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Orientation Skills List for Rehabilitation Registered NurseThe following is an expanded description of competencies incorporated in each component of the Orientation Skills List for Rehabilitation Registered Nurses:KnowledgeDescribes elements of individualized patient care planningLearning BarriersLearning PreferencesCultural CongruencyAdapts educational activities based on the needs of the patient/family with Benner’s Novice to Expert spectrumDevelops care plans that account for patient/family diversityIncorporates evidence based practice and nursing research into practice EBP (Evidence Based Practice)Nursing ResearchQuality improvement processes Participates in Rehabilitation oriented educational opportunities (Continuing Education, Mandatory In-services, HLC’s, Self- directed education)Functional Independence Measurement score (FIM’s)Describe componentsApply to patient scenariosInfection Control (procedure and documentation)Hand HygieneStandard PrecautionsPersonal protective equipmentHazardous waste disposal(sharps/red bags)Isolation precautions (contact, respiratory, TB, MRSA, c-diff)Infection Control reporting Special PrecautionsWandering PrecautionsSeizure PrecautionsSpinal PrecautionsAspiration Precautions Special Procedure PrepGI SeriesGallbladder seriesColonoscopyMRIBarium enemaPre-op cleanseSurgery (TB, MRSA, c-diff)Exposure control plan and follow-up (needle stick, blood, body fluid exposure)Accesses resources appropriatelyPolicies (lucidoc)Nursing Resource Center PlusProcedural Manual (Nursing EBP) Via LibraryUp toDateCase Management, Home Health, In Home Supportive Services, Nutritional Services, Social Services, Wound consults, Pastoral Services, Palliative Care, and Hospice Care.SkillsAccurate documentation on computerized format (EPIC) Admission/Discharge Planning/DocumentationADT, Head to toe assessment, Medications managementAge-Specific EducationMaintains Specific skills utilized in RehabilitationAirway managementTracheostomy Care/plugging (one way valve or red cap)Nasogastric/tracheostomy suctioningQuad coughO2 flow meter setupO2 administration: Nasal cannula, Ventimask, partial rebreather, non-rebreather, mist mask, trach collarUse of portable 02 tank, Oxinet: Setup, apply sensor, set alarms, interpret findingsIncentive spirometryChest tube drainage systems (Set up with/without suction, waterseal, maintenance, site care, output measurement, troubleshooting, transporting)Enteral feeding devices and accesses (Nasogastric tube, Gastrostomy tube, Jejunostomy tube) Insertion and X-ray verification, irrigation, suction as appropriate, recording I &O or residual, removal and documentationSkin Care/Wound Management (Procedure & Documentation)Wound ConsultPressure ulcer identification/staging/photo upon identification and every Monday/ IRIS completed/preventionDressings: Wet-to-dry, wet-to moist, Xerofoam, pressure dressings. VAC dressings, BKA/AKA dressing changes, ACE wraps to lower ext. , PIN-site care, Duoderm/tegaderm applicationSuture/staple removal/Steri-strip application. Wound drains: Penrose, Jackson Pratt, Hemovac, Sump drain (TrueClose), T-tube (Site Care, emptying, recording output, removal, irrigation as appropriate and documentation)Ostomy Care: Skin care, appliance application, emptying, recording output, irritation and documentationColostomy, Ileostomy, UrostomySpecimen Collection (Procedure &Documentation)Sputum, expectorated, suctionUrine: clean catch, catheterized specimen, 24 hour urineStool: Culture, ova & parasites, guaiacWound culture: Aerobic, AnaerobicBedside glucose monitoring (controls and patient testing)Intravenous and Central venous linesPeripheral lines/saline locks: Insertion, site care, tubing change appropriate, site rotation, flushing as appropriate, D/C, lines labeled appropriately, documentationIV piggybackIV pushPICC lines and other CVA lines (site care tubing change, cap change, flushing, removal and blood withdrawal)Hyper-alimentation administrationLipid administrationBlood Administration Procedure & DocumentationType and Cross match ordersPlacing order in EPIC using blood order setPrinting blood pick-up paperwork using EPICPlateletsWhole blood/packed cells (PRBC’s)Fresh frozen plasmaMedication Administration and DocumentationProper patient identification/scan patient/scan wristbandRoutes : IV Push, IV Piggyback, IM, Subcutaneous, Per oral, Nasogastric, Per rectumUrinary Care: Catheter insertion, site care, emptying, recording output, irrigation, removal and documentation Indwelling Catheter protocol and Intermittent catheterization protocolSuprapubic catheterExternal catheter (condom) Intermittent catheterization (Sterile and clean) Bladder Scan/ultrasound Signs/symptoms of autonomic dysreflexia and management.Bowel Care: Stand Procedure & DocumentationEnemas: Tap water/soap sudsHarris flushFleetsBowel Program: Suppository insertion, digitals, teachingEquipment (Use & Documentation)Pyxis OrientationBeds (all functions i.e., positioning, alarms, heel pressure relief, bed scale)Specialty beds/ mattress overlay (Bari-bed, 1st step, waffle mattress)Sequential compression deviceBladder scannerTherapeutic compression hoseK-PadPCA pumpFeeding pumpSuction machineIV pumpDopplerHeating/cooling blanketContinuous Passive Movement machine (CPM)Orthopedic Devices for Stabilization (Aspen and Cervical collars, TLSO, Arm and Knee Braces, Orthopedic boots)Abduction wedge applicationLow Stimulation Designated RoomsConsent Forms & DocumentationSurgical/invasive procedureSpecial consent form/sterilizationBlood consentAgainst Medical Advice (AMA) Emergent SituationsRapid Response Team (RRT)Code BlueCrash Cart CheckProcessesOrdering supplies (traction, Stock room, KCI etc.)Pyxis InventoryCommunicationCondition HChain of CommandChain of Command/JACHOSBAR5-P HandoffGet Well NetworkNursing Chart AuditsCondition HChain of Command/JCAHOAttitudesCollaborates and communicates effectively with the inter/intra-disciplinary team Written communication (team conference notes)Verbal communication (actively participating in team conferences)Interdisciplinary teamIntra-disciplinary teamActs as a change agent and promotes effective change Demonstrates and role models professionalismIntegrates Caring Theory into own professional practice Target 100 ................
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