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/depts/uwhealth/ambulatory-education/checklists/resources/Family-Medicine-Checklist-12132017.pdf

201712353

page

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UWHC,UWMF,

Learning and Development,

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

Family Medicine

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



Family Medicine Clinical Training Checklist

Name: ___________________________ ID: _________ Clinic: ______________ Start Date: ________ Due Date: ________
Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
Online Training: Utilize the Learning and Development System (LDS)
ξ Review and Complete CBT List found in your yellow folder
Basic Office Visit: Data collection will include the following:
ξ Collect reason for visit and short summary of chief complaint (use of .nn
smart phrases)

ξ Review smoking history
ξ Review gender appropriate intake interview data collection
Well Child Exam to include Age Specific Development Assessment (Provide
copies of Bright Future Handouts)

ξ Employee is able to gather data using the Well Visit Exam text in
HealthLink

ξ Well Child Exam - Gather basic data relevant to normal
growth/development using Health Link WCC text

ξ Staff person will review all and be observed on at least 3 well visits in
each age group listed below:

o Child under 5yrs: ________, ________, ________
o Child 6-18: ________, ________, ________
ξ Staff person is also able to find growth chart and compare
ξ Review age appropriate assessment
ξ Anticipatory Guidance for pediatric age groups
ξ Know appropriate care for child with Attention Deficit Hyperactivity
Disorder (ADHD)

Screenings: Employee understands and can explain screenings. Knows where
results are documented.

ξ Why newborns are screened for tryosinemia, CF, toxoplasmosis, etc.
ξ Lead Screening

V 12/13/2017 Draft Ambulatory RN Orientation Review
2
Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
ξ Cholesterol Screening
ξ Anemia Screening
ξ Dental Screening
ξ Reach Out and Read Program
OB Health
ξ Demonstrate knowledge of OB care
ξ Fetal movement monitoring
ξ Calculation of last menstrual period (LMP)/use of wheel in HealthLink
ξ Recognition of signs and symptoms of pre-term labor
ξ Expedited partner therapy
Medications and Vaccines
ξ Enroll in WI Prescription Drug Monitoring Program Database Access at
http://dsps.wi.gov/pdmp/

ξ Employee will demonstrate a minimum of two injections per category
listed:

o Adult or child: intradermal ________ & ________
o Adult >18 years: subcutaneous ________ & ________
o Adult >18 years: intramuscular ________ & ________
o Child 5-17 years: subcutaneous ________ & ________
o Infant 0-5 years: subcutaneous ________ & ________
o Infant 0-5 years: intramuscular ________ & ________
ξ Appropriately performs TB testing and reading
ξ Staff administering allergy injections will have training completed by the
Allergy Department (Clinic to coordinate)

ξ Able to safely administer Depo-Provera per policy
ξ Employee is able to identify different drug classes and locate resources for
drug information

Anticoagulation
ξ Complete LDS course “Anticoagulation Management with Warfarin
Guidelines”


V 12/13/2017 Draft Ambulatory RN Orientation Review
3

Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
ξ Attend live training program “Anticoagulation Management with
Warfarin Guidelines” offered quarterly (optional)

ξ Develop warfarin management plan for a minimum of 5 patients requiring
dose adjustments - cases to be reviewed by preceptor
1.__________ 2.__________ 3.__________ 4._________ 5._________

ξ Demonstrate patient teaching using the Warfarin booklet (HFFY #6900)
Telephone Calls and Triage
ξ Demonstrates knowledge of telephone call documentation requirements;
use of smart phrases

ξ Demonstrates knowledge and use of MyChart messages
ξ Review HIPPA and telephone calls; leaving a voice message
ξ Able to complete consults/referrals to other departments as needed and
provide patient with appropriate resources

ξ Triage resources: Has knowledge of resources appropriate for the age
population

o Barton Schmitt Pediatric triage book
o Telephone Triage Protocols for Nurses by Julie Briggs
o Telephone Triage for Obstetrics and Gynecology by Vicki E. Lond
o External Resources available on HealthLink and Health Facts for
You documents on UConnect

ξ Conduct telephone triage; assessing patient’s/parent’s concerns and
provide the best disposition for the situation

ξ Preceptor to review a minimum of 10 triage calls within first month for
completeness, disposition, and documentation

UW Health Initiatives
ξ Motivational Interviewing 1 Training for RN's

V 12/13/2017 Draft Ambulatory RN Orientation Review
4
Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
Department Specific Skills
ξ Demonstrates ability to use HealthLink forms
ξ Oral Temperature (if applicable)
ξ Ear Temperature (if applicable)
ξ Axillary Temperature (if applicable)
ξ Pulse Rate – radial and apical*
ξ Respirations*
ξ Blood Pressure*
ξ Orthostatic BP and P*
ξ Pulse Oximeter*
ξ Peds to Adult Weight/Height*
ξ Infant weight/length/Head circumference*
ξ Demonstrate ability to set up sterile field
ξ Demonstrate understanding of maintaining sterility during a procedure
ξ Donning sterile gloves
ξ Proper instructions for collection of STD specimens – male and female
ξ Assist with Vasectomy
ξ Assist with IUD insertion
ξ Assist with Endometrial biopsy
ξ Assist with Colposcopy
ξ Lesion removal*
ξ Prepare wound for sutures/staples
ξ Removal of sutures/staples
ξ Fit and apply orthotic device(s)
ξ Fit patient for crutches, provide instructions*
ξ Ear flushing* and Eye flushing
ξ Nebulizer treatments*

V 12/13/2017 Draft Ambulatory RN Orientation Review
5
ξ Correct use of Spirometry
ξ Patient instruction in MDI/ spacers/ peak flow
ξ Vision screening* and Hearing screening
ξ EKG placement*
ξ Tympanogram
ξ Non-Stress Test for OB patients
ξ Wart Removal
ξ Nose Bleeds
ξ Properly collect the following specimens with correct labeling of
specimens and necessary paperwork:

o Urine clean catch
o Throat swab – rapid strep
ξ Complete cytology and requisition slips for PAP and/or lesion removal
ξ Urinary catheter insertion (male/female)
ξ Fluoride varnish application - Review Protocol 91 Fluoride Varnish
Pediatric Ambulatory, Fluoride Varnish Protocol Workflow, Pediatric
Fluoride Decision Tree and use of fluoride specific smart phrases:
.fluorideapply, .fluorideinstruct, .fluoriderefused, and .fluorideseedentist

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