DACUM Competency Profile for Registered Nurse (Medical/Surgical Staff Nurse)

Produced By

Regional Health Occ. Resource Center San Diego/Desert Region Saddleback College 28000 Marguerite Parkway Mission Viejo, CA 92692 (714) 582-4451 (800) 464-1778 Regional Health Occ. Resource Center Orange County/Los Angeles Region Golden West College 15744 Golden West Street Huntington Beach, CA 92647 (714) 895-8155 Orange County/Los Angeles/Long Beach Consortium

October 19-20, 1995

This report is made pursuant to contract/agreement number 94-0134. This project was supported by the Carl D. Perkins Vocational and Applied Technology Education Act. Funds administered by the Chancellor's Office, California Community Colleges.

"This activity which is the subject of this report was supported in whole or in part by the U.S. Department of Education. However, the opinions expressed herein do not necessarily reflect the position or policy of the U.S. Department of Education, and no official endorsement by the U.S. Department of Education should be inferred." DACUM Panel Members Jeannie Ricketts, RN Sonja Wentzel, RN Cheryl Denson, RN Registered Nurse Operations Manager - Outpatient unit Registered Nurse Torrance Memorial Med. Ctr. Saddleback Memorial Med. Ctr Huntington Beach Hosp. Med. Ctr. Torrance, CA Laguna Hills, CA Huntington Beach, CA

Vesta L. Guerrero, RN Anne M. Peterson, RN Margaret (Margo) Beck, RN Registered Nurse Charge Nurse Medical/Surgical Registered Nurse Kaiser Permanente Med. Ct FHP Hospital FHP Hospital Anaheim, CA Westminster, CA Fountain Valley, CA

Diane K. Brown, RN, MSN, CCRN Marilyn Daigle, RN, BA Clinical Nurse II Clinical Supervisor - PCU Hoag Memorial Hospital Little Company of Mary Hospital Newport Beach, CA Torrance, CA

DACUM Facilitator Scot N. Krause DACUM Connections Plain City, OH 43064

Golden West College Evelyn "Sam" Weiss, RN, MA Project Coordinator Regional Health Occupations Resource Center Los Angeles/Orange County Region

Golden West College Board of Trustees William M. Vega, Ed.D. Nancy A. Pollard Armando R. Ruiz Chancellor

Floyd Nelson Sherry L. Baum Paul G. Berger Student Trustee

Walter G. Howald

Orange County/Los Angeles/Long Beach Nursing Consortium

Saddleback College Joanne Gray, RN, MSN Project Coordinator Regional Health Occupations Resource Center San Diego/Desert Region

Saddleback Community College District Board of Trustees Dr. Ned Doffoney John S. Williams Tim Gertz President Student Trustee

Robert A. Lombardi Marcia Milchiker Chancellor Lee W. Rhodes Harriett S. Walther Steven J. Frogue

Joanne Hueter Teddi Lorch DACUM Competency Profile for Registered Nurse (Medical/Surgical Staff Nurse) In order to ensure an optimal level of patient wellness, the Medical/Surgical Staff Nurse coordinates and delivers patient care by assessment, planning, implementation and evaluation. Duties Tasks Assess & Address Physical A-1 Assess cardiovascular A-2 Assess respiratory status A-3 Assess neurological status A-4 Assess/Address gastro and Psychosocial needs status intestinal status A

A-5 Assess genito-urinary A-6 Assess musculo skeletal A-7 Assess endocrine status A-8 Assess integumentary status status status

A-9 Assess nutritional status A-10 Assess social/home A-11 Assess learning needs of A-12 Assess coping environment patient/significant other mechanism of patient/significant other

A-13 Collect patient medical A-14 Assess discharge needs A-15 Assess cultural diversity A-16 Assess social habits history (as it affects patient needs)

A-17 Assess advance directive A-18 Assess spiritual needs A-19 Assess and/or report A-20 Assess learning status elder/spousal abuse readiness of patient/significant other

Coordinate Patient Care B-1 Receive shift report B-2 Conduct patient rounds B-3 Formulate nursing B-4 Determine appropriate diagnosis level of care B

B-5 Collect & refer utilization B-6 Transcribe physician B-7 Update physician with B-8 Receive phone/verbal data orders change of status physician orders

B-9 Schedule B-10 Collaborate with inter- B-11 Give shift report therapeutic/diagnostic tests & disciplinary team procedures Administer Bedside Patient C-1 C-2 C-3 C-4 Care Insert/Maintain/Discontinue Insert/Maintain/Discontinue Insert/Maintain/Discontinue Insert/Maintain/Discontinue C Urinary Catheters NG Tubes PICc Lines Intravenous Lines

C-5 Prepare patient for C-6 Perform wound care C-7 Administer medications C-8 Perform central line & surgery/procedure peripheral line blood draws

C-9 Maintain airway & trach C-10 Monitor/Maintain tubes C-11 Administer tube feedings C-12 Apply/Monitor care & drains continuous passive movement

C-13 Apply/Monitor pain C-14 Initiate/Participate in C-15 Assist doctors with C-16 Transfuse blood and control analgesia code blue procedures blood products

C-17 Perform/Assist with C-18 Perform gastric lavage C-19 Administer & titrate C-20 Monitor pulse oximeter peritoneal dialysis oxygen

C-21 Initiate and maintain C-22 Perform ostomy care isolation

Supervise/ Provide Bedside D-1 Respond to patient call D-2 Give/Assist personal D-3 Weight the patient D-4 Shave Patient Care lights hygiene D

D-5 Give enemas D-6 Assist with elimination D-7 Perform dressing change D-8 Perform range of motion

D-9 Change linens D-10 Collect specimens D-11 Apply traction D-12 Perform blood glucose monitoring

D-13 Reposition patient D-14 Ambulate patient D-15 Feed patient D-16 Apply anti-embolytic hose

D-17 Oversee use of Incentive D-18 Apply Monitor cooling D-19 Initiate & maintain D-20 Provide postmortem care Spirometer blanket/Cooling seizure precautions measures/Heating pad

Teach Patient and E-1 Provide learning materials E-2 Teach & evaluate physical E-3 Explain disease process E-4 Explain critical pathway Significant Others and audiovisual aids for (hands-on) procedures and outcomes E patient & significant other

E-5 Teach physical coping E-6 Teach psychological E-7 Identify behavior E-8 Teach purpose, side skills (i.e. Pursed lip breathing, coping skill (i.e. Stress modification needs (i.e. effects, interaction of pain control) reduction) Smoking cessation, weight medications reduction, diet modification)

E-9 Provide pre-op/post-op E-10 Evaluate & document E-11 Summarize & reinforce teaching (including level of comprehension discharge teaching plan procedures) Document Patient Care F-1 Conduct & document F-2 Conduct & document F-3 Conduct & document F-4 Initiate and/or update plan admission assessment initial shift assessment ongoing assessment of care F

F-5 Document intake & output F-6 Record vital signs F-7 Document medication F-8 Document nursing administration interventions

F-9 Document patient F-10 Document patient's F-11 Document patient F-12 Document restraints as response to nursing response to procedures transfer & discharge per protocol interventions

F-13 Initiate/Document F-14 Verify & sign LVN and conscious sedation protocol unlicensed personnel's documentation

Manage Human/ Material G-1 Assess/Update acuity G-2 Coordinate staffing G-3 Delegate task to assistive G-4 Supervise performance of Resources levels assignments personnel assistive personnel G

G-5 Develop long term or G-6 Monitor unit supply usage G-7 Report defective G-8 Evaluate new medical monthly work schedules equipment/products products

Maintain Work H-1 Check crash cart H-2 Verify narcotic count H-3 Assemble patient charts H-4 Order/stock unit supplies Environment (e.g. Secretarial, patient care & H medications)

H-5 Update census reports H-6 Conduct unit safety H-7 Verify operational status H-8 Participate in fire drill checks of equipment

H-9 Participate in H-10 Initiate security code for H-11 Create/Modify forms internal/external disaster drills potential dangerous patients/visitors

Maintain Professional I-1 Maintain nursing I-2 Demonstrate unit specific I-3 Participate in continuous I-4 Participate/Initiate patient Accountability licensure/certifications competencies/skills quality improvement care conferences I

I-5 Participate in hospital I-6 Participate in inservice I-7 Preceptor staff/students I-8 Maintain disaster committees (i.e. Research, education preparedness ethics, etc.)

I-9 Participate/Facilitate staff I-10 Collaborate with other I-11 Pursue advanced I-12 Develop/Revise nursing meetings providers educational opportunities policies & procedures

I-13 Participate in I-14 Participate in self I-15 Participate in nursing peer/assistive personnel evaluation research projects review Future Concerns & Issues  (problem solving)  Feeding tubes  Advances in technology  Nutrition  Flashlight  Change in hospital orientation to  Organizational  Foley/french catheters business orientation  OSHA regulations  Foot cradle  Collegeability  Pathophysiology  General office suppleis  Computer impact  Pharmacology  Geriatric chair  Dealing with new levels of personnel  Phlebotomy supplies  Gloves  Dealing with public response to new  Principles of adult learning  Goggles levels of personnel  Prioritization  Gowns  Decreased job satisfaction  Problem solving  Graduated measure  Delivery of service  Psychology  Gurney  Entry into practice  Research process  Hand held nebulizer  Environmental controls  Safety  Heating pad  Fiscal Constraints on Health Care  Sociology  Hemostats  Focus on wellness  Statistics  Hoyer lift for transfer  Increased accountability for maintaining  Stress management  Hygiene supplies standards of care  Supervision  Icebag  Increased liability  Teaching  Incentive spirometer  Increased nurse patient ratios  Time management  Infusion control devise  Increased nursing voice in adminsitration  Title 22  Irrigation tray  IV pole  Increasing responsibilities Tools, Equipment, Supplies and  IV tubing/solutions  Job security Materials  Kardex   Limited resources Addressograph  Labels  Outcome orientation  Admission kit  Lancets  Role change  Allergy band  Lubricating ointment  Role of  Ammonia bomb/ampule  Manual resuscitation bag  Shift toward ambulatory care/home care  Angio-cath  Masks  Antiseptic swab  Mattresses/beds (special)   Uncertainty over future of health care Apnea monitor  Meciation cup  Armbands  Name tag General Knowledge & Skills  Aseptic solution  Nebulizers  Analytic  Bed/bath linen  Normal saline  Anatomy/Physiology  Bedpan  O2 concentrator/tank  Aseptic technique  Bedscale  O2 flwo meter  Assessment  Bedside commode  O2 masks/canula  Body mechanics  Blood gluocse monitor  Occlusion clamps  Cardio-Pulmonary Resuscitation  Blood warmer  Ostomy equipment  Change theory  Bulb syringe  Otoscope  Chemistry  Calculator  Phlebotomy supplies  Communication  Call bell  Pill crusher/cutter  computer  Cardiac chair  Pillows  Critical thinking  Cardiac monitor  Pipette  Delegation  Catheter tray  Pneumatic boots  Emergency protocols  Chart form  Polaroid camera  English  Collection container  Policy manuals  Hazrdous materials  Computer  Portable sitz bath  Human behavior  Cont. passive motion equip.  Portable whirlpool  Institutional policies & procedures  Cooling blanket  Procedure manual  Interpersonal  Crash cart (code blue)  Protective shield (one-way valve)  Isolation techniques  Crutches  Protective wear  JCAHO regulations  Diluent solutions  Pulse oximeter  Keyboarding  Distileld water  Razors  Kinetics  Doppler  Ref/res. manual/books  Leadership  Drainage bags  Restraints  Listening  Drainage tubes  Safety pins  Management  Dressing supplies  Scale for weighing patient  Math  Duplicating machine  Scissors  Microbiology  Emesis basin  Sharps containers  NANDA  Enema solution  Shower chair  Nurse practice act  FAX machine  Siderail protectors Tools, Equipment, Supplies and  Physically fit Materials  Problem solver  Skin protector  Professional  Slings  Resourceful  Specimen container  Responsible  Sphygmomanometer  Team player  Splints  Thorough  Staple removers  Tolerant  Sterile H2O  Stethoscope  Strainers (urine)  Suction equipment  Support cushion  Suture remover kit  Syringes/needles  Tape  Tape meausre  Telemetry monitor/electrodes  Telephone  Telephone directories  Thermometers  Tourniquets  Trach care kit  Traction weight  Transfer board  Trapeze (overhead)  Treatment/medication cart  Tube connector  Tubex  Tweezers  Uniform  Urinal  Urometer  Walker  Watch  Water seal drainage  Wheel chair Worker Characteristics  Accountable  Adaptable  Analytical  Committed  Communicative  Compassionate  Competent  Creative  Decisive  Dedicated  Detail-oriented  Empathetic  Ethical  Flexible  Good listener  Handle stress  Humorous  Independent  Open minded  Organized  Patient  Personal hygiene