The Nuts and Bolts of Abdominal Assessment

The following criteria will be used to evaluate successful completion of the didactic/theoretical and skills-lab component of short peripheral I.V. competency

 NOTE: RNs who do not demonstrate satisfactory aseptic technique or infection control in any area will not be able to progress to the hands-on component of the competency

Criteria/Core Competencies

Satisfactory

Needs Improvement

Unsatisfactory

Pre-Test

RN completed pre-test evaluation

n/a

RN did not complete pre-test evaluation

Patient-Centered Care

1. Introduces self to patient and explains procedure
2. Provides individualized care by asking patient his/her preferred name
3. Respects and recognizes patient�s preferred language for communication.
4. Inquire whether patient is right-handed or left handed
5. Offer patient choices for I.V. site if possible
6. Respect and recognizes patient�s religious beliefs by inquiring whether I.V. site will interfere with religious practices
7. Offer dry heat to facilitate venous dilation and visualization

All elements of criteria have been addressed prior to initiating I.V. attempt

Element �a� has been addressed however one or two of the other elements needs further discussion

Element �a� was not addressed

and/or

more than two elements were not addressed prior to initiating I.V. attempt

Evidence-Based Practice

1. Integrates evidence-based practice to formulate an individual plan of care to meet needs of surgical oncology patient(s)
2. Demonstrates aseptic technique during insertion
3. Applies the principles of hand-hygiene before, during, and after insertion
4. Implements evidence-based care during and after I.V. insertion

All elements of the criteria have been met.

RN determines if there is laterality involved in the surgical procedure  and selects opposite side for I.V. insertion

RN selects the right size catheter based on surgical procedure and area of practice

RN inquires if patient has received chemotherapy before surgery and inquires/assesses whether patient has tenderness, hardness or visible vein redness

RN places patient�s arm at or below level of heart to promote venous dilation

RN places tourniquet in appropriate location to promote venous dilation

RN cleans site for 30 seconds with chlorhexidine

RN only touches prepared area with sterile gloves

RN allows site to dry completely before insertion

RN removes tourniquet after successful cannulation or inability to cannulate vein

RN applies pressure above end of catheter to minimize blood loss

RN places transparent dressing on site following insertion

RN places date on site

RN uses needless connector and flushes I.V. with at least 3 ml of normal saline

RN places end cap on needless connector

RN places stylet in sharps container following insertion

RN uses hand sanitizer upon entering room, prior to I.V. insertion, following procedure and upon leaving patient area

Elements �c� & �d� have been met.

One or two other elements need further discussion

Elements �c� & �d� not met

and /or more than two elements were not addressed prior to initiating I.V. attempt

Safety

1. Identifies patient and allergies prior to initiating I.V. insertion
2. Performs nursing skill safely and timely to prevent O.R. delays or delay in treatment
3. Integrates effective use of technology and practices to support safe I.V. insertion
4. Identifies and places appropriate arm band on patients with arm precautions
5. Identifies potential complications of I.V. insertion and implements appropriate actions if complications occur

All elements of criteria have been met.

RN identifies patients who have had axillary dissections or venous thrombosis in upper extremity and places pink armband on

RN selects approved antiseptic solution and/or dressing if allergy is identified

RN uses vein visualizer and/or  dry heat using skin barrier for difficult veins

RN immediately removes catheter and places a pressure dressing and cold compress if hematoma develops

RN immediately removes catheter and notifies LIP if patient complains of altered sensation following catheter insertion

RN completes RISQ report if altered sensation occurs secondary to I.V. insertion

Elements �a� & �d� have been met.

One or two other elements need further discussion

Element �a� has not been met

and/or more than two elements were not addressed prior to initiating I.V. attempt

Informatics

1. Navigates the clinical information system to locate the patient�s electronic health record
2. Locates order to initiate I.V. within computer information system
3. Documents completion of task within computer information system
4. Utilizes technology tools (vein visualizer) for clinical reasoning when appropriate

All elements of criteria have been addressed

Elements �a� and �b� have been met. One or two other elements need further discussion

Elements �a� and �b� have not been met

and/or more than two elements were not addressed prior to initiating I.V. attempt

Teamwork and Collaboration

1. Communicates effectively with the patient. Uses interpreter service to communicate with patient if necessary
2. Collaborates with members of healthcare team
3. Initiates requests for help when appropriate

All elements of criteria have been addressed

RN does not attempt I.V. more than twice

Consults with anesthesia and/or surgical team if free flap or vascular surgery is scheduled

One or two elements need further discussion

Two or more elements were not addressed

Post-Test

RN completed post-test evaluation with a score of 80-100%

RN completed post-test evaluation with a score of 65-79%

Participant completed post-test evaluation with a score below 65%

Or

Participant did not complete post-test evaluation