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Acute Care Services ICU Competency

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© The Johns Hopkins Hospital and Health System 2014 JOHNS HOPKINS MEDICINE Department of Physical Medicine and Rehabilitation Physical Therapy / Occupational Therapy / Speech Language Pathology Osler 1-159/Meyer 2-109 600 North Wolfe Street Baltimore, MD 21287-8319 410-955-6758/410-955-7885 Staff Member: ________________________________________________________________ Acute Care Services ICU Competency Competency Expectation Skill Demonstrated / Verbalized
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  © The Johns Hopkins Hospital and Health System 2014 JOHNS HOPKINS MEDICINE Department of Physical Medicine and Rehabilitation Physical Therapy / Occupational Therapy / Speech Language Pathology Osler 1-159/Meyer 2-109 600 North Wolfe Street Baltimore, MD 21287-8319 410-955-6758/410-955-7885 Staff Member: ________________________________________________________________ Acute Care Services ICU Competency Competency Expectation Skill Demonstrated/ Verbalized (Date) Comments Medical Equipment 1. Be able to identify and verbalize the indications and  precautions for each of the following lines and their  placement location -arterial lines -central lines -HD lines -PA catheter (Swan Ganz) 2. For patients requiring mechanical ventilation, be able to identify the type of airway and verbalize the indications and precautions of each. 3. Be able to identify (in general terms) the following vent settings-Modes (i.e. A/C, SIMV, PS, CPAP) -PEEP -FiO2 -Tidal Volume -Rate 4. Identify common vent  © The Johns Hopkins Hospital and Health System 2014 alarms and indicate the appropriate course of action for each 5. For patients requiring mechanical ventilation, demonstrate common sites of tubing disconnect and be able to demonstrate ability to reconnect tubing as indicated 6. Demonstrates the ability to safely mobilize a patient out of bed with multiple lines and/or mechanical ventilation by positioning the patient and equipment appropriately so as to not cause tension on any lines (N/A for SLP) 7. Be able to identify the following oxygen delivery systems and discuss their indications and precautions for mobility… -Facemask/ trach collar -Non-rebreather mask -BiPAP/CPAP -High flow nasal cannula 8. Identify and discuss the indications and precautions for patients receiving continuous dialysis (CVVHD) Hemodynamic Monitoring 1. Be able to discuss indications for cessation or modification of treatment  based on hemodynamic and other parameters including,  but not limited to… -O2 saturation -ECG rhythm and rate -BP/ MAP  © The Johns Hopkins Hospital and Health System 2014 -Pulmonary status (resp rate/mechanics of breathing) -ABG values 2. Be able to discuss situations in which modification or termination of treatment is necessary in response to changes in hemodynamic status or  patient’s tolerance during therapy Clinical Decision-Making 1. Discuss considerations for planning a treatment session for a patient who is mechanically ventilated. 2. Discuss considerations for a planning a treatment session for patient requiring continuos infusions of the following medications: - vasopressors - anti-arrhythmics - anti-hypertensive agents -insulin 3. Discuss considerations for a planning a treatment session for a patient who is on continuous dialysis 4. Discuss considerations for patients with the following femoral lines: -arterial -venous -HD ICU Quiz Complete the written ICU quiz with ≥ 90% Staff Member Signature: _________________________________________________________ TC/CS/TL Signature: ____________________________________________________________
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