competency: k-1 prenatal care, assessment and · pdf filek-5-3 demonstrate ability to perform...

Manitoba Licensed Practical Nurses Competency Profile 105

Competency: K-1

Prenatal Care, Assessment and TeachingPage: 2

A Licensed Practical Nurse will:

K-1-5 Demonstrate knowledge of complications associated with pregnancy such as:abortionabruption placentaeclampsiaectopic pregnancyeffects of substance abusegestational diabetes mellitushyperemesis gravidaruminuterine growth retardationmalposition of fetusplacenta previatransient hypertension.

K-1-6 Demonstrate the ability to teach the client about complications of pregnancy.

K-1-7 Demonstrate knowledge and ability to apply fetal monitor to facilitate a“Non-Stress” test such as:preparing client for application of “non-stress” testassisting appropriate health professional with on-going monitoring and

reporting of results.

K-1-8 Demonstrate ability to provide nursing interventions to alter non-reactivefetal monitoring reading by:offering juice or ice waterpositioning clientproviding oxygen.


Major Competency Area: K

Maternal / Newborn Care

Competency: K-2

Knowledge and Assessment of Labour


K-2-1 Demonstrate knowledge of birthing process:Stage 1–labour onset to full cervix dilationStage 2–full cervix dilation to delivery of babyStage 3–delivery of baby to expulsion of placentaStage 4–expulsion of placenta to afterbirth recovery.

K-2-2 Demonstrate ability to perform full health assessment and specialized admissionspecific to maternal nursing such as:awareness of risk factorsawareness to blood typesauscultation of fetal heartconsentsdelivery recordlast menstrual cyclenote whether Strep B test is doneprenatal records / historyprevious genetic anomaliesprevious pregnancies (gravida, para)vital signs.




Competency: K-3

Assist with Managing Labour


K-3-1 Demonstrate ability to assist with management of labour:applying external fetal heart monitorassisting with ongoing monitoring throughout labourproviding care to labouring clientreporting and documenting as required.

K-3-2 Demonstrate ability to use non-pharmacological techniques to assistclient in managing pain during labour and delivery.

K-3-3 Demonstrate ability to administer medications to clients in labour as peragency policy.

K-3-4 Demonstrate ability to test appropriate specimens during labour suchas:glucometerurineamniotic fluids using litmus paper / kits.

K-3-5 Demonstrate ability to assist with invasive procedures such as:artificial rupture of membranesepidural anesthesia / analgesiainductioninsertion of internal mode fetal monitoringobtaining consents if applicablevaginal exams.




Competency: K-4

Assist with Delivery


K-4-1 Demonstrate ability to use sterile techniques to set-up delivery suite.

K-4-2 Demonstrate ability to assist authorized professional in delivery process.

K-4-3 Demonstrate ability to use equipment for safe delivery.

K-4-4 Demonstrate ability to provide care and initial medications to stablenewborns as per agency policy.

K-4-5 Demonstrate ability to perform Apgar scoring.

K-4-6 Demonstrate ability to examine placental tissue and cord structure.

K-4-7 Demonstrate ability to assist with appropriate nursing interventions such as: chills hemorrhage seizures shock.

K-4-8 Demonstrate ability to document concisely.

K-4-9 Demonstrate ability to assist client and family in the event of still birth ordeath of a newborn.

K-4-10 Demonstrate ability to assist with neonatal resuscitation.

K-4-11 Demonstrate ability to procure appropriate specimens for analysis such as: cord blood sample.




Competency: K-5

Postpartum Care and Teaching


K-5-1 Demonstrate knowledge of involution process.

K-5-2 Demonstrate knowledge of medical terminology as it applies to postpartumclient.

K-5-3 Demonstrate ability to perform assessment of post delivery client such as:breasts / nipplescaesarean section incisionfundushemorrhoidslochiaperineumvital signs.

K-5-4 Demonstrate ability to recognize post-delivery complications such as:boggy fundusclient passing large clots or tissuedifficulty voiding or distended bladderdisplaced fundusedema (hands and feet)high blood pressurepostpartum hemorrhageseizure activity.

K-5-5 Demonstrate ability to provide appropriate nursing interventions.

K-5-6 Demonstrate ability to recognize physiological changes such as:after painscervical closureconstipationdecreased perineal muscle tone.


Competency: K-5

Postpartum Care and TeachingPage: 2


K-5-6 Demonstrate ability to recognize physiological changes such as: (continued)diuresisinvolution of uteruslactationovulation/menstruationvaginal rugaevital sign changesdiaphoresisweight loss.

K-5-7 Demonstrate ability to recognize psychological changes such as:bondingpostpartum bluespostpartum depression.

K-5-8 Demonstrate the ability to teach and support client in ongoing postpartumcare such as:breast feeding / bottle feedingchanges in family dynamicsimportance of restinvolutionnewborn careperineal hygienepersonal hygienephysiological changespsychological changes.


Competency: K-5

Postpartum Care and TeachingPage: 3


K-5-9 Demonstrate the ability to perform ongoing assessments during postpartumperiod such as:bowel functionbreastscaesarean section incisionedemafunduslegs (deep vein thrombosis)lochiapain in breasts, uterus, perineum, otherperineum–episiotomy / hemorrhoidsvital signsvoiding.

K-5-10 Demonstrate ability to safely use equipment needed in the postpartumperiod.

K-5-11 Demonstrate the ability to assist mother with breast feeding.

K-5-12 Demonstrate the ability to initiate inter-agency referrals as part of dischargeplanning.

K-5-13 Demonstrate ability to provide discharge teaching to mother, father and / orsignificant other.


Major Competency: K


Competency: K-6

Prenatal / Pre-operative Care andTeaching


K-6-1 Demonstrate knowledge and ability to prepare client for elective andemergency caesarean section such as:administer pre-operative medicationscatheterizationcontinuous fetal monitoringensure consent is signedfrequent monitoring of vital signs as requiredinfusion therapyobservation ofchanges in client’s condition and reporting of samepre-operative care and teaching.

K-6-2 Demonstrate knowledge and ability to provide pre-operative /prenatal teaching as per hospital policy / procedures for electiveand emergency caesarean sections such as:breast care post surgerycare of incision post surgerydeep breathing and coughing exercisesdischarge teachinginfusion therapy and nutritionpersonal hygiene carereferralssupport of incision post surgery when mobilizing.




Competency: K-7

Postnatal / Post-operative Care andTeaching


K-7-1 Demonstrate knowledge and ability to provide post-operative / postpartumcare following return from OR / Recovery room.

K-7-2 Demonstrate knowledge and ability to complete ongoing assessments duringpostpartum period and report any changes or abnormalities such as:bowel functionscatheter care–voiding post catheter removalfirmness and position of fundusincision care / dressing changesinfusion therapy / intake and outputlochia–amount and odornutritional requirements when breast feedingpain in breasts, uterus, incision, perineum or legsperineum–episiotomy / hemorrhoidspost epidural protocolsredness, swelling, pain in back of legsvital signs.

K-7-3 Demonstrate ability to safely use equipment needed in postpartum care.




Competency: K-8

Knowledge and Teaching of NewbornCare


K-8-1 Demonstrate knowledge and ability to perform physical assessment onnewborn.

K-8-2 Demonstrate knowledge and ability to perform newborn admission to thenursery:following normal deliveryfollowing caesarean section delivery.

K-8-3 Demonstrate knowledge and ability to monitor clinical manifestations ofnewborn.

K-8-4 Demonstrate knowledge of equipment pertaining to newborn care.

K-8-5 Demonstrate knowledge and ability to provide discharge teaching regardingcare of newborn such as:appointment with physicianevents which should be reported to regulated health professionalevaluate car seat safety / perform car seat testingother referrals as necessaryprovide health link informationreinforce feeding and bathing of newbornvisit by community health nurse.

K-8-6 Demonstrate knowledge and ability to assist appropriate professional withtransferring neonate to specialized care.

K-8-7 Demonstrate knowledge and ability to assist appropriate professional withgavage feeding.


L: Pediatrics


Major Competency Area: L

Pediatrics

Competency: L-1

Knowledge, Assessment and Care ofPediatric Client / Family


L-1-1 Demonstrate ability to apply critical thinking and clinical judgmentthroughout the nursing process when caring for pediatric clients.

L-1 -2 Demonstrate knowledge of anatomy and physiology of pediatric clients:cardiovascular systemcentral nervous systemgastrointestinal systemgenitourinary systemgrowth and development stagesintegumentary systemmusculoskeletal systemmetabolicrespiratory systemendocrinology.

L-1-3 Demonstrate knowledge of common pediatric diseases and medicalconditions such as:asthmacongenital anomalitiescongenital heart diseasecystic fibrosisdowns syndromemuscular dystrophyrespiratory syncytial virus (RSV)spectrum disorderstrauma.

L-1-4 Demonstrate knowledge and ability to assess family environment andsupport.


Competency: L-1

Knowledge, Assessment and Care ofPediatric Client / Family

Page: 2


L-1-5 Demonstrate knowledge and ability to identify suspicion and / or signs ofphysical, sexual, and mental abuse of child, and report and document as peragency policy.

L-1-6 Demonstrate ability to perform initial and ongoing physical assessment ofpediatric clients.

L-1-7 Demonstrate ability to perform health admissions specific to pediatricnursing.

L-1-8 Demonstrate ability to assess need for pain management to pediatric clientsuch as:agebehaviors associated with paincultural influence of family of infant / childlocation and intensity of painmedical treatment / intervention and potential for painphysiological and emotional behaviorsprevious medication and effectivenesssubjective and objective data related to painweight.

L-1-9 Demonstrate ability to report and document related to pain managementsuch as:behaviors that indicate presence of painphysiological and emotional changes related to paineffectiveness of pain management, supportpain assessment resultstime of medication or other therapy to manage pain and effectivenessneed to collaborate with other health professionals as necessary.



Pediatrics

Competency: L-2

Interventions and Safety Procedures


L-2-1 Demonstrate knowledge of safety precautions used in infant / child care such as:checking mechanical equipmentidentifying the clientinspecting toyskeeping personal care supplies out of child’s reachknowing the physical and cognitive abilities of the infant and childmaintaining close physical contact when caring for the infant and childmaintaining medical asepsismedication out of the child’s sight and reach and locked uppreventing cross contaminationproviding a secure environmentunderstanding and applying precaution when oxygen is in use.

L-2–2 Demonstrate understanding of the legalities and agency policy regardingalternatives to restraint or use of restraint on pediatric client.

L-2–3 Demonstrate knowledge and ability to use protective devices as per agency policy.



Pediatrics

Competency: L-3

Support and Teaching to Client / Family


L-3-1 Demonstrate ability to provide support to pediatric client / family.

L-3–2 Demonstrate ability to teach pediatric client / family in relation to areas such as:compliance with treatmentdiagnosisdischargehospital / home routinemedication / pain managementplay arearest period.

L-3–3 Demonstrate ability to assist child / family to adjust to hospitalization such as:calling child by namediscussing concerns and involving parent or significant otherencouraging two-way communicationidentifying behaviors indicating adjustment or lack of adjustment to hospitalizationintroducing child and parent to other children in the roomlistening to how the child feels and encourage questionsmanaging anxieties observed or expressed by client / familymeeting the emotional needs of those involvedpreparing equipment for admission in advanceproviding for child and parent comfortproviding orientation to unitusing empathy in responding to fears of the child and family.

L-3-4 Demonstrate ability to identify and meet emotional needs of family andsignificant others in coping with infant / child illness.


Competency: L-3

Support and Teaching to Client / FamilyPage: 2


L-3 -5 Demonstrate ability to provide discharge teaching to parent and significantother such as:referral agenciesfollow up appointment with physicianawareness of signs and symptoms of complicationsinformation regarding medication, diet, exercise, and activities.

L-3-6 Demonstrate knowledge of the roles of the health care team in assisting thepediatric client, parent, and significant other through child’s illness.



Pediatrics

Competency: L-4

Knowledge and Use of PediatricEquipment


L-4-1 Demonstrate knowledge and ability to safely utilize specific pediatricequipment as per agency policy.


M: Mental HealthNursing


Major Competency Area: M

Mental Health Nursing

Competency: M-1

Knowledge and Assessment of MentalHealth and Illness


M-1-1 Demonstrate ability to apply critical thinking and clinical judgmentthroughout the nursing process with mental health clients, families, andgroups in a variety of health care settings.

M-1-2 Demonstrate knowledge and ability to recognize the difference betweenmental illness and mental health.

M-1-3 Demonstrate knowledge and ability to describe common mental healthissues / illnesses such as:adjustment disordersautismanxiety disordersbrain injurycognitive disordersdementiadevelopmental disorderseating disorders–anorexia nervosa and bulimia nervosalearning and behavioral disordersmood disorders (unipolar, bipolar)personality disorderspost traumatic stress disorderschizophreniasubstance related disorders.


Competency: M-1


Page: 2


M-1-4 Demonstrate knowledge and ability to identify signs and symptoms of mentalhealth issues / illnesses such as:anxietyattempted suicide / suicide riskdelusionsdepressionhallucinationsmaniaparanoiapost-operative psychosis.

M-1-5 Demonstrate knowledge and ability to properly assess mental status:assess and evaluate changes in patient:

o behavioralo emotionalo intellectualo mini-mental examinationo motoro perceptualo suicide risk assessment.

M-1-6 Demonstrate knowledge of diagnostic tools and guides in mental health e.g.,“Diagnostic and Statistical Manual of Mental Disorders Volume 4” (DSM-IV).


Competency: M-1


Page: 3


M-1-7 Demonstrate knowledge and ability to recognize and intervene in crisissituations such as:identifying phases of crisis developmentidentifying signs and symptoms of a crisisidentifying nursing interventionsidentifying the goals and indications for crisis interventionidentifying signs of escalating aggressive behaviorapplying nursing interventions in accordance with agency policy.

M-1-8 Demonstrate ability to communicate and collaborate with the health careteam.

M-1-9 Demonstrate knowledge and ability to assess stress in a client’s / family’s lifesuch as:exploring factors contributing to stressassessing strategies for managing stressexamining adaptability to changeproviding care and direction in crisis staterecognizing behavioral manifestations.

M-1-10 Demonstrate knowledge and ability to understand developmental / childhoodspectrum disorders such as:developmental disordersattention deficit disordersanxiety disordersfetal alcohol syndrome.

M-1-11 Demonstrate knowledge and ability to objectively report and document.




Competency: M-2

Aggressive Behavior


M-2-1 Demonstrate critical thinking and clinical judgment in monitoring andmanaging all types of aggressive behavior.

M-2-2 Demonstrate knowledge of facility policies regarding aggressive behavior.

M-2-3 Demonstrate knowledge and ability to apply self protection / preventiontechniques such as:respect for personal spaceflexibilitydistanceteamworkdistraction techniques.

M-2-4 Demonstrate ability to ensure safety of other clients, self, and colleagues asappropriate.

M-2-5 Demonstrate knowledge and ability to assess level of anxiety and recognizeprogression to agitation and aggression.

M-2-6 Demonstrate knowledge and ability to utilize agitated behavior rating scaleused by agency such as:present to a slight degree–does not prevent other appropriate behaviorpresent to a moderate degree–benefits from cueing to appropriate behaviorresent to an extreme degree–external cueing or redirection not effective.


Competency: M-2

Aggressive BehaviorPage: 2


M-2-7 Demonstrate knowledge and ability to be aware of factors contributing toaggressive behavior such as:psychosocial factorsenvironmental factorspharmacological factorscaregiver factors.

M-2-8 Demonstrate knowledge and ability to respond appropriately to preventand manage aggression such as:decrease noiseeffective and appropriate verbal and non verbal communicationreduce stimuliisolate client, as appropriate.

M-2-9 Demonstrate knowledge and ability to respond appropriately to client who ismaking threats with an object or a weapon.

M-2-10 Demonstrate knowledge and ability to provide post incident managementsuch as :client supportcaregiver and colleagues supportcollaboration with the health care team.

M-2-11 Demonstrate ability to document and report observations as appropriate.




Competency: M-3

Intolerable Behavior


M-3-1 Demonstrate critical thinking and clinical judgment in respondingappropriately to intolerable behavior.

M-3-2 Demonstrate knowledge of types of abuse and intolerable behavior such as:bodily harmemotional and mental harmverbal abusesexual harmneglectadministration or prescribing medication for an inappropriate purposemisappropriating money and / or valuable possessionsfailing to provide adequate nutrition, medical attention or other necessities of lifemisuse of physical and / or chemical restraint.

M-3-3 Demonstrate knowledge of institution policies regarding abuse andintolerable behavior.

M-3-4 Demonstrate knowledge and application of legislation pertaining to abuseand intolerable behavior such as:Protection of Persons in Care ActMental Health Act.

M-3-5 Demonstrate knowledge and ability to accurately assess, manage, report, anddocument all incidences of abuse and intolerable behavior.




Competency: M-4

Prevention and Intervention in Suicide


M-4-1 Demonstrate ability to recognize and understand the warning signs ofsuicide in all ages of clients such as:call to crisis linechange of personalitychange of routinefamily historyidentification of a suicide planincrease in psychosomatic illnessmedication misusepast historysleep and eating patternssuicidal ideologiessuicidal note.

M-4-2 Demonstrate knowledge and ability to intervene immediately with suicidalclient as appropriate.

M-4-3 Demonstrate ability to educate family members to cope with client’sbehavior and feelings such as:observing interactionsteaching effective responsedocumenting findingsparticipating in family conferenceproviding information.

M-4-4 Demonstrate knowledge and ability to provide constant observation forsuicide prevention as appropriate.




Competency: M-5

Substance Abuse Interventions


M-5-1 Demonstrate knowledge and ability to recognize substance abuse.

M-5-2 Demonstrate knowledge and ability to recognize the types of substance abusesuch as:alcoholprescription drugsstreet drugsinhalants / aerosolsover-the-counter drugsstimulants–opiates / narcoticshallucinogensothers.

M-5-3 Demonstrate knowledge and understanding of the effect of substance used.

M-5-4 Demonstrate knowledge and understanding of drug withdrawal,rehabilitation, and recovery.

M-5-5 Demonstrate knowledge and ability to provide nursing care to manage thesymptoms of substance abuse.

M-5-6 Demonstrate knowledge and ability to teach clients, families, and groupsregarding prevention of substance abuse and promotion of health.




Competency: M-6

Mental Health Treatments andInterventions


M-6-1 Demonstrate knowledge and ability to provide medications to mental healthclients including psychotropic drugs.

M-6-2 Demonstrate knowledge and ability to provide education to mental healthclients regarding medication compliance.

M-6-3 Demonstrate knowledge and ability to provide education to mental healthclients regarding medication non-compliance.

M-6-4 Demonstrate knowledge and ability to recognize drug interactions such as:dangerous drug interactionssynergistic drug interactionstherapeutic drug interactionsantagonistic drug interactions.


Competency: M-6

Mental Health Treatments andInterventions

Page: 2


M-6-5 Demonstrate knowledge and ability to participate in mental healthtreatments and interventions such as:behavior modification:

o consistencyo family therapyo group therapyo individual therapyo positive and negative reinforcement

psychotherapy:o art and music therapyo behavior modificationo family therapyo group therapyo occupational therapyo psychoanalysiso recreational therapy.

M-6-6 Demonstrate knowledge and ability to assist with mental health treatmentsand interventions such as:electrotherapy (ECT):o pre and post ECT care

referral to mental health resourcesclient and family educationassist with ECT treatment.

M-6-7 Demonstrate knowledge and ability to report and document treatmentsand interventions in an objective manner.




Competency: M-7

Legal Protocols and DocumentationRequirements


M-7-1 Demonstrate knowledge of relevant Legislation, such as:Mental Health Act (MHA)Freedom of Information and Protection of Privacy Act (FIPPA)Protection for Persons in Care Act (PPIC)Personal Health Information Act (PHIA).

M-7-2 Demonstrate knowledge of the formal certification process and implications.

M-7-3 Demonstrate knowledge and ability to use protective devices as per agencypolicy.

M-7-4 Demonstrate knowledge and ability to participate in client, family, team, andconferences.

M-7-5 Demonstrate knowledge of facility policy and legal protocols.


N: EmergencyNursing


Major Competency Area: N

Emergency Nursing

Competency: N-1

Multi-Systems Assessment


N-1-1 Demonstrate knowledge and ability to apply critical thinking andclinical judgment to adapt health assessment to emergency nursing.

N-1-2 Demonstrate ability to perform neurological assessment such as:neurological vital signsgeneralized seizure activityGlasgow coma scalelevel of consciousnessloss of consciousnessmotor functionpupil reactionoxygen saturationsensory functionvisual acuity.

N-1-3 Demonstrate ability to perform peripheral neurovascular assessment such as:peripheral assessmentcolor, warmth, circulation and movement (CWCM).

N-1-4 Demonstrate ability to perform respiratory assessment such as:accessory muscle useauscultation of lung fieldscolorcoughcyanosisexpectorated secretionsjugular vein distentionO2 saturation per monitor


Competency: N-1

Multi-Systems AssessmentPage: 2


N-1-4 Demonstrate ability to perform respiratory assessment such as: (continued)peak flowpulmonary function testsrespiration–rate, rhythm, qualitytracheal deviationtracheal tug.

N-1-5 Demonstrate ability to assess the cardiovascular system such as:application of external cardiac monitoring leadsauscultation of chestblood pressure, postural, and palpable BPheart rate, rhythm, and peripheral pulsesheart sounds (S1,S2)capillary refillperspirationpitting edemasigns or symptoms of infectionlab findingsapplication and monitoring of 12 lead ECG.

N-1-6 Demonstrate ability to perform a musculoskeletal assessment such as:soft tissue injuries / multiple system injuries / traumafracturesdislocationsdegenerative disordersmobility and ambulation.

N-1-7 Demonstrate ability to perform genitourinary assessment such as:assess patency of urinary cathetercheck external genitalia for signs of traumainsert and remove catheterlab findingsmonitor urinary outputpalpate for bladder distentionstrain urine for calculibladder scanning.


Competency: N-1

Multi-Systems AssessmentPage: 3


N-1-8 Demonstrate ability to complete a gynecological assessment such as:gravida, para, abortionslast normal menstrual period (LNMP)vaginal discharge or blood losscramping, labor painsprevious gynecological surgerylength of last laborprevious premature birthsbirth control historypregnancy testing.

N-1-9 Demonstrate the knowledge and ability to document and report assessmentfindings to the appropriate health professional.



Emergency Nursing

Competency: N-2

Identify Priority Needs


N-2-1 Demonstrate ability to collaborate within health team and contribute toclient assessment such as:participate in the triage and screening of clientsperform secondary assessment that relates to clients overall health statusobtain relevant health historyrecognize individuals at risk for self harm and or harm to othersassess need for precautionary measuresfollow isolation techniquesensure client confidentiality and privacy within limits of environmentdescribe symptomspain assessmentrecord findings and report to health team.


Emergency Nursing

Competency: N-3

Nursing Interventions


N-3-1 Demonstrate knowledge and ability to perform nursing procedures such as:administer medicationsapply and monitor cardiac monitorassemble and use ambubagbladder irrigationburn dressingscatheter insertion, removal, care, irrigationensure consent is signed for invasive proceduresgastrointestinal interventions i.e., insertion of nasogastric tube, enemahot and cold compressesmonitor client on ongoing basis–circulatory, vital signs, O2 saturationophthalmic interventionsostomy care and irrigationpre-operative careprepare body for morgue and viewing while maintaining the integrity of forensic

evidenceprepare client for procedures and treatmentsprovide infusion therapyremove sutures and stapleswound careother treatments and procedures as appropriate within scope of practiceinitiate peripheral infusionnon-stress tests on prenatal clientsapply and monitor telemetryapply 12 and 15 lead ECG and connection to cardiac monitorphlebotomy.

_________________________________________________________________________________Manitoba Licensed Practical Nurses Competency Profile 140


Emergency Nursing

Competency: N-4

Assist with Emergency Interventions


N-4-1 Demonstrate knowledge and ability to assist the physician / nursepractitioner with interventions such as:complex dressing proceduresirrigationsmanual tractionpreserving amputated partsrestraintsstabilize fracturessuturing of woundsadult / child abuse / sexual assault proceduresbiopsylumbar puncturenerve blockparacentesisthoracentesisinsert oral airway, as appropriateassist with other treatments and procedures as appropriate and necessarygastric lavageBier block / pneumatic tourniquet.




Emergency Nursing

Competency: N-5

Knowledge of Equipment


N-5-1 Demonstrate knowledge and ability to set up and maintain equipment anddevices commonly used in emergency departments as per agency policy.



Emergency Nursing

Competency: N-6

Support and Teach Client / Family


N-6-1 Demonstrate knowledge and ability to support and teach client, family, andsignificant others in the emergency nursing environment.


O: GerontologyNursing


Major Competency Area: O

Gerontology Nursing

Competency: O-1

Aging Process and Health Problems


O-1-1 Demonstrate knowledge of effects of aging on normal anatomy andphysiology.

O-1-2 Demonstrate the knowledge and ability to recognize the normal agingprocess such as:physicalemotionalcognitivepsychosocial.

O-1-3 Demonstrate knowledge and ability to assess and recognize multi-systemhealth issues.

O-1-4 Demonstrate knowledge and ability to recognize cognitive dysfunction in theelderly such as:agitation / aggressionanxietyconfusiondeliriumdementia / delusiondepressiondisorientationmental status.

O-1-5 Demonstrate ability to assess for drug induced cognitive disorder.

O-1-6 Demonstrate ability to assess for physiological causes for cognitive changessuch as:urinary tract infection (UTI)constipationupper respiratory infection (URI).


Competency: O-1

Aging Process and Health ProblemsPage: 2


O-1-7 Demonstrate ability to intervene and provide emotional support to client andfamily when required.

O-1-8 Demonstrate knowledge and ability to assist in the provision of therapiessuch as:behavior modificationreality therapyorientation therapyvalidation therapytouch therapymusic therapyaromatherapypet therapyrecreation therapysocialization.

O-1-9 Demonstrate knowledge and ability to investigate alternative therapies theclient may be accessing.



Gerontology Nursing

Competency: O-2

Support and Teaching


O-2-1 Demonstrate the ability to communicate with client and family such as:ability to assess language barriersassess cognitive ability of client / spouse / familyassess family history–abuse, addictions, cultural issuesaware of deficits in hearing, sight, and speechaware of physical disabilitiesaware of psychological, social, and spiritual needsbody languageempathylistening.

O-2-2 Demonstrate ability to provide support to the client and family such as:aware of changes in family rolesaware of losses–possessions, home, partner, skillsaware of Personal Directiveloss of independence–decision making, financessocial changesprovide assistance with activities of daily living (ADL).

O-2-3 Demonstrate ability to provide teaching to client and family such as:access to support groupswithin team conferencesreferral to community agenciesstages of losssupport activities of daily living (ADL)effect of changes.



Gerontology Nursing

Competency: O-3

Nursing Intervention


O-3-1 Demonstrate ability to apply critical thinking and clinical judgment to thenursing process during the provision of daily care to the geriatric client.

O-3-2 Demonstrate ability to apply pharmacological principles in the safeadministration of medication such as : assessing specific needs, weight, age, and health issues of the client monitoring and teaching self medication program preparing medications for client to take on day/night pass as per agency policy recognizing drug interactions, toxic effects, and non-compliance.

O-3-3 Demonstrate knowledge and ability to meet the nutritional special needs ofthe elderly such as: adapting feeding techniques to the elderly adjusting for the decrease in smell, taste and sight assessing need for adaptive devices assessing swallowing ability assessing the nutritional needs of a client communicating and documenting effective feeding techniques noting cultural and religious influences noting allergies providing extra nutritional supplements recognizing importance of environment during meals.

O-3-4 Demonstrate knowledge and ability to consult and / or refer to otherprofessionals such as: dietician speech language pathologist occupational therapist physical therapist social worker.


Competency: O-3

Nursing InterventionsPage: 2


O-3-5 Demonstrate knowledge and ability to meet the elimination needs in theelderly such as: assessing clients individual elimination needs demonstrating patience and understanding initiating appropriate interventions maintaining client privacy and dignity observing signs and symptoms unique to the elderly providing bladder and bowel retraining providing client and family teaching recognizing the special needs of the cognitively impaired.

O-3-6 Demonstrate knowledge and ability to perform skin and wound care such as: preventing skin breakdown through positioning, skin care, hygiene, and nutrition assessing wound, exudate, characteristics and stage of healing identifying cause of the wound observing for signs of infection selecting and applying appropriate wound dressings recognizing when to seek advice from wound care specialist / other health

professional.

O-3-7 Demonstrate ability to provide comfort measures and pain management.



Gerontology Nursing

Competency: O-4

Assessment for Appropriate Placement


O-4-1 Demonstrate knowledge and ability to participate in the assessment of clientsfor placement as per agency policy:assessing clients health statusacting as client’s advocateproviding information regarding client’s usual nursing careresponding to assessor questionsproviding information as requested.




Gerontology Nursing

Competency: O-5

Safety Procedures


O-5-1 Demonstrate ability to provide a safe environment.

O-5-2 Demonstrate ability to respect the client’s and family’s wishes within theparameters of safety.

O-5-3 Demonstrate knowledge and ability to implement alternatives to create asafer environment for client such as:non-skid shoes or socksmotion detectorslow rise bedship protectors.

O-5-4 Demonstrate ability to adhere to agency policy and legislation.

O-5-5 Demonstrate ability to document client behavior, treatment, safetyprecautions, risk issues, and client response.



Gerontology Nursing

Competency: O-6

Communication and Advocacy


O-6-1 Demonstrate knowledge and ability to communicate with client and advocatefor client.

O-6-2 Demonstrate knowledge and awareness of code status of each client.

O-6-3 Demonstrate knowledge of and respect for the client’s Personal Directive.

O-6-4 Demonstrate knowledge of legislation affecting client / family / caregiver,such as:Protection for Persons in Care (PPIC)Personal Health Information Act (PHIA).

O-6-5 Demonstrate knowledge of protocol regarding guardianship, power ofattorney, and trusteeship.

O-6-6 Demonstrate knowledge and ability to participate in team, client, and familyconferences.


P: PalliativeCare


Major Competency Area: P

Palliative Care

Competency: P-1

Assess Physiological Change


P-1-1 Demonstrate knowledge of the physiological characteristics and symptoms ofend of life due to the cessation of normal body functions.

P-1-2 Demonstrate knowledge of best practice for palliative nursing care.

P-1-3 Demonstrate knowledge of the dying process.

P-1-4 Demonstrate ability to recognize the approach of death and assess andprovide nursing care for various alterations in vital functions.

P-1-5 Demonstrate knowledge and ability to pronounce death such as:assessing cessation of vital signsfollowing agency policy.


Major Competency Area: P

Palliative Care

Competency: P-2

Pain Management and Symptom Control


P-2-1 Demonstrate ability to assess objective and subjective signs and symptoms ofclients discomfort such as:confusion, agitation, aggressiondry mouthfacial expressionitchinessnausearestlessnessverbal commentsvital signs.

P-2-2 Demonstrate ability to provide care to manage pain and symptoms such as:administering analgesicassessing client on ongoing basisassessing need for changes in analgesicproviding quiet, comfortable roomidentifying causes of discomfortinvolving family/significant others in client carepromoting eliminationproviding hygiene care, mouth care, skin careaiding reposition, using support devices and / or special mattress.


competency: k-1 prenatal care, assessment and · pdf filek-5-3 demonstrate ability to perform...

Documents