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 Nursing 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 health care 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 Nursing process (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 advanced practice nurse 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