Competency tool for CABG?

mspringer · May 31, 2004

Need help on a competency tool that will help check-off nurses orienting to take care of s/p open-heart surgeries. Does anyone know of a good website?
Thanks,
ethel

Like how s/p? Immediately after they come back from the OR or day 1/2?

Marc

ethelbsnrn · May 31, 2004

Like how s/p? Immediately after they come back from the OR or day 1/2?
Marc

In CVICU. After they come back from the CV OR. Thanks so much.

mspringer · Jun 5, 2004

In CVICU. After they come back from the CV OR. Thanks so much.

Sorry, I know of no competency tool for that. Just working side by side with another nurse until you are observed to be competant, safe, and comfortable with taking those patients.

Sorry for being no help.

zambezi, BSN, RN · Jun 5, 2004

In our unit, we also just have to be observed for a specified amount of time...usually we orient for awhile, then have a buddy...We have individual competencies that we have to be checked off for, ie: inital post-op set up (labs/cxr/connection to monitors) swans, iabp, vent weaning, autotransfusion, pacing, post-op drips, etc...the orientation allows for us to learn the rather extensive post-op orders and what we can and can not initiate per the policy...

It seems that each unit/hospital would be unique in their programs and post op orders...

pickledpepperRN · Jun 27, 2004

In our unit, we also just have to be observed for a specified amount of time...usually we orient for awhile, then have a buddy...We have individual competencies that we have to be checked off for, ie: inital post-op set up (labs/cxr/connection to monitors) swans, iabp, vent weaning, autotransfusion, pacing, post-op drips, etc...the orientation allows for us to learn the rather extensive post-op orders and what we can and can not initiate per the policy...
It seems that each unit/hospital would be unique in their programs and post op orders...

And each individual surgeon!

It is important for the RN who will receive the patient from the OR to prepare the room. There should be a standard set up. This can be written and ALWAYS checked off!

Theory and familiarity with each MDs usual protocol and written standardized procedures are essential.

Perhaps the surgeons can give a class periodically.

zambezi, BSN, RN · Jun 27, 2004

And each individual surgeon!
It is important for the RN who will receive the patient from the OR to prepare the room. There should be a standard set up. This can be written and ALWAYS checked off!
Theory and familiarity with each MDs usual protocol and written standardized procedures are essential.
Perhaps the surgeons can give a class periodically.

We have four surgons...our post op orders for all four are virtually the same...the only differece is is that two like albumin for post op volume replacement and two like hespan...there are boxes to be checked on the orders which specify which is to be used...the only other main difference is that two of the docs prefer autotransfusion and two prefer cell saver with different parameters...again the docs can check which they prefer on the orders, we just have to verify which to follow...Our set up is pretty standardized...on the orders there are only a few check boxes for individual preferences and once you use the orders for each doc awhile, you learn what they like! The orders are clear and easy to follow!!! The docs fill in parameters for starting dopamine, epi, nitro, nipride, IV lasix, volume, etc....but they allow us to use our judgement too depending on patient presentation and are ok with it...I agree, the more standard the better!

pickledpepperRN · Jun 27, 2004

We have four surgons...our post op orders for all four are virtually the same...the only differece is is that two like albumin for post op volume replacement and two like hespan...there are boxes to be checked on the orders which specify which is to be used...the only other main difference is that two of the docs prefer autotransfusion and two prefer cell saver with different parameters...again the docs can check which they prefer on the orders, we just have to verify which to follow...Our set up is pretty standardized...on the orders there are only a few check boxes for individual preferences and once you use the orders for each doc awhile, you learn what they like! The orders are clear and easy to follow!!! The docs fill in parameters for starting dopamine, epi, nitro, nipride, IV lasix, volume, etc....but they allow us to use our judgement too depending on patient presentation and are ok with it...I agree, the more standard the better!

Sounds great!

Perhaps the orientee and preceptor(s) could be allowed to decide when the nurse is ready for full responsibility. Also the charge nurse should be available as resource.

zambezi, BSN, RN · Jun 28, 2004

Sounds great!
Perhaps the orientee and preceptor(s) could be allowed to decide when the nurse is ready for full responsibility. Also the charge nurse should be available as resource.

Our orientation usually consists of about a month on days and two months on nights with a dedicated preceptor. We are a medical and surgical coronary unit so we get cardiogenic shock, post mi, post intervention, post cabg/valve repairs, etc, anything requiring iv vasoactive gtts... During the orientation the preceptor gets first pick of patients and tries to get a little of everything with a large focus being the cardiac surgery patient. Prior to starting in the unit, the preceptor has to take a critical care course...After orientation is over, the preceptee has a dedicated "buddy" each shift as well as the charge nurse in case they have questions/concerns, etc...It seems to work fairly well...