Name: Department: Date Orientation Began: Signature of Preceptor or Evaluators/Initials Levels of Performance: Novice: Novice clinical instructors are gaining knowledge and experience in clinical and technical skills. Under the guidance of a preceptor, each novice nurse collects objective data according to guidelines and rules obtained from nursing education and in orientation. The novice nurse uses this objective data and seeks assistance in making clinical decisions. Advanced : Advanced clinical instructors are guided by policies, procedures and standards. They are building a knowledge base through practice and are most comfortable in a task oriented environment. They describe a clinical situation from the viewpoint of what they need to do rather than relating the context of the situation to how the patient responds. Advanced beginners practice from a theoretical knowledge base while they recognize and provide for routine patient needs. : clinical instructors integrate theoretical knowledge with clinical experience in the care of patients and families. Care is delivered using a deliberate, systematic approach and practice is guided by increasing awareness of patterns of patient responses in recurrent situations. These nurses demonstrate mastery of most technical skills, and begin to look at clinical situations from the patient s and family s viewpoints. Use of this tool: The clinical instructor will use this tool to self assess for each skill. The Education Coordinator will review the tool then set up an orientation to address skills that are not identified as competent. Throughout the orientation period (8 12 hours), the preceptor or Education Coordinator will evaluate the level of competence the nurse demonstrates for each skill. If there are deficits in the skills and the instructor is not competent in certain skills do the following: 1. Discuss with the clinical instructor any plans for additional training or patient care assignments needed to improve skills that are not identified as competent. 2. Document this plan in the Periodic Review of Orientation. Refer to: Guidelines for the use of the Orientation Competency Validation Tool
Competency/Skill Reference Novice Adv. Respiratory Respiratory requiring Oxygen therapy requiring Tracheostomy Care requiring Chest Tube Care requiring suctioning Cardiac Cardiac Neurological Neurological Cares for a patient during a lumbar puncture requiring seizure care requiring a ventriculostomy Gastrointestinal Gastrointestinal with an NG tube. with an enteral feeding tube. and Reassessment of Patients CHEX: Pediatric : The Respiratory System Oxygen Admin to Infants Non Invasive Pulse Oximetry Monitoring Tracheostomy Protocol Tracheostomy Procedure Care of Child with Chest Tube Atrium Oasis Video Atrium Dry Suction Chest Drainage Suctioning of the Naso and Oropharynx CHEX: Peds : The Cardiovascular System Cardiac Cath Protocol Generalized Seizure Protocol Care of Child with an External Ventriculostomy NG Feeding tube insertion NRG Video: Measurement, Placement, Securing and confirming Irrigation of Nasogastric Drainage Tube Naso/Oral Gastric Tube Feeding Transpyloric Tube Insertion Care Card: NG Tube Insertion Care Card: NG Tube Feeding
Competency/Skill References Novice Adv. with a GT/Button requiring a ph Study with a Stoma/Ostomy Genitourinary Genitourinary with a urinary indwelling catheter requiring a straight cath. Integumentary Integumentary Provides care for the prevention of skin breakdown. Provides wound care and dressing changes. n Oral Musculoskeletal Musculoskeletal with a C Collar requiring traction. in a cast or splint. Psychosocial Cares for patients utilizing age Gastrostomy Tube NRG Video: Assessing and Turning Care Card: Gastrostomy Button Mic Key Care Card: Gastrostomy Tube Care First 8 Weeks Care Card: Gastrostomy Tube Feeding Care Card: Gastrostomy Tube Removal Mic Key Feeding Tube Video ph Study Procedure Urinary Catheter Care Skin Integrity Protocol Immobility Protocol NV of Immobilized Extremity Care of Child in Traction Care of Child in a Cast
Competency/Skill References Novice Adv. appropriate interventions. Verbalizes the nurse s role and responsibilities related to: Care of the child in which abuse or neglect is suspected. Care of the child suspected of domestic violence. Pain Management experiencing pain. Medication Administration requiring medications. Demonstrates administration of medications using safe practices. Demonstrates aseptic technique when preparing medications. Demonstrates procedures for administering controlled substances Nursing Interventions Venipuncture for specimen collection Venipuncture for IV Access requiring IV Therapy with a Central Linemodified Demonstrates collection of laboratory Specimens Abuse, Neglect and Intimate Partner Violence Screening and Evaluation Pain Management Policy Oral Sucrose Protocol Massage Therapy Protocol Wong s Procedures related to Administration of Medications p 522 Patient Identification Medication Management Look Alike Sound Alike High Risk Medication Safe Storage of Medications Electronic Medication Reconciliation Use of non CMH Meds Injection Procedure Pyxis Policy Immunization Policy Large Volume IV Med Administration Adverse Drug Reporting Food and Drug Interaction Venipuncture and IV Therapy Policy Heparin Flush Guidelines Central Line Dressing Change and Heparin Flushing Guidelines PICC: Mgmt, Dressing Change, Removal Subclavian, Jugular, Femoral Catheter Care Midline Peripheral Catheter Collection of Chlamydia Specimens Blood Culture Heelstick Pocedure Lumbar Puncture Transporting Specimes to Lab Urine Specimen Collection IV Therapy and Venipuncture
Competency/Skill References Novice Adv. Pre Surgical Procedure requiring surgery Post Surgical Procedure who has undergone Surgery Demonstrates hand Infection Control Manual hygiene Demonstrates the use of personal protective equipment. Demonstrates use of isolation precautions. Performs Height and Physical Measurements Weight Measurements requiring a special diet/npo on breast milk on formula on a calorie count receiving TPN and Lipids requiring the acquisition of a car seat. being admitted. being discharged. at risk to fall requiring thermal management Provides education to Procedure for Ordering Diets Breast milk Protocol Infant Breast Feeding Food Storage Formula, Special Formula & Tube Feeding Intake and Output Lactation Consultation Room Service Policy Checking Accuracy of Special Formula Care Card: Infant Formula Mixing Instructions Infant Feeding Birth to 4 Months Infant Feeding 4 to 6 Months Infant Feeding 6 to 9 Months Infant Feeding 9 to 12 Months Calorie Count Procedure TPN and Lipids Child Passenger Safety Restraint Neonatal Car Seat Screening Admissions Policy Admission Data Base Documentation Guidelines Inpatient Visitation Policy Bear Book Discharge Policy Falls Prevention Policy Patient Safety Policy Scope
Competency/Skill References Novice Adv. the patient/family utilizing all available resources Lexi Comp Pedi PALS Care Cards Equipment Cares for patient utilizing the following equipment: Cardiac Monitor Cardio Respiratory Monitoring CHEX: CR Monitor Defribrillator Defibrillation/Cardioversion Protocol Oxygen Saturation Non Invasive Pulse Oximetry Monitor Monitoring Alaris Large Volume Alaris Self Training Module Infusion Pump Alaris Syringe Pump Alaris PCA Pump Epidural Pump Zevex Enteral Feeding Zevex Pump Phototherapy Phototherapy Protocol Bilimeters Standard Bed Patient Safety Policy Crib Incubator Walk O Bout Oxygen Cylinder Translogic Tubes Translogic Tube System Breast pump Cooling Blanket K pads Radiant Warmer Intermittent Wall Suction
Periodic Review of Orientation Final of Competency: Action Plan: I currently work at Children s Mercy Hospital as a Registered Nurse and have completed the RN Orientation Competency Tool. Please refer to that tool. Employee Signature: Date Manager Signature: Date
Clinical Instructor Orientation Competency Validation Tool Written by: Reviewed by: Bonnie Tecza, RN, MSN Michele Fix, RN, MSN, NE BC Ginny Nyberg, RN, MSN Approval: Nursing Practice Council: Cheri Hunt, RN, MHA, NEA BC Date Chief Nursing Officer/Vice President for Nursing