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/depts/uwhealth/ambulatory-education/checklists/resources/Specialty_Rheumatology_2015.pdf

201504103

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100

UWMF,

Learning and Development,

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

Rheumatology

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


1


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

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

Clinic Location/ number: _______________________ Employee Number ________________________
*Refer to 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 Discussed Observed Preceptor’s Signature Completed date
Employee is able to gather data & appropriately care for a patient with the following:
Ankylosing Spondylitis: Vertebral fractures, back pain
Fibromyalgia: Muscle aches, fatigue
Gout: Pain in toe, hypertension
Lupus: Weight loss, fever, butterfly rash
Lyme Disease: rash, joint pain
Myositis: Muscle pain
Osteoarthritis: Joint pain, swelling, stiffness, decrease movement
Osteoporosis: Pain,, stress fractures
Paget Disease: Bone pain, stress fractures
Psoriatic Arthritis : Pain, swelling in joints, scaly spots on elbows and knees
Polymyalgia Rheumatica: Muscle pain
Polymyositis and Dermatomyositis: Weakness, pain
Raynaud’s Phenomenon: Finger or toes change skin color, numbness tingling or swelling
Reiter Syndrome: Fatigue, weight loss, diarrhea
PSS: Reflux, N/V, difficulty swallowing, constipation, diarrhea, headaches, diplopia,
Morning stiffness

Rheumatic Fever: Myocarditis, Endocarditis,
Rheumatoid Arthritis: Pain, weakness, swelling, stiffness of joints
Juvenile Arthritis (JA): Weight loss, pain, stiffness, fevers, malaise, transient arthritis
Sjogren’s Syndrome: Dry eyes and or mouth, dry upper airways
Obtain vital signs* (Wt, Ht, BP, P, & Pulse ox), smoking history
Employee is able to gather data and appropriately care for a patient with the
following:

Types of Pain: Superficial, Referred, and Phantom (with expressions of pain)
History of Pain intensity (0-10 scale), onset, duration, medications, etc.

2
AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Gather data on psychosocial health statue when indicated
Gather data on patient’s perception of problem
Elicit patient’s expectations regarding medical care
Determine patient’s knowledge level/deficit and ability to understand
Identify cultural practices related to care

Is able to understand use terminology in musculoskeletal assessment:
abduction-away from midline, adduction-toward the midline,
atrophy-wasting away, causalgia-burning
circumduction-moving 360 θ, contracture-absence of motion in joints dorsiflexion–
moving up, eversion–sole of foot facing away from the opposite foot flexion-increase of
the angle, kyphosis-convexity of thoracic column
lordosis-concavity of vertebral column, subluxation- trauma to joint structure


Patient Education- Employee participates in patient/family teaching

Health Education - Employee demonstrates knowledge & can discuss with patient:
Patient teaching related to medications and side effects
Related to injections of Rheumatologic medications
Pain interventions: cold, heat, TENS, distraction, relaxation, narcotics

Consults/referrals to other departments (nutrition) or specialists.
Nutritional and Diabetics Specialists
Specialty Clinics: ie: Plastics, General Surgery
Physical Therapy
Occupational Therapy
Radiology
PM&R
Laboratory
Wound Care
DME
Be able to speak with drug representatives

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



3
AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Provides URGENT Patient Care – Employee is able to:
Initiates AED Defibrillation (if indicated)*
Initiate Emergency Protocols appropriately ( Emergency Procedures Manual)*
Appropriately cares for patient in cardiac arrest (until crash cart help arrives)*


Procedures- Demonstrate competence to assist/set-up/patient care/follow-up
Aspirations*
Injections and Injection teaching*
Proper and complete labeling of specimens and paperwork (in needed)

Administration of Medications
Understand the following drug compatibility’s
Verbalize appropriate dose, mechanism, side effects of the following medications:
Analgesics: Aspirin, Anacin, Ibuprofen, Acetaminophen, Ecotrin, Excedrin,
Demerol, Ketorolac, Midol, Morphine, Percocet, Vicoden

Antibiotics: Amoxicillin, Ceftriaxone, Cefazolin, Bactracin ointment, Gentamicin,
Penicillin, Tobramycin, Vancomycin

Anti-gout: Allopurinol, Colchicine
Anti-Inflammation: Prednisone, Depo Medrol injection
Anti-neoplastic: Methotrexate*
Anti-pyretics: Acetaminophen, Ibuprofen, Dexamethasone
Biologics: Humira, Enbrel, Orencia, Cimzia, Simponi, and Actemra, DMARDS
Methotrexate and Plaquenil.

NSAIDS: Mobic, Diclofinac, Celebrex
Immunosuppressants: Enbrel, Kineret, Humira
Osteoporosis: Actonel, Fosamax, Forteo, Boniva*
BMR: Orencia, Rituxan, Remicade*
Administer IM adult, SQ adult, ID, & sublingual meds *
Administer IV medications *
DEA Procedures/Controlled Substances Log and Controlled Substances Abuse *
Complete the TB CBT in LDS titled “TB Skin Test Administration and Reading”.
Properly perform TB testing and reading – new employee to demonstrate this skill twice for
another staff person (preceptor’s initials) ___________, ____________


Rheumatology Policies
Remicade Program
Corrona Program
Joint Injection*
Joint Aspiration*

4

Status/Recommendations/Comments:
____________________________________________________________________________________________________________________

I, _________________________________________ (employee name) have completed the Rheumatology Training Checklist and attest the
information is true and valid. I have demonstrated or discussed these skills and I am responsible for performing patient care as a Certified Medical
Assistant / Licensed Practical Nurse / Registered Nurse (circle one).

__________________________________________________ ___________________
Preceptor Date

____________________________________________________ ___________________
Supervisor Date

__________________________________________________ ___________________
Provider Date

Additional Preceptor Signatures/initials:
1. _________________________________________________
2. _________________________________________________
3. _________________________________________________
4. _________________________________________________

Initially Completed 3-17-03, Updated 05-20-03, 8-3-05, 8-07, 9/11, 3/12, 6/14, 3/15

 Send the original signed Clinical Training Checklist to Clinical Staff Education-414.
 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:
ξ Brener, T., Doyle, R.M. (Ed.). (2008). Nursing 2008 drug handbook. Philadelphia, PA: Lippincott Williams & Wilkins.
ξ Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
ξ Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby Elsevier.
ξ Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams & Wilkins.