Critical Care

Information

Proficiency Scale

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Assessment Section

General Skills

✔ 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

✔ 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

✔ 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

✔ 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

✔ 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

✔ 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

✔ 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

✔ 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

✔ 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)

✔ Mentoring *
★ ★ ★ ★ ★
✔ Communication *
★ ★ ★ ★ ★
✔ Video assessment *
★ ★ ★ ★ ★
✔ Utilize tele-ICU system *
★ ★ ★ ★ ★
✔ Multi-tasking *
★ ★ ★ ★ ★
✔ Troubleshoot equipment *
★ ★ ★ ★ ★
✔ Giving directions over AV system *
★ ★ ★ ★ ★
✔ Interpretation of data *
★ ★ ★ ★ ★
✔ Critical thinking *
★ ★ ★ ★ ★
✔ Diplomacy *
★ ★ ★ ★ ★

Other

✔ 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

✔ 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) *
★ ★ ★ ★ ★