ICU

SKILLS COMPETENCY RATING EMPLOYEE INFORMATION

Total Competency Rating
Name: Kyle Kahsin
Date Completed: 01/03/2022
Skills Checklist
ICU
Name:
Company: StaffDNA
Assessment ID: --

Overall Proficiency Rating Overall Frequency Rating

SKILLS CHECKLIST DETAILS

A. Cardiovascular Avg. Rating: Proficiency: 3.8 Frequency: 3.8
Proficiency Frequency
1. Assessment
a. Abnormal Heart Sounds/Murmurs 1 2 3 4 NA 1 2 3 4 NA

b. Auscultation (rate, rhythm) 1 2 3 4 NA 1 2 3 4 NA

c. Blood Pressure/Non-Invasive 1 2 3 4 NA 1 2 3 4 NA

d. Doppler 1 2 3 4 NA 1 2 3 4 NA

e. Pulses/Circulation Checks 1 2 3 4 NA 1 2 3 4 NA
2. Interpretation of lab results
a. Cardiac Enzymes and Isoenzymes 1 2 3 4 NA 1 2 3 4 NA

b. Coagulation Studies 1 2 3 4 NA 1 2 3 4 NA
3. Equipment & procedures
a. Assist with
(1) Arterial Line Insertion 1 2 3 4 NA 1 2 3 4 NA

(2) Central Line Insertion 1 2 3 4 NA 1 2 3 4 NA

(3) Open Chest Emergency 1 2 3 4 NA 1 2 3 4 NA

(4) PA Catheter/Swan-Ganz Insertion 1 2 3 4 NA 1 2 3 4 NA

(5) Pericardiocentesis 1 2 3 4 NA 1 2 3 4 NA
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(6) Transesophageal Echocardiogram 1 2 3 4 NA 1 2 3 4 NA

b. Hemodynamic monitoring
(1) Cardiac index 1 2 3 4 NA 1 2 3 4 NA

(2) Cardiac Output 1 2 3 4 NA 1 2 3 4 NA

(3) CVP Monitoring 1 2 3 4 NA 1 2 3 4 NA

(4) Femoral Artery Sheath Removal 1 2 3 4 NA 1 2 3 4 NA

(5) MAP 1 2 3 4 NA 1 2 3 4 NA

(6) PA/Swan-Ganz 1 2 3 4 NA 1 2 3 4 NA

(7) PCW Pressure 1 2 3 4 NA 1 2 3 4 NA

(8) PVR 1 2 3 4 NA 1 2 3 4 NA

(9) Radial a-line 1 2 3 4 NA 1 2 3 4 NA

(10) SVO2 1 2 3 4 NA 1 2 3 4 NA

(11) SVR 1 2 3 4 NA 1 2 3 4 NA
c. Monitoring
(1) 12 Lead EKG Interpretation 1 2 3 4 NA 1 2 3 4 NA

(2) Arrhythmia Interpretation 1 2 3 4 NA 1 2 3 4 NA

(3) Lead Placement 1 2 3 4 NA 1 2 3 4 NA

(4) Rhythm Strip Assessment 1 2 3 4 NA 1 2 3 4 NA

(5) Set Up and Run 12 Lead EKG 1 2 3 4 NA 1 2 3 4 NA

d. Pacemaker
(1) External 1 2 3 4 NA 1 2 3 4 NA

(2) Permanent 1 2 3 4 NA 1 2 3 4 NA

(3) Temporary 1 2 3 4 NA 1 2 3 4 NA

(4) Transthoracic (Epicardial) 1 2 3 4 NA 1 2 3 4 NA

e. Automatic Internal Cardioverter Defibrillator 1 2 3 4 NA 1 2 3 4 NA

f. Cardioversion 1 2 3 4 NA 1 2 3 4 NA

g. CAVH-D 1 2 3 4 NA 1 2 3 4 NA

h. Intra Aortic Balloon Pump 1 2 3 4 NA 1 2 3 4 NA

i. Ventricular Assist Device (RVAD or LVAD) 1 2 3 4 NA 1 2 3 4 NA

4. Care of the patient with
a. Abdominal Aortic Aneurysm Repair 1 2 3 4 NA 1 2 3 4 NA

b. Acute MI 1 2 3 4 NA 1 2 3 4 NA

c. Cardiac Arrest 1 2 3 4 NA 1 2 3 4 NA

d. Cardiac Tamponade 1 2 3 4 NA 1 2 3 4 NA

e. Congestive Heart Failure (CHF) 1 2 3 4 NA 1 2 3 4 NA

f. EP Study & Ablation 1 2 3 4 NA 1 2 3 4 NA

g. Heart Transplant 1 2 3 4 NA 1 2 3 4 NA

h. Immediate Post Open-Heart Surgery 1 2 3 4 NA 1 2 3 4 NA

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i. Infective Endocarditis 1 2 3 4 NA 1 2 3 4 NA

j. Myocardial Contusion 1 2 3 4 NA 1 2 3 4 NA

k. Pericarditis 1 2 3 4 NA 1 2 3 4 NA

l. Post AICD Insertion 1 2 3 4 NA 1 2 3 4 NA

m. Post Atherectomy (DCA) 1 2 3 4 NA 1 2 3 4 NA

n. Post Commissurotomy, Valve Repair, Valve Replacement 1 2 3 4 NA 1 2 3 4 NA

o. Post Intracoronary Stent Placement 1 2 3 4 NA 1 2 3 4 NA

p. Post Percutaneous Balloon Valvuloplasty 1 2 3 4 NA 1 2 3 4 NA

q. Post Rotoblade 1 2 3 4 NA 1 2 3 4 NA

r. Pre/Post Angioplasty 1 2 3 4 NA 1 2 3 4 NA

s. Pre/Post Cardiac Cath 1 2 3 4 NA 1 2 3 4 NA

5. Medications
a. Amiodarone (Cordarone) 1 2 3 4 NA 1 2 3 4 NA

b. Atropine 1 2 3 4 NA 1 2 3 4 NA

c. Bicarbonate 1 2 3 4 NA 1 2 3 4 NA

d. Bretylium (Bretylol) 1 2 3 4 NA 1 2 3 4 NA

e. Digoxin (Lanoxin) 1 2 3 4 NA 1 2 3 4 NA

f. Diltiazem (Cardizem) 1 2 3 4 NA 1 2 3 4 NA

g. Dobutamine (Dobutrex) 1 2 3 4 NA 1 2 3 4 NA

h. Dopamine (Intropin) 1 2 3 4 NA 1 2 3 4 NA

i. Epinephrine (Adrenalin) 1 2 3 4 NA 1 2 3 4 NA

j. Esmolol (Brevibloc) 1 2 3 4 NA 1 2 3 4 NA

k. Inocor (Amrinone) 1 2 3 4 NA 1 2 3 4 NA

l. Lidocaine (Xylocaine) 1 2 3 4 NA 1 2 3 4 NA

m. Metoprolol (Lopressor) 1 2 3 4 NA 1 2 3 4 NA

n. Nipride (Nitroprusside) 1 2 3 4 NA 1 2 3 4 NA

o. Nitroglycerine (Tridil) 1 2 3 4 NA 1 2 3 4 NA

p. Procainamide (Pronestyl) 1 2 3 4 NA 1 2 3 4 NA

q. Reteplase Recombinant (Retavase) 1 2 3 4 NA 1 2 3 4 NA

r. Streptokinase 1 2 3 4 NA 1 2 3 4 NA

s. TPA (Alteplase) 1 2 3 4 NA 1 2 3 4 NA

t. Verapamil (Calan, Isoptin, Verelan) 1 2 3 4 NA 1 2 3 4 NA

B. Pulmonary Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Assessment
a. Adventitious Breath Sounds 1 2 3 4 NA 1 2 3 4 NA

b. Rate and Work of Breathing 1 2 3 4 NA 1 2 3 4 NA

2. Equipment & procedures
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a. Air leak troubleshooting

(1) Mediastinal Chest Tube Removal 1 2 3 4 NA 1 2 3 4 NA

(2) Pleural Chest Tube Removal 1 2 3 4 NA 1 2 3 4 NA

b. Airway management devices
/suctioning
(1) Endotracheal Tube/Suctioning 1 2 3 4 NA 1 2 3 4 NA

(2) Extubation 1 2 3 4 NA 1 2 3 4 NA

(3) Nasal Airway/Suctioning 1 2 3 4 NA 1 2 3 4 NA

(4) Oximetry 1 2 3 4 NA 1 2 3 4 NA

(5) Sputum Specimen Collection 1 2 3 4 NA 1 2 3 4 NA

(6) Tracheostomy/Suctioning 1 2 3 4 NA 1 2 3 4 NA
c. Assist with
(1) Bronchoscopy 1 2 3 4 NA 1 2 3 4 NA

(2) Chest Tube Insertion 1 2 3 4 NA 1 2 3 4 NA

(3) Emergency Tracheostomy 1 2 3 4 NA 1 2 3 4 NA

(4) Thoracentesis 1 2 3 4 NA 1 2 3 4 NA
d. Establishing an airway
(1) Assist with Intubation 1 2 3 4 NA 1 2 3 4 NA

(2) Oral Airway Insertion 1 2 3 4 NA 1 2 3 4 NA

e. Identification/intervention for
respiratory complications
(1) Aspiration 1 2 3 4 NA 1 2 3 4 NA

(2) Laryngospasm 1 2 3 4 NA 1 2 3 4 NA

(3) Tension Pneumothorax 1 2 3 4 NA 1 2 3 4 NA

(4) Use of Pleur-evac or Thoraflex Drainage 1 2 3 4 NA 1 2 3 4 NA

(5) Use of Water Seal Drainage 1 2 3 4 NA 1 2 3 4 NA

f. O2 therapy & medication delivery
systems
(1) Ambu Bag and Mask 1 2 3 4 NA 1 2 3 4 NA

(2) ET Tube 1 2 3 4 NA 1 2 3 4 NA

(3) Face Masks 1 2 3 4 NA 1 2 3 4 NA

(4) Nasal Cannula 1 2 3 4 NA 1 2 3 4 NA

(5) Portable O2 Tank 1 2 3 4 NA 1 2 3 4 NA

(6) Trach Collar 1 2 3 4 NA 1 2 3 4 NA

g. Ventilator management
(1) External CPAP 1 2 3 4 NA 1 2 3 4 NA

(2) High Frequency Jet Ventilation 1 2 3 4 NA 1 2 3 4 NA

(3) IMV 1 2 3 4 NA 1 2 3 4 NA

(4) PEEP 1 2 3 4 NA 1 2 3 4 NA
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(5) Pressure Support 1 2 3 4 NA 1 2 3 4 NA

(6) Weaning Modes and T-Piece Weaning 1 2 3 4 NA 1 2 3 4 NA

3. Care of the patient with:
a. Acute Pneumonia 1 2 3 4 NA 1 2 3 4 NA

b. ARDS 1 2 3 4 NA 1 2 3 4 NA

c. Chest Trauma 1 2 3 4 NA 1 2 3 4 NA

d. COPD 1 2 3 4 NA 1 2 3 4 NA

e. Cor Pulmonale 1 2 3 4 NA 1 2 3 4 NA

f. Fresh Tracheostomy 1 2 3 4 NA 1 2 3 4 NA

g. Lobectomy 1 2 3 4 NA 1 2 3 4 NA

h. Lung Transplant 1 2 3 4 NA 1 2 3 4 NA

i. Near Drowning 1 2 3 4 NA 1 2 3 4 NA

j. Pneumonectomy 1 2 3 4 NA 1 2 3 4 NA

k. Pulmonary Edema/Hypertension 1 2 3 4 NA 1 2 3 4 NA

l. Pulmonary Embolism 1 2 3 4 NA 1 2 3 4 NA

m. Status Asthmaticus 1 2 3 4 NA 1 2 3 4 NA

n. Thoracotomy 1 2 3 4 NA 1 2 3 4 NA

o. Tuberculosis 1 2 3 4 NA 1 2 3 4 NA
4. Medications
a. Alupent (Metaproterenol) 1 2 3 4 NA 1 2 3 4 NA

b. Aminophylline (Theophylline) 1 2 3 4 NA 1 2 3 4 NA

c. Bronkosol (Isoetharine Hydrochloride) 1 2 3 4 NA 1 2 3 4 NA

d. Corticosteroids 1 2 3 4 NA 1 2 3 4 NA

e. Ventolin (Albuterol) 1 2 3 4 NA 1 2 3 4 NA

5. Interpretation of Lab Results-Arterial Blood Gases 1 2 3 4 NA 1 2 3 4 NA

C. Neurological Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Assessment
a. Cranial Nerves 1 2 3 4 NA 1 2 3 4 NA

b. Glasgow Coma Scale 1 2 3 4 NA 1 2 3 4 NA

c. Level of Consciousness 1 2 3 4 NA 1 2 3 4 NA

d. Pathologic Reflexes 1 2 3 4 NA 1 2 3 4 NA

e. Reflex/Motor Deficits 1 2 3 4 NA 1 2 3 4 NA

f. Visual or Communication Deficits 1 2 3 4 NA 1 2 3 4 NA

2. Equipment & procedures
a. Assist with Lumbar Puncture 1 2 3 4 NA 1 2 3 4 NA

b. Halo Traction/Cervical Tongs 1 2 3 4 NA 1 2 3 4 NA

c. Intracranial Pressure Monitoring 1 2 3 4 NA 1 2 3 4 NA

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d. Nerve Stimulators 1 2 3 4 NA 1 2 3 4 NA

e. Rotating Bed 1 2 3 4 NA 1 2 3 4 NA

f. Seizure Precautions 1 2 3 4 NA 1 2 3 4 NA

g. Spinal Precautions 1 2 3 4 NA 1 2 3 4 NA

h. Stryker Frame 1 2 3 4 NA 1 2 3 4 NA

i. Use of Hyper/Hypothermia Blanket 1 2 3 4 NA 1 2 3 4 NA

3. Care of the patient with
a. Aneurysm Precautions 1 2 3 4 NA 1 2 3 4 NA

b. Basal Skull Fracture 1 2 3 4 NA 1 2 3 4 NA

c. Closed Head Injury 1 2 3 4 NA 1 2 3 4 NA

d. Coma 1 2 3 4 NA 1 2 3 4 NA

e. CVA 1 2 3 4 NA 1 2 3 4 NA

f. DTs 1 2 3 4 NA 1 2 3 4 NA

g. Encephalitis 1 2 3 4 NA 1 2 3 4 NA

h. Externalized VP Shunts 1 2 3 4 NA 1 2 3 4 NA

i. Increased ICP 1 2 3 4 NA 1 2 3 4 NA

j. Laminectomy 1 2 3 4 NA 1 2 3 4 NA

k. Meningitis 1 2 3 4 NA 1 2 3 4 NA

l. Metastatic Tumor/Intracranial Tumor Resection 1 2 3 4 NA 1 2 3 4 NA

m. Multiple Sclerosis 1 2 3 4 NA 1 2 3 4 NA

n. Post Craniotomy 1 2 3 4 NA 1 2 3 4 NA

o. Spinal Cord Injury 1 2 3 4 NA 1 2 3 4 NA

p. Ventriculostomy 1 2 3 4 NA 1 2 3 4 NA
4. Medications
a. Barbiturate Induced Coma 1 2 3 4 NA 1 2 3 4 NA

b. Decadron (Dexamethasone) 1 2 3 4 NA 1 2 3 4 NA

c. Dilantin (Phenytoin) 1 2 3 4 NA 1 2 3 4 NA

d. Epidural Administration 1 2 3 4 NA 1 2 3 4 NA

e. Phenobarbital 1 2 3 4 NA 1 2 3 4 NA

f. Valium (Diazepam) 1 2 3 4 NA 1 2 3 4 NA
D. Gastrointestinal Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Assessment
a. Abdominal/bowel sounds 1 2 3 4 NA 1 2 3 4 NA

b. Nutritional 1 2 3 4 NA 1 2 3 4 NA
2. Interpretation of lab results
a. Serum ammonia 1 2 3 4 NA 1 2 3 4 NA

b. Serum amylase 1 2 3 4 NA 1 2 3 4 NA
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c. LFTs 1 2 3 4 NA 1 2 3 4 NA
3. Equipment & procedures
a. Management of
(1) Gastrostomy tube 1 2 3 4 NA 1 2 3 4 NA

(2) Jejunostomy tube 1 2 3 4 NA 1 2 3 4 NA

(3) T-tube 1 2 3 4 NA 1 2 3 4 NA

(4) TPN and lipids administration 1 2 3 4 NA 1 2 3 4 NA

(5) PPN (peripheral parenteral nutrition) 1 2 3 4 NA 1 2 3 4 NA

b. Administration of tube feeding 1 2 3 4 NA 1 2 3 4 NA

c. Balloon tamponade (Sengstaken Blakemore) 1 2 3 4 NA 1 2 3 4 NA

d. Feeding pump 1 2 3 4 NA 1 2 3 4 NA

e. Flexible feeding tube 1 2 3 4 NA 1 2 3 4 NA

f. Gravity feeding 1 2 3 4 NA 1 2 3 4 NA

g. Iced saline lavage 1 2 3 4 NA 1 2 3 4 NA

h. Placement of nasogastric tube 1 2 3 4 NA 1 2 3 4 NA

i. Salem sump to suction 1 2 3 4 NA 1 2 3 4 NA

4. Care of the patient with
a. Blunt trauma 1 2 3 4 NA 1 2 3 4 NA

b. Bowel obstruction 1 2 3 4 NA 1 2 3 4 NA

c. Colostomy 1 2 3 4 NA 1 2 3 4 NA

d. ERCP 1 2 3 4 NA 1 2 3 4 NA

e. Esophageal bleeding 1 2 3 4 NA 1 2 3 4 NA

f. GI bleeding 1 2 3 4 NA 1 2 3 4 NA

g. GI surgery 1 2 3 4 NA 1 2 3 4 NA

h. Hepatitis 1 2 3 4 NA 1 2 3 4 NA

i. Ileostomy 1 2 3 4 NA 1 2 3 4 NA

j. Inflammatory bowel disease 1 2 3 4 NA 1 2 3 4 NA

k. Liver failure 1 2 3 4 NA 1 2 3 4 NA

l. Liver transplant 1 2 3 4 NA 1 2 3 4 NA

m. Pancreatitis 1 2 3 4 NA 1 2 3 4 NA

n. Paralytic ileus 1 2 3 4 NA 1 2 3 4 NA

o. Penetrating trauma 1 2 3 4 NA 1 2 3 4 NA
5. Medications
a. AquaMephyton (Vitamin K) 1 2 3 4 NA 1 2 3 4 NA

b. Inderal (Propranolol) 1 2 3 4 NA 1 2 3 4 NA

c. Kayexelate 1 2 3 4 NA 1 2 3 4 NA

d. Lactulose (Cephulac) 1 2 3 4 NA 1 2 3 4 NA

e. Pitressin (Vasopressin) 1 2 3 4 NA 1 2 3 4 NA
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E. Renal/Genitourinary Avg. Rating: Proficiency: 4 Frequency: 4

Proficiency Frequency
1. Assessment
a. A-V fistula/shunt 1 2 3 4 NA 1 2 3 4 NA

b. Fluid status 1 2 3 4 NA 1 2 3 4 NA
2. Interpretation of lab results
a. BUN and Creatinine 1 2 3 4 NA 1 2 3 4 NA

b. Serum electrolytes 1 2 3 4 NA 1 2 3 4 NA
3. Equipment & procedures
a. Insertion & care of straight and Foley
catheter
(1) 3-way Foley 1 2 3 4 NA 1 2 3 4 NA

(2) Female 1 2 3 4 NA 1 2 3 4 NA

(3) Male 1 2 3 4 NA 1 2 3 4 NA

b. Bladder irrigation 1 2 3 4 NA 1 2 3 4 NA

c. Supra-pubic 1 2 3 4 NA 1 2 3 4 NA
4. Care of the patient with
a. Acute renal failure 1 2 3 4 NA 1 2 3 4 NA

b. CAVH dialysis 1 2 3 4 NA 1 2 3 4 NA

c. Hemodialysis 1 2 3 4 NA 1 2 3 4 NA

d. Nephrectomy 1 2 3 4 NA 1 2 3 4 NA

e. Peritoneal dialysis 1 2 3 4 NA 1 2 3 4 NA

f. Renal rejection syndrome 1 2 3 4 NA 1 2 3 4 NA

g. Renal transplant 1 2 3 4 NA 1 2 3 4 NA

h. TURP 1 2 3 4 NA 1 2 3 4 NA

i. Urinary diversion (ileal conduit nephrostomy) 1 2 3 4 NA 1 2 3 4 NA

j. Urinary tract infection 1 2 3 4 NA 1 2 3 4 NA

F. Endocrine/Metabolic Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Interpretation of lab results
a. Blood glucose 1 2 3 4 NA 1 2 3 4 NA

b. Thyroid studies 1 2 3 4 NA 1 2 3 4 NA
2. Equipment & procedures
a. Blood glucose monitoring 1 2 3 4 NA 1 2 3 4 NA

b. Performing finger stick 1 2 3 4 NA 1 2 3 4 NA

3. Care of the patient with
a. Diabetes mellitus 1 2 3 4 NA 1 2 3 4 NA

b. Diabetic ketoacidosis 1 2 3 4 NA 1 2 3 4 NA

c. Disorders of adrenal gland 1 2 3 4 NA 1 2 3 4 NA

 ICU

d. Disorders of pituitary gland 1 2 3 4 NA 1 2 3 4 NA

e. Drug overdose 1 2 3 4 NA 1 2 3 4 NA

f. Hyperthyroidism (Graves disease) 1 2 3 4 NA 1 2 3 4 NA

g. Hypothyroidism 1 2 3 4 NA 1 2 3 4 NA

h. Insulin shock 1 2 3 4 NA 1 2 3 4 NA

i. Thyroidectomy-disorders of thyroid gland 1 2 3 4 NA 1 2 3 4 NA

4. Medication-insulin pump 1 2 3 4 NA 1 2 3 4 NA
G. Wound Management Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Wound Management Assessment
a. Skin for impending breakdown 1 2 3 4 NA 1 2 3 4 NA

b. Stasis ulcers 1 2 3 4 NA 1 2 3 4 NA

c. Surgical wound healing 1 2 3 4 NA 1 2 3 4 NA

2. Wound Management Equipment &
procedures
a. Air fluidized, low air loss beds 1 2 3 4 NA 1 2 3 4 NA

b. Sterile dressing changes 1 2 3 4 NA 1 2 3 4 NA

c. Wound care/irrigations 1 2 3 4 NA 1 2 3 4 NA
3. Care of the patient with (Wound
Management)
a. Burns 1 2 3 4 NA 1 2 3 4 NA

b. Pressure sores 1 2 3 4 NA 1 2 3 4 NA

c. Staged decubitus ulcers 1 2 3 4 NA 1 2 3 4 NA

d. Surgical wounds with drain(s) 1 2 3 4 NA 1 2 3 4 NA

e. Traumatic wounds 1 2 3 4 NA 1 2 3 4 NA
H. Phlebotomy/IV Therapy Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Equipment & procedures
a. Administration of blood/blood products
(1) Cryoprecipitate 1 2 3 4 NA 1 2 3 4 NA

(2) Packed red blood cells 1 2 3 4 NA 1 2 3 4 NA

(3) Plasma/albumin 1 2 3 4 NA 1 2 3 4 NA

(4) Whole blood 1 2 3 4 NA 1 2 3 4 NA

b. Starting IVs
(1) Angiocath 1 2 3 4 NA 1 2 3 4 NA

(2) Butterfly 1 2 3 4 NA 1 2 3 4 NA

(3) Heparin lock 1 2 3 4 NA 1 2 3 4 NA

c. Drawing blood from central line 1 2 3 4 NA 1 2 3 4 NA

d. Drawing venous blood 1 2 3 4 NA 1 2 3 4 NA

 ICU

2. Care of the patient with

a. Central line/catheter/dressing
(1) Broviac 1 2 3 4 NA 1 2 3 4 NA

(2) Groshong 1 2 3 4 NA 1 2 3 4 NA

(3) Hickman 1 2 3 4 NA 1 2 3 4 NA

(4) Portacath 1 2 3 4 NA 1 2 3 4 NA

(5) Quinton 1 2 3 4 NA 1 2 3 4 NA

b. Peripheral line/dressing 1 2 3 4 NA 1 2 3 4 NA
I. Pain Management Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Care of the patient with
a. Epidural anesthesia/analgesia 1 2 3 4 NA 1 2 3 4 NA

b. IV conscious sedation 1 2 3 4 NA 1 2 3 4 NA

c. Patient controlled analgesia 1 2 3 4 NA 1 2 3 4 NA

2. Assessment of pain level/tolerance 1 2 3 4 NA 1 2 3 4 NA

J. Miscellaneous Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Care of the patient with
a. Anaphylactic shock 1 2 3 4 NA 1 2 3 4 NA

b. Disseminated intravascular coagulation (DIC) 1 2 3 4 NA 1 2 3 4 NA

c. Hypovolemic shock 1 2 3 4 NA 1 2 3 4 NA

d. Multi-system organ failure 1 2 3 4 NA 1 2 3 4 NA

e. Organ/tissue donation 1 2 3 4 NA 1 2 3 4 NA

f. Septic shock 1 2 3 4 NA 1 2 3 4 NA
K. AGE SPECIFIC COMPETENCY Avg. Rating: Proficiency: 4 Frequency: 4
Proficiency Frequency
1. Newborn/Neonate (Birth to 30 Days) 1 2 3 4 NA 1 2 3 4 NA

2. Infant (30 days to 1 Year) 1 2 3 4 NA 1 2 3 4 NA

3. Toddler (1 - 3 Years) 1 2 3 4 NA 1 2 3 4 NA

4. Preschool Child (3 - 5 Years) 1 2 3 4 NA 1 2 3 4 NA

5. School Age Child (5 - 12 Years) 1 2 3 4 NA 1 2 3 4 NA

6. Adolescent (12 - 18 Years) 1 2 3 4 NA 1 2 3 4 NA

7. Young Adult (18 - 39 Years) 1 2 3 4 NA 1 2 3 4 NA

8. Middle Age Adult (40 - 65 Years) 1 2 3 4 NA 1 2 3 4 NA

9. Senior Adult (65+ Years) 1 2 3 4 NA 1 2 3 4 NA

L. CHARTING SYSTEM Avg. Rating: Proficiency: 3 Frequency: 3
Proficiency Frequency
1. Allscripts 1 2 3 4 NA 1 2 3 4 NA

2. Cerner 1 2 3 4 NA 1 2 3 4 NA
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3. EPIC 1 2 3 4 NA 1 2 3 4 NA

4. McKesson 1 2 3 4 NA 1 2 3 4 NA

5. Meditech 1 2 3 4 NA 1 2 3 4 NA

6. Paper 1 2 3 4 NA 1 2 3 4 NA