guidelines for target range for INR
- Antibiotic Prophylaxis –AHA Guidelines
* AHA “Heart Valve Surgery” Brochure

II. CABG (per Ref # 3)
III. Carotid Artery Endarterectomy (per Ref # 3)
IV. Thoracic Procedures (per Ref # 3)
- Mediastinoscopy
- Thoracotomy
- Thoracoscopy


V. Office Procedures (per Ref # 3)
- Thoracentesis with equipment needed post procedure (chest x-ray, disposal of wastes)




2


AREA OF ORIENTATION RN LPN CMA
Discuss Observed
Date Comments
Consults/referrals to other departments (nutrition) or specialists. ************************ ************** ********************
Cardiac Rehabilitation, Pain Clinic
Nutritionist and Diabetes Management
Pulmonary Clinic, Oncology Clinic

Counseling- demonstrate competence in counseling and provide appropriate
resources
************************** ************** ********************
Diet, Smoking, Exercise
Be able to speak with drug representatives
Setting up appointments to meet with providers

Equipment/ Supplies ************************* *************** ********************

Assure all equipment/supplies are available based on patient needs
Assure all equipment functions before use
Assure all emergency equipment/supplies are current and available at all times
Demonstrate competence in the care of 1st line drugs and defibrillator equipment


Procedures- Demonstrate competence to assist/set-up/patient care/follow-up ************************ *************** ******************
Wound Debridement
Thoracentesis
Resting exercise pulse oximetry




Procedures- Demonstrate competence to assist/set-up/patient care/follow-up ************************ *************** *********************
EKG* per UWMF policies see below #14




3

AREA OF ORIENTATION RN LPN CMA
Discuss Observed
Date Comments
Surgery *********************** ************** ********************
Scheduling and Preauthorizations

Scheduling procedures Meriter vs UWMF





Administration of Medications (per Ref # 21) ************************ *************** *********************
Understands the following drug compatibility’s ************************ *************** ********************
Verbalize appropriate dose, mechanism, side effects of the following medications: ************************* *************** *********************
Thrombolytics thins the blood - streptokinase, urokinase, heparin



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 – regulate rhythm – atropine, lidocaine



Anti-anxiety – keep patients calm – diazepam/valium, lorazepam,xanax



Digoxin/Lanoxin



Calcium Channel Blockers – lessens afterload/work on heart – nifedipine,
diltiazen, verapimil



Enoxaparin dose and administration – patient teaching on SQ injection



Coumadin - Anticogulant












Administer IM adult, SQ adult, ID, IV and sublingual medications – * per UWMF policies
See below 15-19



DEA Procedures/Controlled Substances Log* per UWMF policies see below 20


Controlled Substances Abuse


4


AREA OF ORIENTATION RN LPN CMA
Discuss Observed
Date COMMENTS
Cardio/Thoracic Policies

Understand the Role of Department within Meriter Hospital
Understand Meriter phone and pager system





Status/Recommendations/Comments: ________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________

__________________________________________________ ___________________ Please sign initials and name below
Employee Date Initials ______ Name ____________________
Initials ______ Name ____________________
Initials ______ Name ____________________
__________________________________________________ ___________________ Initials ______ Name ____________________
Preceptor/Provider Date Initials ______ Name ____________________
Initials ______ Name ____________________
Initials ______ Name ____________________
___________________________________________________ ___________________ Initials ______ Name ____________________
Supervisors Date Initials ______ Name ____________________

Original date 7-12-02 Updated 05-19-03, 08-30-04

¾ When the Core Competency Checklist has been completed it should be signed and dated by the clinical staff member, preceptor, provider and supervisor.
¾ Two copies of the completed and signed Core Competency Checklist should be made.
¾ The original signed Core Competency Checklist should be sent to the Clinical Staff Educator - #414.
¾ One copy of the signed Core Competency Checklist should be placed in the clinic’s staff employee’s file, and a copy of the signed Core Competencies Checklist given to the
employee.



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REFERENCES:
1. American Academy of Ambulatory Care Nursing Standard of Practice, 2000.
2. American Academy of Ambulatory Care Nursing: Core Curriculum for Ambulatory Care Nursing, Robinson, Editor, WB Saunders Co. 2001.
3. American Association of Critical-Care Nurses: Core Curriculum for Critical Care Nursing, Alspach/Williams WB Saunders Company, 1985.
4. Joint Commission on Accreditation of Healthcare Organization, 2000-2001 Standards for Ambulatory Care.
5. Joint Commission 1996 Comprehensive Accreditation Manual for Ambulatory Care. Jackson, KE: Be competent with competencies. Call Center
Magazine. May '97, 98-103.
6. Lenburg, CB: The framework, concepts and methods of the competency outcomes and performance assessment model. Journal of Issues in
Nursing. 1999, September 30.
7. Nolan, P: Competencies drive decision-making. Nursing Management. March, '98,27-29.
8. Snyder, SA: Assessing and documenting competency to meet JCAHO standards: A workshop for health care managers. 2000.
9. Basic Skills and Procedures: Perry & Potter, 4
th
Ed., 1998, Mosby, St. Louis.
10. Clinical Nursing Skills & Techniques, 5
th
Ed. Perry & Potter, 2002, Mosby, St. Louis.
11. Drug Dosages and Solutions, 3
rd
Ed. Norville, 1998, Appleton & Lange, Norwalk CT.
12. Just the Facts: A Pocket Guide to Basic Nursing, Peterson, and 2nd, ed. Mosby, St. Louis.
13. Lippincott Williams & Wilkins. Procedure Checklists Fundaments of Nursing: The Art and Science of Nursing Care, 4
th
ed. Lillis, LeMone and
LeBon.
14. * Assisting with EKG - UWMF Clinical Policies & Procedures, May, 2002.
15. *Administering an Intradermal Injection - UWMF Clinical Policies & Procedures, February, 2002.
16. * Administering an Intramuscular Injection - UWMF Clinical Policies & Procedures, February, 2002.
17. *Administering a Subcutaneous Injection - UWMF Clinical Policies & Procedures, February, 2002.
18. *Administering a Sublingual Injection - UWMF Clinical Policies & Procedures, May, 2002.
19. * Adding Medications to an IV Solution - UWMF Clinical Policies & Procedures, February, 2002.
20. * Controlled Substance Distribution and Handling Occurrences of Controlled Substance Abuse - UWMF Clinical Policies & Procedures.
21. Nursing2003 Drug Handbook Spring House Lippincott Williams & Wilkins, Philadelphia, PA, 2003
22. AAACN Telephone Triage Standards of Practices, American Academy of Ambulatory Care Nursing Standards of Practice, 2000.