Neonatal Unit Nurse Competency Skills Assessment

Name: Employee Number: Date: .. Assessed Level Key

Level 1 Level 2 Level 3 Level 4

No Experience. Full Supervision Required (Exposure Level) Limited Competency/Proficiency. Supervision Required (Participation Level) Performed infrequently, may require occasional supervision (Independent Practitioner Level) Competent/Proficient/Independent ( Preceptor Level)

Patients Rights Awareness of International Patient Safety Goals Awareness of Emergency CODES within institution Communicates and obtains information while respecting the Rights and Privacy and Confidentiality of Information in Accordance with hospital policy Demonstrates effective communication Meets patient and family needs regarding communication. Including the organization of interpreter services, if needed. Provides accurate and un-bias information to the patient and family, in a timely manner. Assessment and Care of a patient with neurological problems Fontanel and cranial sutures Motor response/Posturing Level of Consciousness Acute Birth Trauma/Brain Injury Intracranial Hemorrhage Neural Tube Defects CNS Infections Neurological Surgery (pre-post operative care) Seizure management VP Shunt management External ventricular drain management Head circumference measurement Assessment and Care of a patient with Cardiovascular problems Cardiac abnormalities. Cardiac monitoring & 3 Lead ECG Interpretation Inotrope infusions & calculations. Invasive blood pressure monitoring

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Central venous line management Non-invasive blood pressure monitoring Assessment and Care of a patient with Cardiovascular problems Heart Sounds Skin Colour / Temperature Pulses (central and peripheral) Capillary Refill Time Edema Ability to set up 12 lead ECG monitoring Response to Neonatal Resuscitation Use of Defibrillator Management of an internal pacemaker Care of a patient with shock: 1. Cardiogenic 2. Neurogenic 3. Septic 4. Hypovalemic Extra Corporeal Membrane Oxygenation (ECMO, Veno-Arterial) Assessment and Care of a patient with Respiratory problems Breath Sounds Respiratory pattern and effort Skin/nail bed color Respiratory secretions (color/consistency) Capillary blood sampling. Chest drain management: 1. Identifies Indications 2. Assists with placement and removal 3. Set Up drainage system 4. Monitor suction pressure and site care

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Arterial Line Management Blood Gas Interpretation Endo-Tracheal Management: 1. Nasally Intubated Neonates 2. Orally Intubated Neonates 3. Assists with intubation/extubation 4. Securing of ETT 5. Suction technique (closed circuit/open) Nasopharyngeal CPAP Nasal Cannula, Hood Pulse Oximetry Caring for an infant with: 1. Acute Respiratory Failure 2. Pneumonia 3. Respiratory Distress Syndrome 4. Pulmonary Edema 5. Tracheotomy 6. Surfactant Replacement Therapy 7. Pneumothorax 8. Pulmonary Hypertension Extra Corporeal Membrane Oxygenation (ECMO, Veno-Venous) Assessment and Care of a patient with Respiratory problems Implications and management for Nitric Oxide Therapy Care and management of a neonate at 24 weeks gestational age Care of a patient requiring ventilation Management (Use, Mode, Complications, Troubleshooting and Weaning) CPAP: Continuous Positive Airway Pressure SIPPV: Synchronized Intermittent Positive Pressure Ventilation SIMV: Synchronized Intermittent Mandatory Ventilation IPPV: Intermittent Positive Pressure Ventilation IMV: Intermittent Mandatory Ventilation CMV: Continuous Mandatory Ventilation PTV: Patient Triggered Ventilation VG: Volume Guarantee HFOV: High Frequency Oscillation Ventilation PC: Pressure Control PSV: Pressure Support Ventilation

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

AC: Assist Control SiPAP: Synchronized Inspiratory Positive Airway Pressure

Assessment and Care of a patient with GI/Renal Probelms Bowel Sounds Abdominal Circumference Measurement Appearance/character of urine and stool Urinalysis: obtaining sample and interpretation Fluid and Electrolyte Balance Post-Operative Care following abdominal surgery Implications and management of stoma Gastrostomy Tube Oro/naso-gastric tube; care & management Gastric decompression/Intermittent Suction Implications and management of urinary catheterization Breast Milk: 1. Implications and contents of breast milk 2. Collection 3. Storage 4. Pump usage/cleaning Bowel Resection & NEC Caloric requirements & calculations Gastroschisis. Congenital Diaphragmatic Hernia Exomphalus Imperforate Anus Myomeningocoele Care and Competency of Vascular Access IV Therapy and Medication Management Insertion and care of peripheral IV cannula Interpretation of blood chemistry values Interpretation of hematology values Interpretation of blood glucose and management Assistance with Lumbar puncture procedure & interpretation of results Exchange transfusion Total parental nutrition (TPN) administration Care of IV insertion site Care of IV tubing and changing of tubing Administration of IV fluids, continuous and bolus Umbilical arterial line management Umbilical venous line management Drug & Fluid calculations (assessment to be completed within probationary period) Medication Administration Record (& Neofax Usage) Administration of Morphine Infusion Administration of Inotropes Heel Prick Blood Sampling Initiation/Monitoring of Transfusion of Blood products Knowledge of Administration of Blood Products

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Assessment and Care of a patient receiving Phototherapy Implications and complications of phototherapy Care and management of phototherapy lights Eye protection Infection Control Standards Standard Precautions Airborne Precautions Contact Precautions Skin prep and cleaning for aseptic procedure Hand Hygiene as per policy Identifies usage of hand sanitizer gel Pain Management Assessment /management using appropriate pain assessment tool Identify appropriate pain relief methods and medications Principles of developmental care and positioning Baby Friendly Hospital Initiative Awareness of BFHI 10 step program Ability to aid mothers with breastfeeding to include: 1. Hand expression 2. Nipple attachment 3. Infant positioning 4. Education 5. Storage/hygiene guidance Managerial Experience Scheduling Staff allocation and delegation Conflict resolution Problem solving Managing change Leadership/Time Management Decision Making Medication Administration Acyclovir Amikacin Aminophylline Amphotericin Ampicillin BCG Vaccine Breast Milk Fortifier Calcium Capoptril Cefotaxime Ceftazidime Chloral Hydrate Dexamethasone

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Level 1

Level 2

Level 3

Level 4

Medication Administration Digoxin DOBUTamine DOPamine Epinephrine Erythromycin Fentanyl Fluconazole Folic Acid Frusemide Gentamycin Heparin Hepatitis B Vaccine Hydrochlorthiazide Indomethacin Inhaled Nitric Oxide Insulin Iron Syrup Lidocaine Magnesium Sulfate Meropenem Metronidazole Midazolam Morphine Multivitamins Naloxone Nitroprusside Nystatin Octreotide Oxygen Paracetamol Paralysing Agents Penicillin Pentaglobin Phenobarbitone Phenytoin Piperacillin-Tazobactam Prostaglandin Ranitidine Sodium Bicarbonate

Level 1

Level 2

Level 3

Level 4

Spironolactone Sucrose Surfactant Theophyline Vancomycin Vitamin K

Level 1 Level 2 Level 3 Level 4 Equipment Knowledge and Skills Alaris Syringe Pump Alaris IV Pump Apnea Monitor Baby Bottle Warmer Bed Elevation Disabled during HFOV Bedside Monitor Biliblanket Blood Gas Analyzer Breast Pump Medela Symphony Digital Thermometer Dual SPO2 EtCO2 Giraffe Omnibed & Incubator Giraffe Weighing Scale Glucometer - Competency Humidification Intensive Care Cot Intensive Phototherapy Laryngoscopes & Blades Mobile Cold Light OR Bed and Portable Ventilator Oxygen Blenders Phototherapy Phototherapy Spotlight Portable Cold Light (Hill Rom) Portable Suction Devices Radiant Warmer (Drager) Radiant Warmer (Ohmeda) Rotating Mattress Sensormedics Oscillator Servo-Control Oxygen TCOM (TCPO2/TCPCO2) Transport Incubator & Ventilator Transport Monitor Twin co-bedding Wall Suction (Normal & Intermittent) Weighing Scale Nappy Weighing Scale & Length Employee Signature Full Name ... Date . Clinical Educator Signature .Full Name Date ..