Critical Care
Proficiency Scale
1 =
No Experience
2 =
Need Training
3 =
Able to perform with supervision
4 =
Able to perform independently
| General Skills | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Advanced directives | |||||
| Patient/family teaching | |||||
| Restrictive devices (restraints) | |||||
| Lift/transfer devices | |||||
| Specialty beds | |||||
| End of life care/palliative care | |||||
| Wound assessment & care | |||||
| Automated Medication Dispensing System, Pyxis, Omnicell, or other | |||||
| Bar coding for medication administration | |||||
| Blood Glucose Monitor (BGM) | |||||
| Cardioversion/defibrillation | |||||
| Electronic ICU | |||||
| National Patient Safety Goals | |||||
| Accurate patient identification | |||||
| Effective communication | |||||
| Interpretation & communication of lab values | |||||
| Medication administration | |||||
| Medication reconciliation | |||||
| Labeling (medications & specimens) | |||||
| Anticoagulation therapy | |||||
| Monitoring conscious sedation | |||||
| Pain assessment & management | |||||
| Infection control | |||||
| Universal precautions | |||||
| Isolation | |||||
| Minimize risk for falls | |||||
| Prevention of pressure ulcers | |||||
| Use of rapid response teams | |||||
| Awareness of HCAHPS |
| Cardiovascular | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Assessment of breath sounds | |||||
| Interpretation of arrhythmias | |||||
| Performing 12 lead EKGs | |||||
| Interpretation of 12 lead EKG | |||||
| Interpretation of hemodynamic monitoring | |||||
| CVC (Central Venous Catheter) | |||||
| Arterial line | |||||
| Swanz Ganz catheter | |||||
| Flow trac or Vigileo monitoring caths | |||||
| Intra-Aortic Balloon Pump (IABP) | |||||
| Ventricular Assist Device (LVAD, RVAD) | |||||
| Permanent pacemakers | |||||
| Implantable Cardioverter Defibrillator (ICD) | |||||
| External pacemakers | |||||
| Epicardial pacemaker wires | |||||
| Discontinuing venous/arterial sheaths | |||||
| Femostop/vasoseal | |||||
| Acute myocardial infarction | |||||
| Pre/post: cardiac catheterization | |||||
| Congestive heart failure | |||||
| Cardiomyopathy | |||||
| Dysrhythmias/conduction disturbances | |||||
| Aortic aneurysm | |||||
| Thoracic/abdominal surgery | |||||
| Endoluminal graft | |||||
| Cardiogenic shock | |||||
| Hypertensive crisis | |||||
| Pericarditis/endocarditis | |||||
| MAZE procedure | |||||
| Post open heart (CABG/valve) | |||||
| Cardiac contusion/trauma | |||||
| Heart transplant | |||||
| Cardiac tamponade | |||||
| ACLS medications and protocols | |||||
| Antidysrythmics | |||||
| Antihypertensives | |||||
| Vasoactive/vasopressor agents | |||||
| Anesthetics (propofol/presedex) | |||||
| Thrombolytics (retavase/activase) | |||||
| Platelet inhibitors (ReoPro/Integrilin/Aggrastat) | |||||
| Flolan for pulmonary hypertension | |||||
| Pulmonary |
| Pulmonary | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Assessment of breath sounds | |||||
| Oral/NT/ET airway | |||||
| Tracheostomy | |||||
| Arterial blood gas analysis/interpretation | |||||
| Obtaining ABG blood sample/arterial line | |||||
| Pulse oximetry | |||||
| BiPAP (Bi-level Positive Airway Pressure) | |||||
| Oscillation/high-frequency ventilation | |||||
| Nitric | |||||
| Interpretation of weaning parameters | |||||
| Maintenance & management of pleural chest tubes | |||||
| Acute respiratory failure | |||||
| Adult Respiratory Distress Syndrome (ARDS) | |||||
| Sudden Inflammation Respiratory Syndrome (SIRS) | |||||
| Inhalation injuries | |||||
| Pneumonia | |||||
| Pulmonary edema | |||||
| Near drowning | |||||
| Chronic Obstructive Pulmonary Disease (COPD) | |||||
| Pre/post thoracic surgery | |||||
| Pulmonary embolism | |||||
| Pulmonary/chest trauma | |||||
| Pulmonary hypertension | |||||
| Status asthmaticus | |||||
| Rapid sequence intubation drugs/protocols | |||||
| Nebulizer treatments: Ventolin, Atrovent |
| Neurology | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Cranial nerve assessment | |||||
| Glasgow coma scale | |||||
| NIH stroke scale | |||||
| NIH stroke certification | |||||
| Seizure precautions | |||||
| Skeletal traction | |||||
| Cervical spine precautions/logroll positioning | |||||
| Halo vest/halo traction | |||||
| Monitoring of neuromuscular blocking agents/paralytics | |||||
| Assist with lumbar puncture | |||||
| Ventriculostomy | |||||
| Subarachnoid screw/bolt | |||||
| Lumbar drains | |||||
| Cerebral aneurysm | |||||
| Subarachnoid hemorrhage | |||||
| Status epilepticus | |||||
| TBI (Traumatic Brain Injury) | |||||
| Spinal cord injury | |||||
| CerebroVascular Accident (CVA) | |||||
| Pre/post cranial surgery | |||||
| Meningitis | |||||
| Myasthenia gravis | |||||
| Clipping and/or coilings of aneurysms | |||||
| Pituitary Tumor | |||||
| Steroids: Decadron, Solu-Medrol | |||||
| Anticonvulsants: Dilantin, phenobarbital | |||||
| Paralytic Agents: Norcuron, Pavalon, Nimbex, Tracrium, vecuronium | |||||
| Mannitol | |||||
| Antipsychotics: Haldol |
| Trauma & Burns | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Mass casualty | |||||
| Electrocution | |||||
| Amputation | |||||
| Gangrene | |||||
| Multiple fractures | |||||
| Thermoregulation: hypothermia/hyperthermia | |||||
| Berdow Formula/Rule of Nines | |||||
| Lund and Browder chart | |||||
| Fluid resuscitation | |||||
| Care & management of burns |
| Gastrointestinal | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Small bore feeding tube insertion (Dobhoff or Keofeed) | |||||
| Nasogastric tube insertion | |||||
| Post pyloric feeding tube insertion | |||||
| Gastric lavage | |||||
| Use of activated charcoal | |||||
| Maintenance of gastric/jejunostomy tube | |||||
| Stoma care | |||||
| Maintenance & management of enteral tube feedings | |||||
| Assisting/monitoring bedside procedures: endo/chest tubes/bronchs/trach insertion/PEG tubes | |||||
| Abdominal trauma | |||||
| Acute gastrointestinal hemorrhage | |||||
| Esophageal varices | |||||
| Balloon tamponade devices (i.e. Blakemore tube) | |||||
| Peritonitis | |||||
| Acute pancreatitis | |||||
| Bowel obstruction | |||||
| Liver/pancreas transplant | |||||
| Antiemetics: Reglan, Zofran | |||||
| H2 receptor antagonists |
| Renal | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Foley catheter insertion | |||||
| Suprapubic tube | |||||
| Nephrostomy tube | |||||
| Peritoneal dialysis | |||||
| Continuous Arteriovenous Hemofiltration (CAVHD, CVVHD, SCUF, CRRT) | |||||
| Hemodialysis of the critically ill patient | |||||
| Acute renal failure | |||||
| Chronic renal failure | |||||
| AV fistulas, shunts & dialysis catheters | |||||
| Nephrectomy | |||||
| Renal transplant | |||||
| Renal/urinary tract trauma |
| Endocrine | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Diabetic Ketoacidosis (DKA) | |||||
| Hyperosmolar Hyperglycemic Nonketotic Coma (HHNK) | |||||
| Diabetes Insipidus (DI) | |||||
| Syndrome of Inappropriate Antidiuretic Hormone (SIADH) | |||||
| Administration & monitoring of insulin infusion | |||||
| Use of Endo tool |
| Intravenous Management | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Starting peripheral IVs | |||||
| Care of patient with Peripherally-Inserted Central Catheter (PICC) | |||||
| Administration/monitoring of Total Parenteral Nutrition (TPN) | |||||
| Administration of blood/blood products | |||||
| Administration of narcotics/sedatives: (fentanyl, Valium, Ativan, Versed, morphine) | |||||
| Bispectral monitoring |
| Tele-ICU (ICU-E) | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Mentoring | |||||
| Communication | |||||
| Video assessment | |||||
| Utilize tele-ICU system | |||||
| Multi-tasking | |||||
| Troubleshoot equipment | |||||
| Giving directions over AV system | |||||
| Interpretation of data | |||||
| Critical thinking | |||||
| Diplomacy |
| Other | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Drug or chemical overdose (TCA, ethanol, ASA) | |||||
| Poisoning (CO, cyanide) | |||||
| Substance abuse (ETOH, stimulants, narcotics) | |||||
| Human Immunodeficiency Virus (HIV) | |||||
| Multisystem Organ Dysfunction Syndrome (MODS) | |||||
| Anaphylaxis | |||||
| Disseminated Intravascular Coagulation (DIC) | |||||
| Septic shock | |||||
| Cancer | |||||
| Administration of chemotherapy | |||||
| Monitoring of chemotherapy (does not initiate) | |||||
| Hyperbaric oxygenation | |||||
| Organ/tissue donation procedures | |||||
| Suicide precautions |
| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Adolescent (ages 13-21 years) | |||||
| Young adult (ages 22-39 years) | |||||
| Adult (ages 40-64 years) | |||||
| Older adult (ages 65-79 years) | |||||
| Elderly (ages 80+ years) |