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ADULT CRITICAL CARE NURSING POSTGRADUATE DIPLOMA

ADULT CRITICAL CARE NURSING POSTGRADUATE DIPLOMA 1

CONTRIBUTORS

Preparation Curriculum Scientific Committee

Dr. Hassan A. Alshahrani Dr. Fahad S. Alblowi

Dr. Mahaman Moussa Mr. Abdulelah Alhaidray

Mr. Ayman Alasmari

Reviewed and Approved Nursing Scientific Council

Dr. Ahmad Aboshaiqah Dr. Hassan Al Shahrani Dr. Sana Al Mahmoud

Dr. Eshtiaq Al Faraj Dr. Hasna Banjar

Dr. Wael Al Zayer Dr. Shadia Yousef

Dr. Khalid Al Johani Dr. Elham Bukhari

Ms. Bushra Al Hunidi Supervision

Curriculum Specialist Prof Zubair Amin Dr. Sami Alshammari

Edited (2019) Mr. Obaidullah Alonazi

Reviewed and Approved By

The Executive Director of Training Dr. Sami Al Haider


COPYRIGHTS AND AMENDMENTS All rights reserved. © 2016 Saudi Commission for Health Specialties. This material may not be reproduced, displayed, modified, or distributed without prior written permission of the copyright holder. No other use is permitted without prior written permission of the Saudi Commission for Health Specialties. Any amendment to this document shall be approved by the Specialty Scientific Council and the Executive Council of the commission and shall be considered effective from the date of updating the electronic version of this curriculum published on the commission website unless different implementation date has been mentioned. For permission, contact the Saudi Commission for Health Specialties, Riyadh, Kingdom of Saudi Arabia. This program is approved by: This curriculum has been recommended by the Scientific Council of Nursing and was approved by the Central Training Committee in the Saudi Commission For Health Specialties (SCFHS). Correspondence: P.O. Box: 94656 Postal Code: 11614 Consolidated Communication Center: 920019393 International Contact Call: 00-966-114179900 Fax: 4800800 Extension: 1322 Website: www.scfhs.org.sa Formatted and Designed by: Manoj Thomas Varghese, CMT/Salem Al Tamimi (SCFHS)

4 ADULT CRITICAL CARE NURSING POSTGRADUATE DIPLOMA

ACKNOWLEDGMENTS We thank Allah (SWT) for giving us the opportunity to accomplish this work. May Allah’s (SWT) blessing be upon our noble Prophet Mohammed. (May the peace and blessing of Allah be upon him, his family, and noble companions.) We also would like to express our deepest gratitude to the Saudi Commission for Health Specialties for honoring us with the responsibility to develop this curriculum. May Allah (SWT) make these humble efforts beneficial to the patients, families, nurses, and nursing professionals.


TABLE OF CONTENTS ACKNOWLEDGMENTS 4 INTRODUCTION 7 PROGRAM OVERVIEW 8 INSTRUCTIONAL METHODS 11 ON-LINE UNIVERSAL TOPICS 12

Universal Topics: First Year 13 Universal Topics: First Year 16

FIRST-YEAR TRAINING MODULES 18 Module I: Foundations of Intensive Care Nursing 18 Module II: Ethics in Nursing and Dimensions of Care 19 Module III: Behavioral Problems and Psychosocial Concepts 20 Module IV: Advanced Health Assessment 21 Module V: Pathophysiology and Nursing Management 22 Module VI: Infection Control 23 Module VII: Pharmacology for Critically Ill Patients 24

SECOND-YEAR TRAINING MODULES 26 Module VIII: Epidemiology 26 Module IX: Nursing Research and Evidence-Based Practice in Nursing 27 Module X: Biostatistics 28 Module XI: Healthcare Informatics 29 Module XII: Leadership and Management 30 Module XIII: Professional Development 31 Module XIV: Intensive Care Nursing Practicum I 32 Module XV: Intensive Care Nursing Practicum II 33

ASSESSMENT 34 MODULE REFERENCES 36 CURRICULUM DEVELOPMENT REFERENCES 37 APPENDICES 1–9 38


INTRODUCTION In the Kingdom of Saudi Arabia, critical care is a booming specialty in nursing. Currently, hospitals are offering critical care nurses more attractive incentives, including sign-on bonuses, relocation bonuses, and reimbursement for continuing education and certification. Although there have always been very sick and severely injured patients, the concept of critical care as a specialty, is relatively modern. Given the advances in medicine and technology, the nursing care of patients has become more complex. To provide appropriate care, nurses require specialized knowledge and skills as the mechanisms of delivering care evolve to support patients’ needs for continuous monitoring and treatment. The practice of intensive care nursing of adults has improved over the past decades. Knowledge of the pathophysiology of life-threatening conditions and the technological capacity to monitor and treat adult patients suffering from these conditions, have advanced rapidly during this period. Currently, in the Kingdom of Saudi Arabia, there is a high incidence and prevalence of acute medical conditions among adults. In Saudi Arabia, there is a high prevalence of acute illnesses and complications of chronic illness due to the sedentary (inactive) lifestyle of the Saudi population. There has also been an increase in trauma cases e.g., road traffic accidents, as accidents continue to increase. Therefore, nurses who are specialized in critical care are in demand in Saudi Arabia to meet the healthcare needs of critically ill patients. To meet the national and international standards of critical care nursing, the Saudi Commission for Health Specialties (SCFHS) offer an evidence-based training and educational program, tailored specifically to intensive care unit (ICU) nurses. The expected outcomes of this program include the generation of research investigations and dissemination of research findings related to this specialized area of practice. This program will focus on the nursing care of adult patients with acute and complex health problems. The emphasis is on enhancing the critical thinking skills necessary to make sound nursing judgments and promote self-directed nursing care of patients with acute and complex health problems. Furthermore, this program will synthesize evidence-based data to deliver competent, culturally sensitive, and appropriate holistic care to clients with complex health needs.


PROGRAM OVERVIEW The Advanced Practice Nursing Program in Adult Critical Care is a two-year program designed to provide opportunities for registered nurses to acquire updated clinical knowledge and skills, and further develop professional attitudes and behaviors, which will enable them to work with critically ill patients. This program will help the trainee nurses to develop intellectual and creative abilities to facilitate the development of independent judgment and problem-solving skills. The ultimate goal of this program is to prepare registered nurses with sound skills and attitudes to perform competently in critical care settings. Upon successful completion of the Adult Critical Care Nursing Postgraduate Diploma, the nurse will be awarded a certificate from the SCFHS to practice as a Senior Specialist in Adult Critical Care Nursing.

Program Objectives Upon completion of the Adult Critical Care Nursing Postgraduate Diploma, the learner will be able to: 1. Integrate knowledge of nursing and related sciences with the care of critically ill adults. 2. Identify common risk factors that may adversely affect the physical and psychosocial well-

being of adult patients with acute life-threatening diseases. 3. Utilize the nursing process in the care of adult patients with acute life-threatening health

problems. 4. Demonstrate the interpersonal and psychomotor skills needed to implement effective

nursing care of critically ill adults. 5. Utilize critical thinking skills to improve the health outcomes of patients with acute life-

threatening diseases. 6. Provide health education and counseling to adult patients and their families. 7. Manage sudden or acute deteriorations in the conditions of adult patients who are ill with

acute life-threatening diseases. 8. Apply infection control and safe-patient care standards when caring for adult patients with

acute life-threatening diseases. 9. Develop an improvement project proposal targeting the adult population e.g., to reduce the

fall rate of hospitalized patients. 10. Utilize an evidence-based approach to evaluating nursing practice in adult settings. 11. Apply concepts of quality improvement to the evaluation of nursing care. 12. Manage ethical issues concerning the care of adult patients and their families in

accordance with Islam, Saudi culture, and their regulations. 13. Participate in professional development activities, including self-directed learning and

continuing professional education. 14. Demonstrate competencies in the attached skills (Appendix 7) 15. Assess and facilitate patients’ and families’ use of effective coping mechanisms in times of

crisis. 16. Provide safe and effective practice in the administration and disposal of drugs used in the

care of the critically ill patient; assess the effects of drug therapy and initiate action according to the clinical unit’s protocols.

17. Analyze management and leadership using relevant theories and demonstrate their application to professional practice.

PROGRAM OVERVIEW


18. Reflect and critically evaluate their own practice in the application of an appropriate model

of nursing. 19. Apply knowledge demonstrate knowledge and request of patient’s rights in professional

clinical practice.

General Training Requirements 1. The trainee shall abide by the regulations and obligations established by the Saudi

Commission for Health Specialties (SCFHS). 2. Training is a full-time commitment. The trainee shall be enrolled on a full-time, continuous

basis for the entire duration of the program. 3. Training is to be conducted in institutions accredited for nurses’ training by the Saudi

Commission for Health Specialties. 4. The training will be comprehensive in the specialty of the critical care of adults. 5. The trainee shall be actively involved in patient care.

Admission Requirements Eligible applicants must fulfill the application requirements of the SCFHS (as outlined in the executive policy of the acceptance and registration) and meet the following criteria: 1. Be a graduate from an accredited nursing program with a Bachelor of Nursing (BSN)

degree. 2. Pass the interview for admission. 3. Have a current license to practice nursing. 4. Provide a letter from an employer supporting a full time enrollment in the program. 5. Provide evidence of current certification in Basic Life Support (BLS). 6. For more information about registration and acceptance in the program please visit the

SCFHS website https://www.scfhs.org.sa/MESPS/AcceptanceRegister/Pages/default.aspx To obtain a certificate of the Adult Critical Care Nursing Postgraduate Diploma, the candidate must fulfill the following requirements: 1. The required period for the completion of this program is two calendar years. 2. The program consists of a 47 weeks per calendar year, excluding examination weeks and

annual vacation. A total of 94 weeks must be completed during the entire study period. 3. A total of 40 hours of didactic and clinical hours must be completed each week. 4. The trainee rotation consists of an 8-hour shift, excluding lunchtime or a 12-hours shift to

complete the required total of 40 hours per week. 5. The program’s language of instruction is English

Leaves 1. Trainees are entitled to have an annual leave of four weeks in addition to one-week Eid

leave (trainee entitled for one Eid leave only) per year, in addition to an optional scientific leave.

2. All leaves (including sick leave, maternity leave, and “emergency” leave) will be treated according to the executive policy of interruption (Available on SCFHS website). Trainees will be required to compensate for such interruptions with an equivalent number of days before being awarded the program’s certificate of completion.

3. Leave that are not utilized in due time within the year cannot be shifted to the coming year.

https://www.scfhs.org.sa/MESPS/AcceptanceRegister/Pages/default.aspx

PROGRAM OVERVIEW


4. Trainees may be granted a special leave for scientific purposes not to exceed seven days

per training year to attend scientific conferences, seminars, or workshops in the same specialty area (Critical Care Nursing). The trainee is required to provide proof of attending such activities.

5. For more details and specifications please review SCFHS policy https://www.scfhs.org. sa/MESPS/TrainingProgs/RegulationBoard/Pages/default.aspx

Time Frame for Program Completion

Year Modules Number of Weeks

MODULES OF FIRST

YEAR TRAINING

Orientation 2 Module I: Foundations of Intensive Care Nursing I 4 Module II: Ethics in Nursing and Dimensions of Care

3

Module III: Behavioral Problems and Psychosocial Concepts

3

Module IV: Advanced Health Assessment 10 Module V: Pathophysiology and Nursing Management

15

Module VI: Infection Control 2 Module VII: Pharmacology for Critically Ill Patients 8 Total 47 weeks

MODULES OF

SECOND YEAR

TRAINING

Module VIII: Epidemiology 4 Module IX: Nursing Research and Evidence-Based Practice in Nursing

4

Module X: Biostatistics 4 Module XI: Healthcare Informatics 3 Module XII: Leadership and Management 4 Module XIII: Professional Development 4 Module XIV: Intensive Care Nursing I Practicum 12 Module XV: Intensive Care Nursing II Practicum 12 Total 47 weeks

Annual Vacation: 4 weeks

Eid Vacation: one of the two Eid holidays according to training institution standards.


INSTRUCTIONAL METHODS 1. Interactive lectures and discussions. 2. Computer assisted interactive instructional programs. 3. Weekly reading assignments and use of the SCFHS digital library. 4. Simulations and clinical skills demonstrations. 5. Presentations. 6. Group discussion of case studies. 7. Clinical practicums to include:

a) Theory to precede related clinical assignments (as needed). b) Post clinical debriefing: 1 - 2 times per week, as needed, and the development of

nursing plans of care for selected patients. 8. Case presentations: Guidelines: Each trainee will present a case study of a patient cared

for in the clinical setting. The case presentation should include the patient’s past medical/surgical history, disease diagnosis/treatment history, current medical/surgical diagnosis, and nursing diagnosis with appropriate assessment findings, and current plans of care with identification of optimal outcomes. Presentations are to be approximately 15 minutes with the trainee facilitating the post-presentation discussion. The discussion should include a comparison of plans of care with the current American Association of Critical-care Nurses (AACN) Clinical Practice guidelines, Standards of Care, and any other evidence-based practice standards see appendix 5 &7.

This program contains fifteen modules that address topics relevant to the education and training of nurses enrolled in an advanced practice program with a focus on critical care nursing. Each module targets specific competencies. The program’s clinical competencies have been adopted from Mosby’s online nursing skills database, with some modifications to meet the outcomes of this program (Appendix 8). Each trainee will be issued a username and a password to access Mosby’s Nursing Consult database. The trainee is expected to perform the competency exams online. The assigned clinical instructor (CI) monitors the test results and schedules trainees for competency checks in the nursing skills laboratory, based on the trainees’ online-exam scores.

Hospital Rotations Most hospitals’ critically ill patients are in the intensive care units. Therefore, to experience the role of the adult critical care nurse, trainees are provided with adequate specialty experience. The purpose is to enable them to have confidence and gain competence in terms of the assessment and overall holistic management of critically ill patients in varied critical care settings. Some hospitals have several ICUs, such as a Trauma, Surgical, and Burn ICUs. Additionally, some critically ill patients arrive in the Emergency Department and then transfer to another hospital or die. Therefore, trainees are advised to see these cases with his/her clinical instructor and get oriented to the process of receiving critical care patients in ER.


ON-LINE UNIVERSAL TOPICS These universal topics were developed by SCFHS as learning resources for trainees. The topics that are important for trainees either because they are very common or because they deal with important clinical conditions. Pre- and post-test multiple choice questionnaire’s (MCQs) are provided to assist learning and to ensure that trainees have learnt the content. These MCQs are not meant to be used as assessment tools in the more conventional sense. Of course, conditions described in the universal topics may be assessed in various ways in other examinations. Passing score: As stated above, these topics are meant to be learning resources. Pre- and post-test MCQs should be viewed as learning aids rather than examinations. However, to ensure that trainees have indeed reviewed these online lectures, a score of 60%-80% is required in the post-test MCQs as evidence of learning. Trainees may review the lectures as many times as required and then take the post-test. The duration of each topic is around 90 minutes. Completion of the universal topics: The assigned topics should be completed within the allocated year. Trainees and mentors should take personal initiatives to complete the universal topics on time. If a trainee fails to complete the assigned universal topics within a given year due to unforeseen circumstances, s/he may be allowed to carry these over to following years. Trainees must, however, complete all the topics before attempting the final exit exam. For this program, the Advanced Nursing Practice in Cardiac (Adult) Specialization, trainees are expected to cover the selected online universal topics set out below, according to the given time line. Instructors and trainees must refer to the Saudi Commission for Health Specialties Online Universal Topics, which can be accessed at http://www.scfhs.org.sa/en/MESPS/Pages/ UniversalTopics.aspx The universal topics modules are streamlined in accordance with the program curriculum. Important note for program coordinators and trainees: The universal topics as a whole include some objectives that are not within the scope of nurses, who are not required to complete these.

Universal Topics

First Year Second Year Module 1: Introduction Module 4: Medical and Surgical

Emergencies Module 3: Diabetes and Metabolic Disorders

Module 5: Acute Care

Module 7: Ethics and Healthcare

ON-LINE UNIVERSAL TOPICS


Universal Topics First Year

Module 1: Introduction 1. Safe drug prescribing 2. Hospital acquired infections (HAI) 3. Sepsis; Systemic inflammatory response syndrome (SIRS); disseminated intravascular

coagulation (DIVC) 4. Antibiotic stewardship 5. Blood transfusion Safe drug prescription: At the end of the learning unit, you should be able to: 1. Recognize the importance of safe drug prescribing in healthcare; 2. Describe the various adverse drug reactions with examples of commonly prescribed drugs

that can cause such reactions; 3. Apply principles of drug-drug interactions, drug-disease interactions, and drug-food

interactions in common situations; 4. Apply principles of prescribing drugs in special situations, such as renal failure and liver

failure; 5. Apply principles of prescribing drugs in elderly and pediatric patients, and in pregnancy and

lactation; 6. Promote evidence-based cost effective prescribing; and 7. Discuss the ethical and legal framework governing safe-drug prescribing in Saudi Arabia. Healthcare-associated infections (HAI): At the end of the learning unit, you should be able to: 1. Discuss the epidemiology of HAI with special reference to HAI in Saudi Arabia; 2. Recognize HAI as one of the major emerging threats in healthcare; 3. Identify the common sources and presentation of HAI; 4. Describe the risk factors of common HAIs, such as ventilator associated pneumonia,

methicillin resistant staphylococcus aureus (MRSA), central line associated bloodstream infection (CLABSI), and vancomycin resistant enterococcus (VRE);

5. Identify the role of healthcare workers in the prevention of HAI; 6. Determine appropriate pharmacological (e.g., selected antibiotic) and non-pharmacological

(e.g., removal of indwelling catheter) measures in the treatment of HAI; and 7. Propose a plan to prevent HAI in the workplace. Sepsis, SIRS, DIVC: At the end of the learning unit, you should be able to: 1. Explain the pathogenesis of sepsis, SIRS, and DIVC; 2. Identify patient-related and non-patient related predisposing factors of sepsis, SIRS, and

DIVC; 3. Recognize a patient at risk of developing sepsis, SIRS, and DIVC; 4. Describe the complications of sepsis, SIRS, and DIVC; 5. Apply the principles of management of patients with sepsis, SIRS, and DIVC; and 6. Describe the prognosis of sepsis, SIRS, and DIVC.



Antibiotic stewardship: At the end of the learning unit, you should be able to: 1. Recognize antibiotic resistance as one of the most pressing public health threats globally; 2. Describe the mechanism of antibiotic resistance; 3. Determine the appropriate and inappropriate use of antibiotics; 4. Develop a plan for safe and proper antibiotic usage, including correct indications, duration,

types of antibiotic, and discontinuation; and 5. Appraise local guidelines in the prevention of antibiotic resistance. Blood transfusion: At the end of the learning unit, you should be able to: 1. Review the different components of blood products available for transfusion; 2. Recognize the indications and contraindications of blood product transfusion; 3. Discuss the benefits and risks of and the alternatives to transfusion; 4. Undertake consent for specific blood product transfusion; 5. Perform the steps necessary for safe transfusion; 6. Develop an understanding of the special precautions and procedures necessary during

massive transfusions; and 7. Recognize transfusion associated reactions and provide immediate management.

Module 3: Diabetes and metabolic disorders 1. Recognition and management of diabetic emergencies 2. Management of diabetic complications 3. Comorbidities of obesity Recognition and management of diabetic emergencies: At the end of the learning unit, you should be able to: 1. Describe the pathogenesis of common diabetic emergencies, including their complications; 2. Identify risk factors and groups of patients vulnerable to such emergencies; 3. Recognize a patient presenting with a diabetic emergency; 4. Institute immediate management; 5. Refer the patient to appropriate next level of care; and 6. Counsel patient and families to prevent such emergencies. Management of diabetic complications: At the end of the Learning Unit, you should be able to: 1. Describe the pathogenesis of important complications of Type 2 diabetes mellitus; 2. Screen patients for such complications; 3. Provide preventive measures for such complications; 4. Treat such complications; and 5. Counsel patients and families with special emphasis on prevention. Comorbidities of obesity: At the end of the learning unit, you should be able to: 1. Screen patients for the presence of common and important comorbidities of obesity; 2. Manage obesity related comorbidities; and 3. Provide dietary and lifestyle advice for the prevention and management of obesity.



Module 7: Ethics and healthcare 1. Occupational hazards of health care workers (HCWs) 2. Evidence-based approach to smoking cessation 3. Patient advocacy 4. Ethical issues: transplantation/organ harvesting; withdrawal of care 5. Ethical issues: treatment refusal; patient autonomy 6. Role of doctors in death and dying Occupation Hazards of HCWs: At the end of the learning unit, you should be able to: 1. Recognize common sources and risk factors of occupational hazards among HCWs; 2. Describe common occupational hazards in the workplace; 3. Develop familiarity with legal and regulatory frameworks governing occupational hazards

among HCWs; 4. Develop a proactive attitude to promoting workplace safety; and 5. Protect yourself and colleagues against potential occupational hazards in the workplace. Evidence-based approach to smoking cessation: At the end of the learning unit, you should be able to: 1. Describe the epidemiology of smoking and tobacco usage in Saudi Arabia; 2. Review the effects of smoking on the smoker and family members; 3. Effectively use pharmacological and non-pharmacological measures to treat tobacco usage

and dependence; and 4. Effectively use pharmacological and non-pharmacological measures to treat tobacco usage

and dependence among special population groups, such as pregnant women, adolescents, and patients with psychiatric disorders.

Patient advocacy: At the end of the learning unit, you should be able to: 1. Define patient advocacy; 2. Recognize patient advocacy as a core value governing medical practice; 3. Describe the role of patient advocates in the care of patients; 4. Develop a positive attitude towards patient advocacy; 5. Be a patient advocate in situations of conflict; and 6. Be familiar with local and national patient advocacy groups. Ethical issues: transplantation/organ harvesting; withdrawal of care: At the end of the learning unit, you should be able to: 1. Apply key ethical and religious principles governing organ transplantation and withdrawal of

care; 2. Be familiar with legal and regulatory guidelines regarding organ transplantation and

withdrawal of care; 3. Counsel patients and families in the light of applicable ethical and religious principles; and 4. Guide patients and families to make informed decisions. Ethical issues: treatment refusal; patient autonomy: At the end of the learning unit, you should be able to: 1. Predict situations in which a patient or family member is likely to decline prescribed

treatment; 2. Describe the concept of the “rational adult” in the context of patient autonomy and

treatment refusal;



3. Analyze key ethical, moral, and regulatory dilemmas in treatment refusal; 4. Recognize the importance of patient autonomy in the decision making process; and 5. Counsel patients and families declining medical treatment in the light of a patient’s best

interests. Role of doctors in death and dying: At the end of the learning unit, you should be able to: 1. Recognize the important role a doctor can play during a dying process; 2. Provide emotional as well as physical care to a dying patient and family; 3. Provide appropriate pain management in a dying patient; and 4. Identify suitable patients and refer them to palliative care services.

Universal Topics: Second Year

Module 3: Medical and surgical emergencies 1. Management of acute chest pain 2. Management of acute breathlessness 3. Management of altered sensorium 4. Management of hypotension and hypertension 5. Management of upper gastrointestinal (GI) bleeding 6. Management of lower GI bleeding For all the above, at the end of the Learning Unit, you should be able to: 1. Triage and categorize patients; 2. Identify patients who need prompt medical and surgical attention; 3. Generate preliminary diagnoses based on history and physical examination; 4. Order and interpret urgent investigations; 5. Provide appropriate immediate management to patients; and 6. Refer patients to the next level of care, if needed.

Module 4: Acute care 1. Pre-operative assessment 2. Post-operative care 3. Acute pain management 4. Chronic pain management 5. Management of fluid in the hospitalized patient 6. Management of electrolyte imbalances Pre-operative assessment: At the end of the learning unit, you should be able to: 1. Describe the basic principles of pre-operative assessment 2. Perform pre-operative assessment in an uncomplicated patient with special emphasis on (i)

general health assessment, (ii) cardiorespiratory assessment, (iii) medications and medical advice assessment, (iv) drug allergy, and (v) pain relief needs; and

3. Categorize patients according to risks.



Postoperative care: At the end of the learning unit, you should be able to: 1. Devise a post-operative care plan, including monitoring of vitals, pain management, fluid

management, medications, and laboratory investigations; 2. Hand over a patient properly to the appropriate facilities; 3. Describe the process of post-operative recovery in a patient; 4. Identify common post-operative complications; 5. Monitor patients for possible post-operative complications; and 6. Institute immediate management for post-operative complications. Acute pain management: At the end of the learning unit, you should be able to: 1. Review the physiological basis of pain perception; 2. Proactively identify patients who might be in acute pain; 3. Assess a patient with acute pain; 4. Apply various pharmacological and non-pharmacological measures available for acute pain

management; 5. Provide adequate pain relief for uncomplicated patients with acute pain; and 6. Identify and refer patients with acute pain who may benefit from specialized pain services. Chronic pain management: At the end of the learning unit, you should be able to: 1. Review bio-psychosocial and physiological bases of chronic pain perception; 2. Discuss various pharmacological and non-pharmacological options available for chronic

pain management; 3. Provide adequate pain relief for uncomplicated patients with chronic pain; and 4. Identify and refer patients with chronic pain who may benefit from specialized pain

services. Management of fluid in hospitalized patients: At the end of the learning unit, you should be able to: 1. Review the physiological basis of water balance in the body; 2. Assess a patient for hydration status; 3. Recognize a patient with over- or under-hydration; 4. Order fluid therapy (oral as well as intravenous) for a hospitalized patient; and 5. Monitor fluid status and response to therapy through history, physical examination, and

selected laboratory investigations. Management of acid-base electrolyte imbalances: At the end of the learning unit, you should be able to: 1. Review the physiological basis of electrolyte and acid-base balance in the body; 2. Identify diseases and conditions that are likely to cause or be associated with acid-base

and electrolyte imbalances; 3. Correct electrolyte and acid-base imbalances; 4. Perform careful calculations, checks, and other safety measures while correcting acid-base

and electrolyte imbalances; and 5. Monitor response to therapy through history, physical examination, and selected laboratory

investigations.


FIRST-YEAR TRAINING MODULES

Module I: Foundations of Intensive Care Nursing

Learning Objectives: At the end of this module, the learner will be able to: 1. Appraise the functions and responsibilities of the professional critical care nurse and select

essential criteria for establishing a professional portfolio; 2. Obtain initial subjective and objective data from the critically ill patient; 3. Implement the basic principles of time management in the performance of nursing activities

to care for critically ill patients. The learner will prioritize a plan of care according to the changing acuity of a patient;

4. Differentiate among the potential stressors in the critical care environment and select strategies to minimize their effects on patients and families;

5. Describe the different methods of therapeutic-airway management; 6. Describe the principles of wound and burn management; and 7. Demonstrate cardiopulmonary resuscitation techniques.

Module Outline A. Roles and responsibilities of intensive care nurses:

Scope of practice Professionalism and ethics Accountability Professional relationships Legal responsibility Advance practice roles Credentialing Professional development Professional portfolios Identifying stressors Burnout Managing stress and stress-reduction techniques Sensory deprivation ICU psychosis Patterns and routines Team work Acuity index

B. Crisis management: Communication skills Family counseling Framework for crisis management Transcultural issues in death and dying Grief counseling

C. Proficient vascular access monitoring D. Airway management and ventilation E. Calculate and administer drugs safely F. Care of patients undergoing invasive procedures



G. Wound management H. Burn management I. Cardiopulmonary resuscitation

Clinical Competencies 1. Monitor and interpret pulse oximetry and carbon dioxide levels. 2. Monitor vascular access. 3. Administer IV infusion fluids, blood, and blood products. 4. Assist airway management and ventilation. 5. Perform suctioning from different orifices. 6. Assist the patient undergoing invasive procedures. 7. Assist with pleural decompression (thoracentesis). 8. Perform standard procedures for wound dressings. 9. Measure burn surface areas (%) and manage burns. 10. Participate in direct current defibrillation for ventricular fibrillation. 11. Contribute to/participate in synchronized cardioversion.

Module II: Ethics in Nursing and Dimensions of Care

Learning Objectives: At the end of this module, the learner will be able to: 1. Examine the nature and role of ethical theories in guiding sound ethical decision-making in

workplace settings; 2. Discuss the ethical and legal contexts of professional nursing practice; 3. Examine key ethical issues occurring in nursing and related healthcare contexts; 4. Discuss the processes for achieving desired moral outcomes in nursing and healthcare

domains; 5. Analyze the conflicting duties and rights inherent in moral dilemmas; 6. Discuss the impact of current issues related to healthcare delivery; 7. Use ethical reasoning to synthesize standards of practice, ethical principles, and

legal/regulatory requirements in the resolution of ethical dilemmas; 8. Discuss the relevant ethical issues of traumatized patients; 9. Discuss staff members’ refusal to implement Do Not Resuscitate (DNR) orders from the

family members; 10. Recognize the importance of family members’ desire to attend the resuscitation of their

loved ones; and 11. Discuss the process of organ procurement and transplantation, and facilitate the process in

brain-dead patients.

Module Outline A. Introduction to moral and legal concepts B. Credentialing and licensing C. Autonomy and paternalism D. Bereavement E. Life and death F. Public health



G. Ethical and legal issues related to emergency situations and critically ill patients H. Organ donation and organ procurement I. Brain death

Clinical Competencies 1. Identifies basic ethical principles related to emergency management in the Kingdom of

Saudi Arabia. 2. Distinguishes between moral and legal concepts in relation to trauma diagnosis and

treatment. 3. Identifies ethical and cultural life-and-death considerations encountered in the Kingdom of

Saudi Arabia. 4. Demonstrates knowledge by identifying common ethical dilemmas related to trauma

patients. 5. Lists ethical issues related to organ procurement and organ donation. 6. Discuss the bereavement process and brain death certification. 7. Discuss nosocomial infections, medical errors, and medication errors.

Module III: Behavioral Problems and Psychosocial Concepts

Learning Objectives: At the end of this module, the learner will be able to: 1. Identify communication and interpersonal relationship skills used in the emergency

management of critically ill patients and their families; 2. Describe the relationship between stress and anxiety; 3. Identify the stages of the grieving process and describe nursing interventions for each

stage; 4. Recognize the emotional implications of transferring a patient from the critical unit and

describe interventions that help the patient cope with changes; 5. Discuss the physical and emotional responses to stress, including the local and general

adaptation syndromes, mind-body interaction, anxiety, coping, and defense mechanisms; and

6. Discuss the relevant ethical issues of traumatized patients.

Module Outline A. Assessment and management of mental-health emergencies:

Anxiety and panic reaction Ineffective coping and situational crisis Depression Suicidal behavior

B. Therapeutic communication skills C. Developmental factors in effective coping responses:

Stress Anxiety Dependency Responses to loss

D. General systems theory applied to individual and family coping responses



E. Major coping risks associated with physical and/or emotional illness:

Major developmental issues Control Loss Guilt

F. Psychosocial interventions for ineffective coping by patients and/or families G. Interventions with dying patients and their families

Clinical Competencies 1. Apply principles of interpersonal communication in critical care settings and/or crisis

situations. 2. Interact effectively with patients and their caregivers in times of extreme stress or crisis. 3. Demonstrate respect for patients’ dignity and autonomy. 4. Utilize stress-management resources available for patients and families. 5. Develop a sense of responsibility, accountability, and advocacy in the care of the critically

ill. 6. Teach critically ill patients and their families about crisis management and coping. 7. Demonstrate psychosocial interventions with patients and/or families with ineffective coping

methods. 8. Apply proper interventions with dying patients and their families.

Module IV: Advanced Health Assessment

Learning Objectives: At the end of this module, the learner will be able to: 1. Demonstrate knowledge of health assessment skills; 2. Comprehend the various components of a comprehensive health assessment; 3. Determine the four basic assessment techniques of physical examination (i.e., inspection,

auscultation, palpation, and percussion) and their mnemonic sequences; 4. Integrate knowledge of pathophysiology when conducting a comprehensive health

assessment for the different body systems; and 5. Describe the use of primary and secondary surveys to diagnose and manage life-

threatening injuries.

Module Outline A. Patient history B. General approaches to physical examination C. Assessment of treatment modalities and their side effects D. Assessment of nutritional state and spiritual and behavioral changes E. Pain assessment F. Comprehensive system assessment (head-to-toe examination) G. Adapting assessments to special populations e.g., people with special needs, such as

deafness H. Documentation of quality of care issues associated with critically ill patients



Clinical Competencies 1. Prepare equipment necessary to perform a health assessment. 2. Utilize effective communication skills with family members to conduct a health history if the

patient is unconscious. 3. Utilize principles of interviewing techniques when assessing ICU patients. 4. Demonstrate competence in performing physical examination skills using the correct

mnemonics. 5. Assess patients systematically and according to priorities. 6. Monitor new technologically complex procedures. 7. Perform a pain assessment. 8. Apply primary and secondary surveys to diagnosis and manage life-threatening injuries. 9. Collect, analyze, interpret, and document data correctly.

Module V: Pathophysiology and Nursing Management

Learning Objectives: At the end of this module, the learner will be able to: 1. Recognize physiological changes occurring during life-threatening illnesses. 2. Understand the pathophysiology of disease processes commonly seen in critically ill

patients. 3. Understand the inflammatory response and infection process. 4. Discuss fluid, electrolyte, and acid-base balance and imbalances. 5. Explain the pathophysiology of shock.

Module Outline A. Introduction to pathophysiological adaptations and alterations in cellular function B. Body defense mechanisms C. Inflammation and repair D. Immunity E. Fluid, electrolyte, and acid base balance and imbalances F. Pathophysiology of various types of shock, such as cardiogenic shock, septic shock, and G. neurogenic shock H. System and associated pathophysiological problems:

Respiratory alterations Cardiovascular alterations Hematological disorders Neurological disorders Gastrointestinal disturbance Endocrine disorders Urinary disorders Motor, sensory disturbances Immunologic and lymphatic disorders Reproductive disorders

I. Toxicological emergencies



Clinical Competencies 1. Demonstrate knowledge of the assessment of patients with organ/system disorders.2. Monitor pathophysiological alterations seen in different types of medical emergencies.3. Monitor patients’ homeostasis.4. Measure fluid intake and output correctly.5. Compare the physiological changes seen in different types of medical emergencies.6. Interpret knowledge related to pathophysiological changes to implement appropriate

nursing interventions.

Module VI: Infection Control

Learning Objectives: At the end of this module, the learner will be able to: 1. Delineate the professional responsibilities associated with monitoring infection-control

practices and interventions for compliance and safety;2. Explain the chain of the spread of infection and describe the ways infection control

concepts are applied;3. Wear barriers and personal protective equipment (PPE) for the protection from exposure to

potentially infectious materials;4. Explain the importance of reprocessing methods (cleaning, disinfection, and sterilization) to

ensure the safety and integrity of patient-care equipment;5. Identify occupational health strategies to prevent the transmission of blood borne

pathogens and other communicable diseases through healthcare workers.

Module Outline A. Standard Precautions:

Transmission-based precautions Airborne precautions Droplet precautions Contact precautions Empiric precautions Patient placement Transportation of infectious patients

B. Special Infections: Blood borne Infections

○ Hepatitis B○ Hepatitis C○ Hepatitis D

Human Immunodeficiency Virus (HIV) Tuberculosis

○ Mycobacterium Tuberculosis Infection○ Tuberculosis Transmission and Control○ Tuberculosis Control Recommendations

H1N1 and other respiratory organisms MERS.Cov Respiratory protection (precaution) Multiple Drug Resistant Organisms



MRSA and VRE Central line associated blood stream infections (CLABSI)

C. Long-term ventilation D. Cather-related infections

Clinical Competencies 1. Apply the five moments for hand hygiene. 2. Apply all standard precautions. 3. Apply air born precautions. 4. Apply contact precautions. 5. Apply droplet precautions. 6. Apply knowledge of the correct use of PPE. 7. Implement infection-control precautions.

Module VII: Pharmacology for Critically Ill Patients

Learning Objectives: At the end of this module, the learner will be able to: 1. Apply knowledge of the legal and ethical aspects of drug administration and the importance

of correct drug calculations to nursing practice; 2. Calculate drug dosages, read prescriptions, and become familiar with commonly use

medical abbreviations; 3. Discuss the principles of pharmacokinetics, pharmacodynamics, and drug interactions; 4. Discuss the clinical pharmacology of anticoagulant and thrombolytic drugs; 5. Describe toxicological emergencies that occur in the prehospital setting; and 6. Recognize the major classifications and types of drugs used in critical care settings.

Module Outline A. Introduction to pharmacology and the legal and ethical aspects of drug administration B. Dose calculation, administration of IV fluids, drug incompatibilities, and prescription reading C. Principles of pharmacokinetics and pharmacodynamics D. Adverse drug reactions and drug interactions E. Psychological factors affecting drug therapy F. Toxicological emergencies in the prehospital setting G. Drugs and coagulation (anticoagulants, thrombolytics):

Inotropes: Noradrenaline, Dopamine, and Dobutamine Sedatives: Midazolam, Fentanyl high dose, Propofol, and Precedex Sedation Scale: Richmond Agitation-Sedation Scale (RASS)

H. Drugs used in the treatment of different diseases in ICU settings: Respiratory system diseases Cardiovascular system diseases Neurological system diseases Gastrointestinal system diseases Renal system diseases Endocrine system diseases Obstetrical and gynecological systems diseases Behavioral emergencies



Clinical Competencies 1. Apply knowledge of the principles and routes of drug administration and storage forms. 2. Calculate appropriate drug dosages. 3. Administer drugs through a variety of routes safely and efficiently 4. Describe hemodynamic monitoring and normal values. 5. Demonstrate the specialized administration rates used in critical and emergency care. 6. Utilize the systems of drug-dose and drug-level measurement: units of measurement. 7. Apply basic precautions to ensure safe drug administration.


SECOND-YEAR TRAINING MODULES

Module VIII: Epidemiology

Learning Objectives: At the end of this module, the learner will be able to: 1. Describe the mechanisms and dynamics of disease transmission in populations and the

risk factors that determine their distribution; 2. Calculate measures of morbidity, mortality, incidence, and prevalence; 3. Assess the validity and reliability of diagnostic and screening tests; 4. Explain the different mechanisms used to describe disease prognosis in quantitative terms

for groups of patients; 5. Assess the efficacy of preventive and therapeutic measures via randomized trials; 6. Critique epidemiological study designs (cohort, cross-sectional, retrospective, and

prospective); 7. Differentiate between association and causation; 8. Identify potential biases, confounders, and interacting factors in an epidemiological study; 9. Explain the role of genetic and environmental factors in disease causation; 10. Apply epidemiologic methods to evaluate screening programs; 11. Identify the sources of information for disease occurrence; and 12. Critique medical and other health-related research studies.

Module Outline A. Definitions of epidemiology and health B. Dynamics of disease transmission C. Epidemiology of infectious diseases D. Measuring the occurrence of diseases E. Assessing the reliability and validity of diagnostic and screening tests F. Assessing the efficacy of preventive and therapeutic measures through randomized trials G. Cohort studies H. Case control and cross-sectional studies I. Estimating risk and determining associations J. Estimating the potential for prevention K. From association to causation: Deriving inferences from epidemiologic studies L. Bias, confounds, and interactions M. Roles of genetic and environmental factors in disease causation N. Ethical and professional issues in epidemiology

Clinical Competencies 1. Identify the basic principles of epidemiology. 2. Describe the dynamics of disease transmission and occurrence. 3. Determine the associations among diseases and other variables of interest (e.g., patient

characteristics), and estimate the potential for disease prevention. 4. Identify the roles of genetic and environmental factors that contribute to the causation and

occurrence of disease.



Module IX: Nursing Research and Evidence-Based Practice in Nursing

Learning Objectives: At the end of this module, the learner will be able to: 1. Define the basic concepts of research methodology; 2. Describe different research designs; 3. Describe the scientific process and its use in nursing research; 4. Design a research proposal; 5. Define the steps of the research process in the proposal and/or conduct a circumscribed

nursing research project; 6. Identify research problems and the components of the literature review process related to

nursing practice; 7. Compare and contrast research designs; 8. Discuss appropriate statistical techniques used in the analysis of data; 9. Critique current studies of nursing practice; 10. Discuss the utilization of research findings; 11. Discuss the historical perspective of evidence-based practice; and 12. Define and apply evidence-based practice principles, which have been identified through

nursing research.

Module Outline A. Overview of nursing research B. Research methodology and process C. Research designs D. Data collection and analyses E. Evidence based research and application

Clinical Competencies 1. Demonstrate familiarity with research terminology. 2. Demonstrate knowledge of research designs. 3. Conduct a literature search using all resources (electronic and non-electronic resources). 4. Gather and interpret relevant data to make judgments. 5. Identify evidence-based principles and their application to practice. 6. Apply a critical appraisal approach to all steps of the research process. 7. Review and critique journal articles. 8. Formulate a research proposal for an investigation of a topic of interest in the specialty. 9. Apply the research process to the design and implementation of a research project. 10. Prepare a manuscript for publication. Please see appendix 1



Module X: Biostatistics

Learning Objectives: At the end of this module, the learner will be able to: 1. Demonstrate familiarity with statistical terminology and the purpose of statistics;2. Identify ways of organizing data;3. Define and compute measures of central tendency and variability;4. Demonstrate an understanding of the analysis of statistical data within the context of the

research process;5. Provide the necessary statistical rationale for analyzing data and drawing inferences from

the analysis; and6. Demonstrate understanding of the logic of hypothesis testing.

Module Outline A. Descriptive statistics, frequencies, shapes, and measures of central tendencyB. Univariate descriptive statistics, measures of variability, range, standard deviation, scores

in a distribution, z scores, and standardized distributionsC. Bivariate descriptive statisticsD. Inferential statistics, probability, sampling distribution, and hypothesis testingE. Power analysis, Type1 and Type II errors, level of significance/critical regions, confidenceF. interval, one-tailed and two-tailed tests, and parametric testsG. Bivariate inferential statistics, t-tests for independent groups, and paired t-tests (dependent

groups)H. ANOVA, between groups versus within groups, non-parametric tests, chi square, tests forI. independence, and Pearson’s correlation coefficient (r) as an inferential statistic

Clinical Competencies 1. Demonstrate familiarity with the terminology of biostatistics, as listed in the module’s

outline.2. Demonstrate organization of data.3. Define and compute measures of central tendency and variability.4. Discuss the logic of hypothesis testing.5. Analyze data and draw inferences from the analysis.6. Demonstrate an understanding of the role of statistical data in the research process.



Module XI: Healthcare Informatics

Learning Objectives: At the end of this module, the learner will be able to: 1. Describe nursing informatics as an emerging field and identify key factors and legislative

organizations that have helped shape nursing informatics; 2. Discuss evolving models and theories that define the roles of and competencies in nursing

informatics; 3. Explain the implications of nursing informatics for nursing practice, administration,

education, and research; 4. Demonstrate skills in the acquisition and retrieval of nursing information using health

information systems within institutions and through the worldwide web and various electronic resources; and

5. Apply methods to safeguard data and information integrity while maintaining privacy and confidentiality.

Module Outline A. Introduction of nursing informatics and overview B. Nursing informatics goals, standards, and scope of practice C. Nursing informatics competencies (i.e., computer literacy skills, informatics literacy skills,

etc.) D. Models and theories of informatics E. Internet, search engines, electronic databases, and resources F. Selection of healthcare information systems G. System implementation, maintenance, and development H. Data integrity, security, and confidentiality I. Intranet, extranet, and network integration J. Information technology in patient education K. Integrating computers and information technology in nursing education and practice

Clinical Competencies 1. Assess the application of information and communication technology (ICT) in the

management of patients/patient-related data. 2. Identify different models of computerized health-care electronic records. 3. Differentiate among the models of health information management systems. 4. Analyze the implications for healthcare delivery arising from tele-health and telemedicine. 5. Recognize the impact of the information-technology revolution on nursing practice. 6. Apply skills to access, create, store, and retrieve nursing–related information from the

internet and the worldwide web. 7. Demonstrate ways of integrating nursing informatics with nursing administration, education,

clinical practice, and research. 8. Identify security regulations to safeguard data consisting of information about patients and

organizations. 9. Recognize ethical issues related to nursing informatics. 10. Assess the future of information technology and its impact on the nursing practice.



Module XII: Leadership and Management

Learning Objectives: At the end of this module, the learner will be able to: 1. Analyze the components of organizational structure and culture; 2. Apply theories of effective leadership and management in selected healthcare areas; 3. Employ the skills of the nursing process, critical thinking, ethical decision-making,

communication, and therapeutic nursing interventions in managing culturally competent and cost-effective care of groups of patients across the wellness/illness continuum;

4. Collaborate with multidisciplinary healthcare team members in prioritizing and coordinating health care that is high quality and cost effective;

5. Demonstrate leadership and management of a care-giving team comprised of individuals with varied cultural backgrounds and levels of clinical knowledge and competencies;

6. Utilize inquiry and research skills to enhance the healthcare team’s knowledge base, facilitate change, and improve quality of care;

7. Demonstrate professional accountability for effective leadership in nursing practice; and 8. Contribute to the organization’s strategic planning and its implementation at different levels

within the healthcare facility.

Module Outline A. Organizational structure and culture B. Application of leadership and management theories C. Organizational and personal mission, vision, and goals D. Critical thinking, problem solving, and effective decision making E. Quality and risk management F. Budgeting, cost, care-delivery models, and staffing G. Communication, motivation, and team building H. Change and conflict management I. Role transition and delegation J. Strategic planning and strategic management K. Career planning

Clinical Competencies 1. Apply “systems thinking” to analyses of healthcare organizations. 2. Utilize effective time-management skills. 3. Discuss and implement the principles of information management. 4. Utilize resources effectively (i.e., staffing and scheduling, resource allocation, etc.) 5. Examine a healthcare organization’s financial management (cost analyses, budget

forecasting, etc.) 6. Develop plans for quality and risk management (quality plans, risk management models,

etc.). 7. Use organizational principles to manage organizational change and conflict resolution. 8. Outline the steps of the strategic planning process. 9. Identify the components of strategic management. 10. Develop a career plan based on trends in health care.



Module XIII: Professional Development

Learning Objectives: At the end of this module, the learner will be able to: 1. Assume responsibility for personal and professional development;2. Initiate independent learning activities;3. Provide care in an inter-professional environment;4. Advocate for the health and safety of patients;5. Identify differences between effective and ineffective communication;6. Discuss the meaning of active listening;7. Identify three skills necessary for active listening;8. Describe ways patients and coworkers benefit when nurses communicate effectively;9. Discuss the difference between “I” and “You” statements; and10. Identify skills required for therapeutic communication.

Module Outline A. Sources of data for evidence-based practiceB. Educational process (teaching and learning principles)C. Legal issuesD. Ethical issuesE. Patient advocacyF. Quality assuranceG. Professional developmentH. Multidisciplinary collaborationI. Effective communication

Clinical Competencies 1. Assume responsibility for personal and professional development.2. Initiate independent learning activities.3. Advocate for the health and safety of patients.4. Describe and provide examples of differences between effective and ineffective

communication.5. Define and demonstrate the meaning of active listening.6. Demonstrate three skills necessary for active listening.7. Demonstrate through role-play, three ways patients and coworkers benefit when nurses

communicate effectively.8. Demonstrate the difference between “I” and “You” statements.9. Demonstrate through role-play, the skills required for therapeutic communication.



Module XIV: Intensive Care Nursing Practicum I

Learning Objectives: At the end of this module, the learner will be able to: 1. Understand the principles of the electrocardiogram (ECG) and 12-Leads ECGs; 2. Discuss the measures used to control hemorrhage related to head trauma, such as

subdural hematoma and subarachnoid hemorrhage; 3. Discuss the difference between internal and parenteral nutrition; 4. Describe the route used for blood glucose monitoring and the nursing care for diabetic

ketoacidosis; and 5. Insert a urinary bladder catheter correctly and manage patients undergoing supra-pubic

bladder drainage.

Module Outline A. The principles of the ECG and the 12-Leads ECG B. Nasogastric tube intubation and removal C. Hemorrhages related to head trauma, such as subdural hematomas and subarachnoid D. hemorrhages E. Enteral and parenteral nutrition F. Blood glucose monitoring techniques and nursing care for diabetic ketoacidosis. G. Catheterization of the urinary bladder H. Management of patients undergoing suprapubic bladder drainage. I. Glasgow Coma Scale

Clinical Competencies 1. Monitor a cardiac ECG and demonstrate skills for a 12-Leads ECG interpretation and

tracing. 2. Manage patients undergoing invasive hemodynamic monitoring. 3. Apply principles to nasogastric tube insertion and removal. 4. Perform the measures used for control of esophageal bleeding. 5. Administer enteral and parenteral nutrition. 6. Teach patients to monitor their blood glucose and perform self-administered injections of

Insulin. 7. Perform urinary bladder catheter insertion and removal. 8. Manage patients undergoing suprapubic bladder drainage. 9. Use the Glasgow Coma Scale in the clinical setting.



Module XV: Intensive Care Nursing Practicum II

Learning Objectives: At the end of this module, the learner will be able to: 1. Effectively monitor central venous pressure (CVP) and provide related nursing care;2. Assist in central venous catheter (CVC) insertion;3. Assist with arterial lines and related hemodynamics monitoring;4. Assist with the insertion of a peripherally inserted central catheter (PICC) line and provide

related nursing care;5. Administer blood and blood-products transfusions safely to patients in ICUs;6. Assist with chest tube (CT) insertion, monitoring, and nursing care;7. Provide evidence-based nursing care for patients with a CVA;8. Assist with intracranial pressure (ICP) and external ventricular drain (EVD) insertion,

monitoring, and related nursing care;9. Manage continuous renal replacement therapy (CRRT) operation and monitoring in

accordance with the ICU’s protocols.

Module Outline A. Demonstrate knowledge of the indications of CVP and the interpretation of related dataB. Understanding the indication for an arterial line and interpret arterial line parameters.C. Understand the indication for a PICC line.D. Demonstrate optimal blood and blood-products transfusions safely.E. Review updated nursing care for the patient with a chest tube.F. Acquire knowledge and clinical skills to provide effective nursing care for patients with

CVAs, ICPs, and EVDs.G. Understanding CRRT operations and monitoring.

Clinical Competencies 1. Implement nursing care related to CVP and interpretation of CVP-related data2. Demonstrate competence when assisting with the insertion of an arterial line and in the

interpretation of arterial line parameters.3. Perform the ideal nursing care for patients with PICC lines.4. Demonstrate optimal safety during the administration of blood and blood products

transfusions.5. Implement proficiency in providing nursing care for the patient with a chest tube.6. Demonstrate effective knowledge and clinical skills when providing nursing care for

patients with CVAs, ICPs, and EVDs.7. Demonstrate competence in implementing CRRT operations and monitoring.


ASSESSMENT Overall, the evaluation and assessment of trainees is carried out in accordance with the Saudi Commission training and examination rules and regulations. Assessment is divided into two parts: Formative Assessment Summative Assessment

A. The Formative Assessment The main aim of the formative assessment is to evaluate every aspect of the trainee’s performance during his or her time at the training center. This process enables those involved in the training process (i.e. head nurses) to provide objective feedback. It also involves evaluating interactive training activities such as case studies and seminars. A report will be submitted to the Training Supervisory Committee of the Specialty for review and follow-up of the trainee’s progress. The following components are parts of the continuous evaluation process, for further details on assessment tools criteria, frequency, and scoring, please refer to the updated statement from the Scientific Committee of the specialty:

Chart -1: Description of Formative Assessment Tools (please refer to SCFHS executive policy of continuous assessment for further details,

available on www.scfhs.org )

ASSESSMENT


B. The Summative Assessment The end-of-program examinations are comprehensive. The trainee will be awarded his or her diploma certificate once he/she has successfully completed these examinations. 1. Final Written Examination

This exam assesses the trainees’ theoretical knowledge and critical thinking skills in relation to all of the topics and clinical experience covered during the program. The examination format (including the number of questions, eligibility, and the scores required to pass) will be based on the Saudi Commission Examination Rules and Regulations, available from the Saudi Commission Website, https://www.scfhs.org.sa/MESPS/ TrainingProgs/RegulationBoard/Pages/default.aspx

2. Final Clinical Examination An objective structured clinical examination (OSCE) will be held to assess the trainees’ clinical skills, including data gathering, patient management, communication, and counseling. This examination will include a specific number of stations designed to achieve the training objectives. The examination format (including the number of questions, eligibility, and scores required to pass) will be based on the Saudi Commission Examination Rules and Regulations, available from the Saudi Commission website, https://www.scfhs.org.sa/MESPS/TrainingProgs/RegulationBoard/Pages/default.aspx

Certification The certificate of training completion will be only issued upon the trainee’s successful completion of all program requirements, including training modules, rotations, competencies and formative assessment. Trainees completing the program will be eligible to set for final examination and upon success will be awarded a postgraduate certificate of “Nursing Saudi Diploma in Adult Critical Care”.

https://www.scfhs.org.sa/MESPS/TrainingProgs/RegulationBoard/Pages/default.aspx


MODULE REFERENCES Moon, J. & Kim, J. (2015). Ethics in the Intensive Care Unit. Journal of Tuberculosis and

Respiratory Diseases. Morton. G, Fontaine. K. (2013) Critical Care Nursing: A Holistic Approach, 10th ed.

Philadelphia. Lippincott Williams & Wilkins Urden, L. D., Stacy, K. M., & Lough, M. E. (2013). Critical Care Nursing, Diagnosis and

Management, 7th ed. Critical Care Nursing: Elsevier/Mosby. Sally S. Roach (2004). Introductory Clinical Pharmacology .7th edition. Lippincott Williams &

Wilkins Jarvis, C. (2015). Physical Examination and Health Assessment: Elsevier Health Sciences. Gordis, Leon. (2014). Epidemiology. 5th Ed. Saunders, Elsevier. Polit. d, beck .c, (2003). Nursing Research: Principles and Methods. 7th ed. Lippincott. Plichta. S, Garzon.L, (2009). Statistics for Nursing and Allied Health. 1st ed. Lippincott. Jones. R, (2007). Nursing Leadership and Management: Theories, Processes, and

Practice. Davis Company.


CURRICULUM DEVELOPMENT REFERENCES For further information about leaves, refer to Article 6 of the Rules of Procedure for Training of

Saudi Board Specialties authored by the Saudi Commission for Health Specialties Training and Examination, 4th edition, 2012, available at: http://www.scfhs.org.sa/en/Reglations/ Documents/Rules%20of%20Procedure%20for%20Training%20of%20Saudi%20Board%20Specialties.pdf (Accessed: May 21, 2016)

For information about the severe shortage of nurses internationally, refer to Nurses for a

Healthier Tomorrow, a coalition of many healthcare organizations, available at: http://www.nursesource.org/critical_care.html (Accessed May 21, 2016)

Needham, D. M., et al. Improving long-term outcomes after discharge from intensive care unit:

Report from a stakeholders’ conference. Critical Care Medicine. 40(2); (2012): 502-509. The SCFHS Digital Library provides instructors and trainees access to diverse electronic

learning resources, including full-text evidence-based reports of best practices, such as the Ovid Medical Collection, Mosby’s Nursing Consult, LexiComp, PubMed Central, and the up to date Digital Library that is available at: http://www.scfhs.org.sa/eservices/ ELibrary/Pages/default.aspx (Accessed: May 21, 2016)

Instructors and trainees will refer to an electronic logbook, in which trainees record their

learning activities that can be reviewed by the instructors. The instructions and login website for users are available at: http://www.scfhs.org.sa/en/MESPS/TrainingProgs/ ElectrobookCases/Pages/default.aspx (Accessed: May 21, 2016) www.scfhs.info/medical/ Bmedical/login.php

For information about the clinical practice, certification, and education of critical care nurses

internationally, refer to the website of the American Association for Critical-Care Nurses, available at: http://www.aacn.org (Accessed: May 21, 2016)

Instructors and trainees will need to refer to the Saudi Commission for Health Specialties

General Examination Rules and Regulations, 4th edition, 2011, which is available at: http://www.scfhs.org.sa/en/Reglations/Pages/default.aspx (Accessed May 21, 2016)

For further information about evaluation, promotion, and completion of training, refer to Article 7

in the Rules of Procedure for Training of Saudi Board Specialties, authored by the Saudi Commission for Health Specialties Training and Examination, 4th edition, 2012, available at: http://www.scfhs.org.sa/en/Reglations/Pages/default.aspx (Accessed May 21, 2012)

http://www.scfhs.org.sa/en/MESPS/TrainingProgs/


APPENDICES

Appendix 1

Nursing Research Project Guidelines Under the guidance of an adviser, the trainee takes three credit hours for a research project and submits it to the adviser. The trainees are allowed to work in the research as an individuals or in a group work. The clinical research project falls under the supervision of a faculty member and employs the scientific process in analyzing a clinical problem or issues related to advanced nursing practice. Emphasis is on a project that has tangible application to the practice setting.

Learning Objectives At the end of this module, the trainee will be able to: 1. Demonstrate the ability to collect, analyze, synthesize, and evaluate information;2. Formulate research questions on problems of clinical significance in advanced nursing

practice;3. Critically analyze and apply studies pertinent to patient care;4. Interpret research findings and recommendations to patients, agencies, and health care

professionals; and5. Write a scholarly paper in a format suitable for professional publication.

Clinical research project guidelines

Utilization Studies A trainee may conduct a research utilization project that is relevant to nursing. Examples include the design of clinical protocols for the implementation of previous research findings.

Pilot Studies A trainee may conduct a small-scale study as a foundation for future study, for example, a pilot study (based on a smaller sample or refined methodology), a descriptive survey of a group targeted for later study, an intervention study, or a study that establishes or extends the reliability and validity of a tool.

Replication Studies A trainee may conduct an exact or approximate replication (under similar conditions) of a study in order to extend the findings of previous research.

Advisor For each research project, one faculty member will function as advisor, who gives final approval for the trainee to register for the course, advises the trainee during implementation of the project, verifies that all requirements for the project and written report have been met, and submits the final course grade. Graduate faculty will assign faculty members to the role of advisor or reader.

APPENDICES


For preliminary approval (prior to registration for the project module) 1. Select an advisor for the project who has expertise or an interest in the area of your

proposed clinical research 2. Provide a description of the project, including the following:

Problem statement Purpose and objectives of the project Significance of the project

Completion of the project module 1. Register for the project module assigned to an advisor. 2. Attend conferences with the advisor as recommended or requested. Submission of working

drafts of the research report to the faculty advisor is recommended. 3. Submit copies of the written research report to the advisor.

Evaluation 1. Written research report 2. Completion of the clinical research project, as outlined.

Grading criteria The maximum score for this paper is 100 points (see the project assessment tool below). Each item is weighted in terms of its importance in fulfilling the purposes of the project.

Research Project Assessment Tool

Trainee: ID Number: Date: Specialty Area for Research: Program Director: Mark Obtained: Percentage: Scientific Nursing Research 0 1 2 N/A Remarks The title page includes the following: Topic Candidate’s name and surname Course name Timely submission /4 The table of contents includes the following: Headings/sub-headings Numbering of headings/sub-headings

APPENDICES


Page numbers indicate where the headings appear in the text.

Headings/sub-headings correspond with those in text.

/4 Introduction: The clinical problem to be researched is stated.

Background information to the clinical problem is provided.

The importance of conducting the research is stated.

/6 Problem Statement: The problem statement is formulated either in question or declarative form.

The problem statement includes the topic, target group, and setting.

/4 Purpose and Objectives: The purpose of the intended research is stated.

Measurable objectives are stated to support the purpose.

/4 Definitions: The main concepts in the topic, problem statement, purpose, and objectives are defined.

/2 Literature Review: The literature review is relevant to the research problem.

Mainly primary sources are reviewed.

The sources are up to date (not older than five years, except classical sources).

The best/most relevant evidence has been collected to support the data.

/8

APPENDICES


In-text citations (Harvard method) are included to avoid plagiarism.

/2 Research design, Population, Sample and Sampling: The selected research design is motivated.

The research population is described.

The research sample is described. The sampling method is described.

/8 Ethical Considerations: A letter requesting permission to conduct research in a particular setting is included (Appendix).

Informed consent from the patient was obtained (where applicable).

Confidentiality of data is maintained.

/6 Data Collection Method and Analysis: The data collection method is described.

A structured questionnaire is included (where applicable).

The reliability and validity of the data collection method/instrument is described.

An appropriate data analysis method is selected (e.g. pie chart).

/8 Discussion: A conclusion is drawn from the research findings.

The strengths and weaknesses of the research project are briefly described.

Recommendations are made for future research practices.

/6

APPENDICES


List of Sources: A detailed list of sources is included. The list of sources appears on a separate page. A variety of up to date sources are consulted. The sources correspond with the text references. The sources are in alphabetically order (according to the surname of the author). The sources are not numbered. The appendices appear after the list of sources.

/7 General: The research report is neat The research steps flow systematically. The research report is free of spelling mistakes. The correct use of grammar. Effort was done. Timely submission of the research report.

/6 Total: /75 Comments: Program Director: _________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Program Director Name: Signature: Date:

Trainee Name: Signature: Date:

APPENDICES


Appendix 2

SCFHS Guidelines for Mentor

Goals of mentorship 1. Guidance of trainees towards personal and professional development through continuous

monitoring of progress 2. Early identification of both struggling and high achieving residents 3. Early detection of trainees at risk of emotional and psychological problems 4. Provision of career guidance

Roles of the Mentor The primary role of a mentor is to nurture a long-term professional relationship with his/her assigned trainees. The mentor is expected to provide an “academic home” for trainees so that they might feel comfortable sharing their experiences, expressing their concerns, and clarifying issues in a nonthreatening environment. The mentor is expected to maintain confidentiality with regard to sensitive information about trainees The mentor is expected to make appropriate and timeous referral to the program director or department head if a problem arises requiring expertise or resources beyond his/her capacity. Example of such referral might include: 1) Serious academic problems, 2) Progressive deterioration of academic performance, 3) Potential mental or psychological issues, 4) Personal problems interfering with academic duties, 5) Professional misconduct, etc. Note that the following are NOT expected roles of a mentor: 6) Providing extra tutorials, lectures, or clinical sessions 7) Providing counseling for serious mental and psychological problems 8) Involvement in trainees’ personal matters 9) Providing financial or other material support

Roles of the trainees 1. To submit a resume at the beginning of the relationship 2. To provide the mentor with short-term (one year) and long-term (two year) goals 3. To take primary responsibility in maintaining the relationship 4. To schedule four-weekly meetings with the mentor in a timely manner, avoiding requests

for ad hoc meetings except in an emergency 5. To recognize self-learning as an essential element of specialty training 6. To report any major events to the mentor in a timely manner

Who can be a mentor? Any faculty member of consultant grade and above within the specialty program can be a mentor. No special training is required.

APPENDICES


Number of trainees per mentor As a guideline, each mentor should have no more than four to six trainees. As far as possible, trainees from both first and second years of training should be assigned, so that a senior trainee might guide a junior trainee.

Frequency and duration of engagement The recommended minimum frequency of trainee–mentor meetings is once every four weeks. Each meeting may take 30 minutes to an hour. It is preferable for each trainee to remain with the same mentor for the entirety of his/her training i.e., for two years.

Tasks during each meeting The following are suggested tasks to be completed during each meeting: 1. Discuss overall clinical experience of the trainee with particular attention to any concerns

raised. 2. Review logbook or portfolio with the trainee to determine whether the trainee is on target

for meeting training goals. 3. Revisit earlier concerns or unresolved issues, if any. 4. Explore any non-academic factors seriously interfering with training. 5. Document excerpts of the interaction in the logbook.

Mandatory reporting to program director or department head 1. Consecutive absence from three scheduled meetings without valid reason 2. Unprofessional behavior 3. Consistent underperformance despite counseling 4. Serious psychological, emotional, or health problems that may potentially lead to unsafe

patient care 5. Any other serious mentor concern

APPENDICES


Appendix 3

Adult Critical Care Nursing

In-Training Evaluation Reports

Evaluated By :evaluator’s name Evaluating :person (role) or moment’s name (if applicable) Dates :start date to end date

* Indicate Mandatory response

N/A Clear Fail (1)

Borderline (2)

Clear Pass (3)

Exceed Expectations

A. MEDICAL EXPERT: History & Physical Examination: 1. Comprehensive, accurate &

concise with all relevant details

Diagnostic Tests: 2. able to carry out diagnostic

procedures safely

Clinical Decision: 3. Able to formulate appropriate

nursing diagnosis according to NANDA

4. Able to analyze, integrate, and formulate effective and holistic nursing care plan.

Knowledge: 5. Broad Clinical & Basic

knowledge of a wide variety of medical problems and develops a plan of secondary prevention.

6. review current evidence based literature in a scientific way

7. participate effectively in scientific activity

8. utilize research to improve the clinical knowledge and practice

Emergency Management: 9. Able to identify and respond

appropriately to urgent cases

APPENDICES


Evidence-based Practice/Critical Appraisal Skills:

10. Aware of the role of evidence in clinical decision-making.

11. Able to apply relevant information in problem solving.

12. Demonstrates knowledge of medications used, mechanisms of action, clinically relevant pharmacokinetics, indications, contraindications, and adverse effects.

Procedural Skills: 13. show time- management skills

in carrying out procedures

14. Document and records nursing notes accurately in accordance with organization policy.

15. recognize possible limitations and complications

16. understand the rational and indications of the procedure

17. Act as consultant/ supervisor for junior staff in the department

18. Follow the procedures checklist according to patient situation

19. Utilize critical thinking abilities to take decisions in emergencies or deviations.

B. COMMUNICATOR 20. Communicates effectively with

patients, their families, and HCPs.

21. Able to maintain clear, accurate & appropriate records.

22. Written orders and progress notes are well organized & legible.

23. Discharge summaries are concise & completed promptly.

C. COLLABORATOR: 24. Works effectively in a team

environment with attending, juniors & nursing staff.

APPENDICES


D. MANAGER : 25. Serves in administration and

leadership roles as appropriate.

26. Appropriate & efficient use of health care resources.

E. SCHOLAR : 27. Attends and contributes to

rounds, seminars, and other learning events.

28. Accepts and acts on constructive feedback.

29. Contributes to the education of patients, junior residents, house staff, and students.

30. Contributes in scientific research.

F. HEALTH ADVOCATE : 31. Able to identify the

psychosocial, economic, environmental & biological factors, which influence the health of patients and society.

32. Offers advocacy on behalf of patients at practice and general population levels

G. PROFESSIONAL : 33. Delivers the highest quality of

care with integrity & compassion.

34. Recognizes limitations and seeks advice and consultations when necessary.

35. Reflects the highest standards of excellence in clinical care and ethical decision making

36. show discipline and reliability

37. Reflects the highest standards of excellence in multidisciplinary teamwork.

Comments (areas of strengths/areas for improvement)

APPENDICES


The following will be displayed on forms where feedback is enabled (for the evaluator to answer...) *Did you have an opportunity to meet with this resident to discuss their performance?

Yes No

(for the evaluee to answer...) *Are you in agreement with this assessment?

Yes No

Please enter any comments you have (if any) on this evaluation.

APPENDICES


Appendix 4 Trainee: Name: __________________________ Ward/Unit: ________________________

Adult Critical Care Nursing Diploma Logbook

Specialty: Day/date Registration No.: Level of

Training: T1 T2

Patient Data

Demographic data: Age: ……. Gender: …… Occupation: ………….…………………… Education: ….…………… Marital status: ………… Religion ………………… Medical Diagnosis: …………………… Admission date…………………….

Current Health Status :

Chief Complain:

………………………………………………………………………………………..

Present Illness:

………………………………………………………………………………………..

Past History:

………………………………………………………………………………………..

Family History:

………………………………………………………………………………………..

APPENDICES


Physical assessment (Systems review)

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

Diagnostic studies and investigation:

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

Safety assessment and Precaution (risk assessments and isolation precaution):

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

Nursing Process

(Nursing Care Plan)

Assessment data: Subjective: ………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

Objectives:

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

APPENDICES


Nursing Diagnosis (using NANDA terminology)

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

Planning

Goal:

………………………………………………………………………………………..

………………………………………………………………………………………..

Objectives:

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

………………………………………………………………………………………..

Intervention

1- ……………………………………………………………………………………..

……………………………………………………………………………………..

2- ……………………………………………………………………………………..

……………………………………………………………………………………..

3- ……………………………………………………………………………………..

……………………………………………………………………………………..

4- ……………………………………………………………………………………..

……………………………………………………………………………………..

Evaluation

………………………………………………………………………………………..

………………………………………………………………………………………..

APPENDICES


Learning Points

1- …………………………………………………………………………………..

2- …………………………………………………………………………………..

3- …………………………………………………………………………………..

Controlled and Signed: Program Director: _________________

APPENDICES


Appendix 5 Adult Critical Care Nursing Diploma

Case-Based Evaluation Rating Form

Specialty

Trainee’s Name Registration No. Date Level of Training T1 T2

Brief summary of case

New Case

Follow-up Case

Assessment setting:

Inpatient Ambulatory ICU CCU NICU

Emergency department Others________

Complexity:

Low Moderate High Assessment:

No Questions Score Unsatisfactory S satisfactory Superior 1 2 3 4 5 6 7 8 9 10

1 History taking 2 Physical examination skills

3 Nursing care plan 4 Communication skills 5 Critical judgment 6 Humanistic

quality/professionalism

7 Organization and efficiency 8 Overall clinical care Total Score

APPENDICES


Total Score { } Total Mark: x 10 = % No. of Evaluated { } Suggestions for Development: 1 2 3

Evaluator: ________________________ Signature: ________________ Date:____________

Question Description History taking Facilitates patient’s narrative; uses appropriate questions to

obtain accurate, adequate information effectively; responds to verbal and nonverbal cues appropriately

Physical examination skills Follows an efficient, logical sequence; examinations are appropriate for clinical problems; provides patients with explanations; is sensitive to patients’ comfort and modesty

Nursing care plan Plans patient-specific care , Implements nursing interventions and makes individualized therapeutic decisions related to the patient’s condition and planned outcomes

Communication skills Explores patients’ perspectives; jargon free speech; open and honest; empathetic; agrees management plans and therapies with patients

Critical judgment Forms appropriate diagnoses and suitable management plans; orders selectively and performs appropriate diagnostic studies; considers risks and benefits

Humanistic quality/professionalism

Shows respect, compassion, and empathy; establishes trust; attends to patient’s comfort needs; respects confidentiality; behaves in an ethical manner; is aware of legal frameworks and his or her own limitations

Organization and efficiency Prioritizes; is timely and succinct; summarizes

Overall clinical care Demonstrates global judgment based on the above topics

APPENDICES


Appendix 6

Adult Critical Care Nursing Diploma Trainee’s Overall Evaluation of The Training Program

(This tool is to be used by a trainee to evaluate the program after each year of training. The evaluation feedback is to be discussed by the program director and program supervisory

committee to identify improvement opportunities.) Program Name: Hospital Name: Program Director Name: Date of Program, From: __________ To: _________ Unit/area of training:

Region: Duration of Program:

Performance Indicators: Weak: 1 Fair: 2 Good: 3 Very Good: 4 Excellent: 5 Assessment Criteria 1 2 3 4 5

General Information: 1 The program participants manual included all information I

needed to know about the program.

2 I had adequate knowledge about the program before it started.

3 The overall program goals were clearly explained to me before the start of the program.

4 The knowledge to be gained during the course of the program was introduced to me before the start of the program.

5 The skills to be mastered during the program were explained to me before it started.

Program Curriculum:

6 The program content met its stated objectives. 7 I was satisfied with the quality of the content. 8 An appropriate amount of material was covered. 9 The activities in the program helped me achieve the stated

objectives.

10 The program materials were well designed and organized to aid understanding.

11 Instructional methodologies (case studies, examples, group work, etc.) were used appropriately to aid the understanding of the subject.

12 The structure of the program helped me acquire the required knowledge to practice my specialty professionally.

13 The structure of the program helped me develop the required skills to practice my specialty competently.

LEARNING OPPORTUNITIES


14 The structure of the program emphasized the concept of respect for others.

15 The structure of the program emphasized the concept of compassion for others.

16 The structure of the program emphasized the concept of patients’ autonomy.

17 Learning opportunities to improve computer use skills (e.g., training sessions) were suggested.

18 The structure of the program emphasized the concept of patients’ privacy rights.

19 The sequence of training was appropriate. 20 During the course of the program, I was introduced to the

required elective activity (research/education, administrative training, or simulation).

21 The program emphasized the “nursing expert” competency as stated in the Mosby.

22 The training program introduced me to principles of patient safety.

23 The training program introduced me to principles of healthcare quality improvement.

24 I was given an opportunity to participate in a patient safety or healthcare quality project at my training center.

25 Required readings/texts were valuable. 26 Readings, homework, and laboratories contributed to my

appreciation and understanding of the subject. Faculty:

27 Instructors were well prepared for the course. 28 Instructors facilitated the achievement of the program’s

learning objectives. 29 Instructors had an adequate level of communication skills. 30 Instructors used a variety of training methodologies. 31 Instructors were able to maintain an effective learning

environment. 32 Instructors connected learning objectives to content. 33 Instructors cooperated with trainees. 34 Instructors motivated me to interact with other trainees. 35 Instructors encouraged me to interact with

employees/trainees from other professions. 36 Instructors provided me with sufficient feedback about my

learning. 37 Instructors encouraged and guided me in participating in a

patient safety or healthcare quality project at my training center.

APPENDICES


38 Instructors provided me with timely feedback. 39 Instructors demonstrated competence in their specialty. 40 Instructors used technology (audiovisuals) to enhance

education. 41 Instructors were adequately accessible to trainees during

office hours or after class. 42 Instructors were enthusiastic about teaching the program. 43 Instructors were dynamic and energetic in conducting the

program. Evaluation:

44 I was regularly supervised by my instructors and preceptors.

45 The level of evaluation was based on the expected level of competency.

46 The evaluation was based on measurable objectives. 47 I was made aware of the type of evaluation to be used. 48 I was made aware of the frequency of evaluation. 49 I was made aware of evaluation policies. 50 I was made aware of the mechanism of evaluation data

collection. 51 I was made aware of my legal responsibilities. 52 I was made aware of education/training policies at my

training center. 53 I was made aware of how to access policies at my training

center. 54 I was made aware of the how to obtain educational

resources. 55 I was evaluated based on the Mosby “nursing expert”

competency. Examinations:

56 Feedback on examinations/graded materials was valuable. 57 Methods of evaluating trainee work were fair and

appropriate. 58 Examinations/graded materials tested course content as

emphasized by instructors. 59 Access to the SCFHS online universal topics was

adequate. Participants:

60 I was able to develop self-evaluation skills during the program.

61 During the course of the program, I was given a chance to evaluate my performance.

APPENDICES


62 I was encouraged to develop my personal learning

objectives.

63 I developed a list of personal learning objectives to achieve during the program.

64 I read the details of the program (manual and curriculum). 65 I understood the details of the program (manual and

curriculum).

Environment: 66 I had convenient access to all training areas. 67 I had convenient access to library services (including

electronic resources).

68 The technologies that were used for training purposes were in working order.

69 Overall, I am satisfied with the program design (curriculum).

70 Overall, I am satisfied with the program management. 71 Overall, I am satisfied with the program environment. 72 Overall, I am satisfied with the outcomes of the program.

Suggestions for improvement: Trainee’s Signature: Date completed:

APPENDICES


Appendix 7

Adult Critical Care Nursing Diploma Presentation Rating Form

(Form 7) Specialty Trainee’s Name Registration

No.

Date of Presentation Level of

Training T1 T2

Topic Please use the following scale to evaluate the presentation

Very weak Weak Acceptable Good Very Good Not Applicable

1 2 3 4 5 N/A No. Description 1 2 3 4 5 N/A

I Nursing Expert 1. Demonstrated thorough knowledge of the

topic

2. Presented at the appropriate level and with adequate details

3. Well-prepared, knows content and answers questions

*Comments (optional) II Communicator 4. Provided objectives and an outline 5. Presentation was clear and organized 6. Used effective methods and presentation

style

7. Established good rapport with the audience *Comments (optional)

III Collaborator 8. Invited comments from learners and led

discussions

9. Worked with supervisor/team effectively in preparing the session

*Comments (optional) IV Health advocate 10. Managed time effectively 11. Addressed preventive aspects of care *Comments (optional)

V Scholar 12. Posed appropriate learning questions 13. Accessed and interpreted the relevant

literature

*Comments (optional)

APPENDICES


VI Professional 14. Maintained patients’ confidentiality if clinical

material was used

15. Identified and managed relevant conflicts of interest

16. Supported conclusions with relevant convincing evidence

*Comments (optional) Total Score

Total Score { } Total Mark: x 20 = No. of Evaluated { }

Overall Performance

Did Not Meet Expectations

Short of Expectations

Met Expectations

Exceeded Expectations

Far Exceeded Expectations

Comments: Evaluator: ______________________________ Signature: ________________________ Date: ________________

%

APPENDICES


Appendix 8

Competency List 1. Arterial and Venous Sheath Removal 2. Arterial Catheter Insertion (Assisting), Care, Removal, and Blood Sampling 3. Arterial Puncture: Arterial Blood Gas Sampling and Interpretation 4. Aspiration Precautions 5. Assessment: Abdomen, Genitalia, and Rectum 6. Assessment: Cardiovascular 7. Assessment: Focused 8. Assessment: General Survey 9. Assessment: Head and Neck 10. Assessment: Intake and Output 11. Assessment: Musculoskeletal and Neurologic 12. Assessment: Nutrition Screening 13. Assessment: Orthostatic Vital Signs 14. Assessment: Respirations 15. Assessment: Thorax and Lungs 16. Assessment: Wound 17. Automated Internal and External Defibrillator (AED) 18. Blood and Fluid Pressure Infusers 19. Blood Glucose Monitoring 20. Blood and Blood Products Administration 21. Blood Specimen Collection: Blood Cultures 22. Burn and Wound Care 23. Cardiac Monitor Setup and Lead Placement 24. Central Venous Catheter Insertion, Blood Sampling, Removal, and Site Care 25. Chest Physiotherapy: Percussion, Vibration, and Shaking 26. Chest Tube Insertion, Removal, and Care 27. Chest Tube: Closed-Drainage Systems 28. Code Management 29. Continuous Renal Replacement Therapy 30. Continuous ST-Segment Monitoring 31. Electrocardiogram: 12 Lead 32. Emergent Sternotomy and Internal Defibrillation: Advanced Practice 33. Endotracheal and Tracheostomy Tube Cuff Care 34. Endotracheal Tube and Tracheostomy Tube: Oxygen Administration 35. Tracheostomy Tube Decannulation 36. Endotracheal Tube Extubation and Tracheostomy Tube Decannulation 37. Endotracheal Tube Intubation 38. Endotracheal Tube and Tracheostomy Tube: Suctioning 39. Endotracheal Tube: Skin and Oral Care 40. Epidural Catheter Insertion, Management and Removal 41. Eye Care for Unconscious Patients 42. Fall Prevention 43. Feeding Tube: Enteral Nutrition via Nasoenteric, Gastrostomy, or Jejunostomy Tube 44. Hemodialysis 45. Hyperthermia Measures

APPENDICES


46. Hypothermia Measures 47. Hypothermic and Hyperthermic External and Intravascular Monitoring 48. Intra-abdominal Pressure Monitoring 49. Intracranial Pressure Monitoring: External Ventricular Drain and Care 50. Intravenous Therapy: Insertion, Discontinuation, and Administration Set Change and Care 51. Intravenous Therapy: Dose and Flow-Rate Calculations 52. Isolation Precautions: Personal Protective Equipment 53. Lumbar Catheter Assisting with Insertion, Care, and Removal 54. Fluid and Electrolytes Infusions 55. Mechanical Ventilation: Volume and Pressure Modes, and Weaning 56. Medication Administration: Intermittent Infusion Methods 57. Medication Administration: Parenteral Routes 58. Nasal Cannula or Oxygen Mask Application 59. Nasogastric Tube: Insertion, Irrigation, and Removal 60. Oral Airway Insertion 61. Oral Care (e.g., Oral Hygiene) 62. Oral Nutrition Assistance for Adult Patients 63. Oxygen Therapy and Oxygen Delivery 64. Preoperative Care 65. Pressure ulcer care 66. Pressure Ulcer: Risk Assessment and Prevention 67. Pressure Ulcer: Treatment 68. Pulse Oximetry 69. Pulse Assessment 70. Skeletal Traction and Pin Site Care 71. Skin Traction 72. Staple and Suture Removal 73. Sterile Gown and Gloves (Closed Gloving) 74. Transducer System Setup and Zeroing 75. Safe Patient Transfer 76. Urinary Catheter: Suprapubic Insertion, Removal, and Care 77. Wound Drain Care 78. Wound Drainage Evacuation 79. Restraint Use as per Policy 80. Sedation Assessment (e.g., RAMSAY)

APPENDICES


Appendix 9

Adult Critical Care Nursing

Rotation Evaluation

Evaluated By :evaluator’s name Evaluating :person (role) or moment’s name (if applicable) Dates :start date to end date

* Indicate Mandatory response Strongly

Disagree Disagree Neutral Agree Strongly Agree

1. I found this rotation to be useful to my training

2. The objectives and clinical competencies were clear to me at the beginning of the rotation

3. I was provided positive and constructive feedback in a timely manner that helped me improve during the rotation

4. I was treated with respect by the faculty and staff. And functioned as part of the healthcare team.

5. I was provided the opportunity to demonstrate my knowledge, skills, and attitudes during this rotation

Any other comments to improve the rotation?

APPENDICES


The following will be displayed on forms where feedback is enabled (for the evaluator to answer...) *Did you have an opportunity to meet with this resident to discuss their performance?

Yes No

(for the evaluee to answer...) *Are you in agreement with this assessment?

Yes No

Please enter any comments you have (if any) on this evaluation.