NICU PBDS Test

EricJRN, MSN, RN · Oct 20, 2006

Moved to NICU Forum for more responses. Good luck!

dawngloves, BSN, RN · Oct 20, 2006

I have no idea what that is. :uhoh21:

Renee' Y-Y · Oct 20, 2006

I know PBDS very well - but not the NICU version...but it is all basically the same. PBDS (Performance Based Development System) is an assessment of your skills and knowledge. It involves problem identification/recognition and problem management; interpersonal skills assessment; there might be some abnormal pictures that you have to look at and discuss what is going on and how you would manage; prioritization skills; and EKG interpretation.

Institutions will use PBDS as a development tool for their own employees - those that are FT, PT, PRN...but they use it as a "weed-out" tool for agency. The reason being, if you are paying "out-the-wazoo" for an agency nurse, then that nurse should come as a "full-package" without any significant development/training needs. If that nurse needs that level of training, then the institution is not willing to pay "agency price" and then spend their own money on top of that doing additional training.

With problem recognition and management, you are given a short video vignette w/ s/s and you are to identify the problem, whether or not you would notify the physician, what orders you would expect, what nursing actions you could take (those things that nurses can do without a physician order - I/O, daily weight, etc.) It is very writing or typing intensive depending on whether or not you get the written or computer version. I always told my students to pretend you are trying to describe the interventions to a lay-person, not a nurse. In other words, don't say, "I would assess." You need to state EXACTLY what you would assess - B/P, HR, RR, T, skin color, lung sounds, etc.

Interpersonal skills involves identifying the underlying issue. IE: If a physician is upset and ranting about the help, the underlying issue is probably he ordered something that wasn't done - don't reply to the "overt" message but reply to the "underlying" issue.

Prioritization skills are just that. You will get a list of stuff and you determine the urgency of that particular problem.

EKG interpretation - just that. If you are NALS/PALS certified, you will need to state the appropriate interventions as well.

What I have noticed is that more experienced nurses don't put enough information down and less experienced nurses sometimes do better but their critical thinking skills are not well developed.

In my opinion, it is an EXCELLENT tool - VERY ENLIGHTENING!! I used to do feedback for nurses that took it at my facility. I have taken it as well - I have been a critical care nurse for about 20 years - I did fine on it. It is a VERY GRUELING DAY! So come prepared - snacks, stuff to drink - and prepared to be sitting and writing/typing for several hours (6-8).

Best of luck.

nell · Oct 21, 2006

...In other words don't say, "I would assess." You need to state EXACTLY what you would assess - B/P, HR, RR, T, skin color, lung sounds, etc....[/quote']
I took the NICU PBDS a long time ago so don't remember any specifics. I was temporarily assigned to "screen" some adult ICU ones recently though and Renee has good advice. The ones I screened had an example of what was expected at the top - if yours does, pay attention to it.
Write down EVERYTHING you would do, even obvious stuff. State if an MD should be called and if so, what specifically he/she should be notified of.
You have to make the correct assessment of the situation (diagnosis) based on what you see in the video - look at everything.
Ours also has an IV part where you look at photos and have to identify things like infiltration, phlebitis, cracked bottle, line apart etc. Be sure you say specifically if a new IV site is needed, new tubing, comfort measures (heat or cold), whatever.
Good luck.
nell

efuchs1 · Oct 30, 2006

Is there anyone out there that has taken the NICU PBDS that can tell me how easy or difficult it is? The fact that I have to medically diagnose intimidates me a little. I'm assuming the test will have things such as hyperbili, PDA, hyperglycemia, etc... Anyone know?

Humbled_Nurse · Oct 30, 2006

Hey, I think I can help. I took the PBDS about a year ago. Personally, I didn't think the test was too hard and I did well on it. I really don't have test anxiety (lucky me) so I think that helped. Anyway, the scenarios I had were all NICU related. Basically what would happen is they would show a short video/vinette of a baby and maybe add in some vital signs, history and/or lab results. You do need to put what the problem is such as RDS, Jaundice, etc... and put what you would do about it. I always would put what my nursing interventions would be, said I would call the doctor, and I would write what my anticipated orders were. I will try to give you an example:

Baby Boy Jones was born 2 hours ago and is 34 weeks and is on room air, and has visible retractions and audible grunting. A recent arterial blood gas shows a pH of 7.21, CO2 of 60, HCO3 of 20, and P02 of 45. What is your diagnosis? Think the obvious and routine. My answer would be Respiratory Distress Syndrome. I would alert physician of infant's condition. I would anticipate this infant needing respiratory support such as CPAP or possibly ventilator support. I would anticipate the need for surfactant and draw necessary labs per physician orders such as blood culture and CBC to rule out the possibility of sepsis due to this infants respiratory distress although the most likely cause of the infant's respiratory distress is surfactant deficiency. Would set up for umbilical lines if physician plans to place lines. As a nurse my interventions would be thermoregulation, support parents, decreasing stimulation, etc....

This is not a perfect example, but this gives you an idea what to expect. I think the scenarios I had on my PBDS test were:

ABO incompatibility

Tracheoesophageal atresia

Temp. instability

Apnea

As far as the above scenario. The scenario will likely not tell you the infant is retracting or grunting. That will be something you will hear and see on the video.

Just be familiar with the most common neonatal conditions and always remember your ABC's.

Hope this helps some!

Good luck and let us know how it goes.

nell · Oct 31, 2006

Excellent response, Humbled_Nurse. Anytime the PBDS question comes up, we should pull up this post - it says it all.

nell

rn-johni · Nov 7, 2006

I take the NICU version of the PBDS next Monday and I'm not sure what scenarios I may encounter. The hospital I'm going to work at sent me a list of diagnosises (I know I spelled that wrong :lol2: ) for Med/Surg, OB, and ICU but not for NICU. I'm taking a travel position and my contract depends on me passing this God-Aweful thing. The whole thing seems unfair, but to not even have any idea what dx's to study for seems even more disheartening. If anyone's taken this, please let me know what was on your test; any help will be GREATLY appreciated!

THANK YOU!

rn-johni · Nov 7, 2006

I'm also taking this test for a travel position next Monday, the 13th (Thank God it's not Friday the 13th, huh?) and I'm terrified! Where are you traveling to? Have you taken it yet? Maybe between the two of us we can figure this out, huh? Any info you get, please pass along to me and I'll do the same. Good Luck!

Humbled_Nurse · Nov 10, 2006

Hey rn-johni:

First off you need to relax. I know, I know easier said than done. If you have at least a year or more of experience you should do fine on the test. Generally, they are going to pick the more common NICU patient diagnosis like RDS, jaundice, temp. instability, sepsis, etc..... I don't think it is a test you should have to study for. It should be knowledge you already have. Of course it wouldn't hurt to review some of the more common neonatal conditions. If you have a good neonatal book or if you don't just look on the internet.

Good luck and don't worry you will do fine.

captn_smallfry · Nov 11, 2006

Are you by any chance going to Pitt county Johni? I take it in a couple weeks. My roomate and I have to stay in a hotel until we pass! If we dont pass it, we have to find new jobs! Im so upset about all of this, I have test anxiety to top it all off!