Written: September, 1993 Reviewed: 4/98, 4/01, 1/04 Divisional Policy Manual Revised: 2/89, 6/92, 7/94, 5/95, 9/97, 2/98, 3/01, 2/03, Ambulatory Care Division 10/06, 6/09, 10/12 LSU Health Sciences Center-Shreveport Page 1 of 6 ORIENTATION AND CONTINUED COMPETENCY ASSESSMENT PURPOSE: To acquaint the new employee with policies of the institution and Ambulatory Care Division. To define a mechanism for assessment and initial competency of staff to perform job duties. To define the ongoing mechanism for competency assessment and evaluation of each employee of the LSUHSC Ambulatory Care Division, based on developmental needs of the patient population. POLICY: 1. The Ambulatory Care Division clinic staff adheres to the policies and procedures for orientation and competency assessment as defined by the Department of Nursing. Refer to the Patient Care Services Nursing Policy/Procedure Manual, policies: N-38, Competency Assessment N-46, Orientation for Nursing Employees 2. Orientation A. New employees, volunteers, and students in the Ambulatory Care Clinics shall report to the Administrative RN Supervisor who shall issue an orientation packet to the employee and have the employee complete a Nursing Staff Data Form. 1) The new employee shall be instructed to notify the assigned clinic RN Supervisor of any changes in his/her name, address, or phone number. 2) The department's orientation/competency program and the employee's responsibilities will be reviewed during clinic orientation. B. The employee who is new to the institution shall be assigned to attend the Medical Center Orientation Program provided by the Human Resource Management Department and return documentation of evidence of attendance to the clinic RN Supervisor. C. All new employees shall also attend the Nursing Department orientation unless they are transferring from within the LSUHSC system and have worked in the Nursing Department within the last year. 1
Orientation and Continued Competency Assessment Page 2 of 6 D. All new employees shall receive an appointment to the Occupational Health Clinic for initiation/update of health records and immunizations as required. E. All new/transfer employees shall be scheduled to attend Electronic Health Record computer system classes as needed. F. Employees shall adhere to the following: 1) New employees shall receive a minimum clinic orientation of six (6) weeks. 2) "Float" staff and employees assigned to special care areas may require a longer orientation period as determined by each clinic's RN Supervisor based on the employee's progress and the complexity of the job responsibilities; however, basic clinic competencies must be completed within six (6) months from the first day of employment in assigned clinic. 3) Float" staff will continue to orient to various clinics at the discretion of the department RN Manager/Director. G. Clinic-specific procedures must be satisfactorily performed via return demonstration prior to the employee performing the procedure independently. H. The Clinic RN Supervisor is responsible for the orientation of all new employees or float staff in his/her assigned clinic. I. Upon completion of the orientation period, when it has been deemed the new employee can function independently, the clinic RN Supervisor shall ensure completion of all orientation forms and submit to the RN Manager or Administrative RN Supervisor. Orientation forms to be completed include: 1) ACD Generic Orientation Checklist 2) Department Orientation Essentials 3) Clinic-specific Job Specific Orientation Checklist 4) Job Performance Standards/Performance Evaluation (signed) 5) Evaluation of the new Employee by Unit Supervisor 6) New Employee Self-Evaluation 7) Skills Checklists/Competencies Validation appropriate to assigned clinic 8) Age specific competency module 3. For continued competency assessment, refer to the policies and procedures for competency assessment based on developmental needs of the patient population served as defined by the Department of Nursing (Patient Care Services Policy/Procedure Manual, N-38, Competency Assessment). 2
Orientation and Continued Competency Assessment Page 3 of 6 NURSING PROCEDURES AND RELATED EQUIPMENT Generic to most clinics: Blood Cultures/Venipuncture Catheterizations Defibrillator Review Intradermal Skin Testing IV therapy/devices IVAC Vital Check IVAC Thermometers Medication Administration Pain Assessment Point of Care Testing Diebold/Medselect 1. CHILDREN'S HEALTH Allergy Injections/ Testing Assist with Procedures Blood/Blood Components Ear Irrigations Hand Held Nebulizers Hickman Catheter access/flush Microtemp MDI with Spacer Usage Instructions NG Tube Insert/DC Peak Flow Port-a-cath Access/Flush Visual Acuity 2. COMPREHENSIVE CARE CLINIC Ear Irrigation Hand Held Nebulizers 3. ENDOSCOPY Blood/Blood Component Admin. Capsule Endoscopy Conscious Sedation Monitoring Endoscopy Procedures, Assisting Hickman, Central Line Access/Flush Manual Scope Cleaning/Disinfecting Tube Insert/DC PICC Line Procto Procedures, Assisting Steris Sterilizer 3
Orientation and Continued Competency Assessment Page 4 of 6 4. FAMILY PRACTICE Ear Irrigations Hand Held Nebulizers 5. Infusion Recovery Area Blood and Blood Component Administration IV Chemotherapy (Rituxan, Cytoxan, etc.) IV Medications (IVIG, Ferrlecit, Remicade, Reclast, Orencia, Vancomycin, etc.) Port-a-Cath Access and Flush PICC Lines 6. MEDICINE SPECIALTY Central Line Access/Flush Gold Injections 7. NEUROSURGERY/ NEUROLOGY 8. ONCOLOGY - FEIST WILER CANCER CENTER (FWCC) FWCC Adult Oncology Blood/Blood Components Admin. Central Line Access/Flush Hickman Catheter Access/Flush IV Chemotherapy IV Push Medications Zoladex Admin. FWCC Pediatric Oncology Blood/blood Component Administration Port-a-Cath Access/ Flush Hickman/ Broviac Access/ Flush IV and IM Chemotherapy Administration IVIG Infusions IV Push Medications FWCC Surgical Oncology Assist with Endoscopy Procedures Assist with Minor Procedures Central Line Access/Flush Dressing Changes Hickman Cath Access/Flush IV Push Medications 4
Orientation and Continued Competency Assessment Page 5 of 6 FWCC Surgical Oncology continued IVCS Monitoring Manual Scope Cleaning/ Processing NG Tube Placement and Removal PAC Access/Flush PIC Line Access/Flush Post Anesthesia Monitoring Pre/Post Op Instructions Steris Sterilzer Processing Suture/Staple Removal Trach Suctioning and Care 9. OPTHALMOLOGY Assisting with laser Auto lensometer ICG administration Intraocular pressures Intravitreal Injections IV Fluorescein Admin. Photodynamic therapy Visual acuity 10. ORAL SURGERY Conscious Sedation/Monitoring Oral Surgery Procedures, Assisting Oral and Maxillofacial X-rays 11. ORTHOPEDICS Cast Application/Removal Suture/Staple Removal Unna Boots Application 12. OTOLARYGOLOGY (ENT) Allergy Skin Testing/Therapy Assist with Laser Procedures Conscious Sedation Monitoring Manual Scope Cleaning/Disinfecting Otorhinolaryngology Procedures, Assisting Trach Suctioning and Care 13. PSYCHIATRIC CLINIC Does not perform nursing procedures 5
Orientation and Continued Competency Assessment Page 6 of 6 14. SURGERY Dressing Changes NG Tube Insert/DC Procto Procedures, Assisting Surgical Procedures, Assisting Manual Scope Cleaning/ Disinfecting Diabetic Limb and Wound Care Hilo Tables Liquid Nitrogen 15. UROLOGY Bladder Instillation/Irrigation Blood/Blood Component Conscious Sedation Monitoring Catheterization Flow Studies Manual Scope Cleaning/Disinfecting Steris Sterilizer Urodynamics Zoladex Administration 16. VIRAL DISEASE Hand Held Nebulizer NG Tube Insert/Discontinue 17. WOMEN'S HEALTH Antenatal RhoGam Admin Essure OB/Gyn Procedures, Assisting Non-stress testing NOTE: All RNs and LPNs are required to give a satisfactory return demonstration for IV therapy (LPNs if certified), medication administration, crash cart, and defibrillator review. All Nursing Assistants will give a satisfactory return demonstration on the use of IVAC vital check machine, manual blood pressures, and IVAC Thermometer. 6