Vanderbilt University
Hospital
Advanced Practice Orientation
NCU, SICU, MICU, Trauma,
Burn, Neurosurgery
© August 21, 2011 Kapu -- Vanderbilt University Hospital
Advanced Practice Provider Orientation
Checklist for Advanced Practice Provider Orientation
Name of Advanced Practice Provider:
Hire Date:
Prior to first day-You will receive a letter or email from your ACNP team with a basic overview of orientation and identification of your
preceptor(s), contact information, first day of work and New Staff Orientation dates.
Learn more about Nashville! http://www.nashvillechamber.com/Homepage/Relocation/RelocateFamily/GettingEstablished.aspx
Review the Newcomers Guide to Nashville online: http://www.mc.vanderbilt.edu/documents/gme/files/NewcomersGuide1.pdf
Prepare for New Staff Orientation – Review where and when to go, where to park, what to expect, what to bring, what to wear,
etc. http://hr.vanderbilt.edu/training/newstafforientation.php
Review Vanderbilt’s benefits plan online: http://hr.vanderbilt.edu/benefits/benefitspackage.php
Review the Vanderbilt University Faculty Manual online: http://www.vanderbilt.edu/facman/
First two to three weeks -Attend New Staff Orientation Week
Documents to bring to orientation: http://hr.vanderbilt.edu/training/employeeforms.php
 Employment paperwork , including IDs for I-9 form
 Voided check or savings deposit slip, if available (for direct deposit) Must be pre-printed with your name and address.
 Social security numbers of dependents (to complete your Benefits Enrollment Form)
 Supervisor name, department name and department phone number
 ID Card Authorization Form (this will be given to you ahead of time by April or Elizabeth in MCN A1204). Your initial ID
badge will be an RN badge or equivalent, as you are in provisional status until credentialed as an advanced practice
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Advanced Practice Provider Orientation

provider.
Copies of immunization records http://occupationalhealth.vanderbilt.edu/occupational-health-clinic/article/newemployee-evaluation
Attend Coding Class which occurs the Wednesday during Hospital Clinical Orientation). Mandatory for all billing providers.
Training covers stringent documentation, coding and compliance requirements.
Complete Conflict of Interest disclosure (either at orientation or online) https://webapp-a.mis.vanderbilt.edu/coi
Become familiar with how to resolve computer issues through the Help Desk www.mc.vanderbilt.edu/infocntr/helpdesk/
For problems with your VUnet ID or RACF ID, contact: Clara Collins with Security Systems Management -- at 66778
Activate VUnetID - www.vanderbilt.edu/epassword
Obtain pager and/or cell phone when applicable. Contact Shelly Moore for pager – at 26477, Discuss with Asst. Dir as you may
need further information before obtaining pager.
Review shuttle map and boarding locations - www.mc.vanderbilt.edu/root/pdfs/vumctraffic/SHUTTLEMAP.pdf
Review key HR policies: http://hr.vanderbilt.edu/policies
Locate Connect to Human Resources (C2HR) website to review demographics, pay info, etc. – https://webappa.mis.vanderbilt.edu/c2hr
Become familiar with Vanderbilt’s faculty/staff discount program – http://hr.vanderbilt.edu/benefits/perqs.htm
Learn about payroll and the payroll schedule – http://hr.vanderbilt.edu/
compensation/VanderbiltUniversityHumanResources.htm
Learn about Interpreter Services – http://www.vanderbilthealth.com/main/14548
HIPAA and privacy compliance
Webinservice: http://www.webinservice.com/vanderbilt/login50
Privacy Office: www.mc.vanderbilt.edu/root/vumc.php?site=hipaaprivacy
Meet with Health and Wellness about available services
Work/Life Connections-EAP: Drug-free and violence-free workplace policy, crisis intervention, wellness programs
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Schedule systems training classes:
http://www.etraining.mc.vanderbilt.edu
StarPanel, HEO/WIZ
Learn about online training resources
Online safety training: www.vandysafe.com
Online compliance training: www.webinservice.com/vanderbilt/login50
Learning Center: www.vanderbiltlearningcenter.org
Human Resources: http://hr.vanderbilt.edu/training/workshoplist.htm
Identify clinical leaders and administrators in your area and introduce yourself.
Specifically find out who the nursing managers are in your area and introduce yourself. Developing a strong working relationship
with nursing management and the nurses in your area is vital to patient care and successful outcomes. If you ever have nursing
questions or concerns, please communicate with the nursing management.
Review AIDET, HEART and credo behaviors https://www.mc.vanderbilt.edu/vunet/vumc.php?site=Elevatesite VUMC Credo –
“We provide excellence in healthcare, research and education. We treat others as we wish to be treated. We continuously
evaluate and improve our performance.”
I make those I serve my highest priority.
I respect privacy and confidentiality.
I communicate effectively.
I conduct myself professionally.
I have a sense of ownership.
I am committed to my colleagues.
Review SBAR communication -- SITUATION, BACKGROUND, ASSESSMENT, RECOMMENDATION
Advanced Practice Provider Objectives
Review the VUMC Medical Staff Bylaws, Rules and Regulations, Policies and Procedures, and Nursing Bylaws paying particular
attention to Advanced Practice Provider guidelines. -- https://mcapps.mc.vanderbilt.edu/EManual/Hpolicy.nsf/AllDocs/F5A41DF5B2744EC5862577A4005FB159
Review the Tennessee Board of Nursing Rules and Regulations for Advanced Practice Nursing. The BON rules are more specific to
prescriptive prerequisites and the management of pain.
http://www.state.tn.us/sos/rules/1000/1000-04.20100620.pdf
Review the Tennessee Board of Medical Examiners Rules and Regulations for Advanced Practice Providers. The BME rules
mandate a supervising physician and the use of written guidelines for patient management. They stipulate a minimum of 20%
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Advanced Practice Provider Orientation
chart review by the supervising physician. http://tennessee.gov/sos/rules/0880/0880-06.pdf
Review the Center for Advanced Practice Nursing and Allied Health website. Here you will find important information for
Advanced Practice Providers, resource links, educational events, samples of credentialing forms including the “One Packet” and
further orientation information -- http://www.mc.vanderbilt.edu/root/vumc.php?site=CAPNAH
Faculty Offer Letter (for billing providers only) – This letter outlines your terms and agreement of employment. Please sign and
return the signed offer letter within 14 days of receipt.
Faculty Appointment Letter (for billing providers only) – A Faculty Appointment letter is generated by the School of Nursing or
School of Medicine (based on your department) upon receipt of your signed offer letter. A Faculty Appointment for Advanced
Practice Providers is mandatory for all billing providers as set forth in the Medical Center By-Laws.
When you require a faculty appointment letter from the School of Medicine, you will need to submit an updated CV and 3
reference letters, along with your offer letter. Your Assistant Director/Administrator will also submit an Affirmative Action Form.
When you require a faculty appointment letter from the School of Nursing an email needs to be sent by your Administrator/Asst.
Director to Dr. Bonnie Pilon and copy Carolyn Arakelian with the following information:
• the APN’s name as it appears on licensure
• start/end* date *if applicable
• Salary source
• FTE information
• Attach an electronic copy of the APN’s CV
Send Carolyn the following back up documents:
• RN/APN license
• DEA certificate
• Board Certification
• Copies of educational certificates
• Original nursing academic transcripts that correspond to educational certificates
• CPR certification
Schedule One Packet Appointment/Overview – The APP must schedule a meeting with CAPNAH staff, Assistant Director or
Administrator to review the delineation of privileges, notice and formulary, rules and regulations, the development of protocols
and the credentialing/One Packet process.
Complete and Submit the “One Packet” – Initial Credentialing Application. This information provides the basis which Provider
Support Services begins the verification process which takes approximately 90 days. The One Packet is issued by Provider Support
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Advanced Practice Provider Orientation
Services only upon request of the Assistant Director/Administrator or Department Manager and with the approval of CAPNAH
upon receipt of a One Packet (initial) Request Form. Administrators/Assistant Directors can contact PSS directly for a One Packet
Request Form (to be available electronically in the future). A supervising physician must be identified prior to issuing a One
Packet. Protocols and Delineation of Privileges must be near completion prior to release of the One Packet. The One Packet must
be completed by the provider and returned to Provider Support Services together with the following supporting documents:

Copy of Master’s Level Diploma

Copy of original and current RN and APN license

Copy of Board Certification

Copy of Advance Practice Training Certificates

Curriculum Vitae

Copy of US Govt photo ID (driver’s license)

Copy of Social Security Card

Copy of ACLS, BLS cards

Copy of DEA certificate-- http://www.deadiversion.usdoj.gov/drugreg/reg_apps/onlineforms_new.htm

Copy of Notice and Formulary signed by Supervising MD -- http://www2.state.tn.us/health/Downloads/g6014278.pdf

Copy of letter assigning NPI - https://nppes.cms.hhs.gov/

Completed Protocol Signature Sheet

Copies of 3 professional peer references
Review and/or develop your clinical practice protocols –
 Protocols are mandated by the Tennessee Board of Medical Examiners (Chapter 0880-6.02, Tennessee Board of Medical
Examiners Rules and Regulations)
 A protocol is defined as a written guideline for the medical management of a patient’s condition.
 Protocols should be jointly developed and approved by the supervising physician and advanced practice provider.
 Protocols should account for all protocol drugs by appropriate formulary.
 Protocols should be dated and signed.
 Copies of approved protocols must be maintained at the practice site and available for inspection.
 Protocols must be reviewed and/or revised every two years.
 If developing new protocols, you may utilize the protocol development template located on CAPNAH website.
 Protocols can be submitted electronically to CAPNAH for approval.
 Ideally, electronic copies are maintained by Provider Support Services.
 It is acceptable to adopt existing protocols within the same department or division.
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In conjunction with your Assistant Director, complete the billing application. The billing application must include the following:
specific salary source information, job code, cost center numbers. It must be signed by the Department Chair. The completed
billing application form is then forwarded to CAPNAH for approval. The billing application form MUST be accompanied by a copy
of the Faculty Appointment Letter.
Receive Billing Approval (for billing providers only). CAPNAH is obligated to confirm the salary source cost center numbers. The
billing application is sent for vote to the Billing Committee. Once voted upon and approved by the Committee, the information is
then forwarded to Provider Support Services, Epic and Payor Enrollment.
Review your Delineation of Privileges, the list of Domains and Core Competencies for Nurse Practitioners
Health Professions Regulatory Advisory Council
APPENDIX E –
THE NATIONAL ORGANIZATION OF NURSE PRACTITIONER FACULTIES’
2006 DOMAINS AND CORE COMPETENCIES FOR NURSE
PRACTITIONERS
In 2006, the National Organization of Nurse Practitioner Faculties (NONPF) refined the domains and core competencies for Nurse
Practitioners to enhance their usability. The purpose of this revision was not to change the content of the original competencies
but rather to revise the language and presentation to facilitate measurement and evaluation. The resulting articulation of the
Core Competencies reduces the number of terminal competencies to be measured by removing redundant competencies that
appeared in several of the seven domains and by clustering competencies into aggregates.
All Nurse Practitioners should be able to demonstrate these core competencies at graduation. Each set of specialty
competencies builds upon this set of core competencies. Throughout the competencies, patient is defined as the individual,
family, group, and/or community.
DOMAIN 1: Management of Patient Health/Illness Status
The nurse practitioner demonstrates competence in the management of patient health/illness status when she/he:
1. Provides health promotion services
2. Provides disease prevention services
3. Provides health protection interventions
4. Provides anticipatory guidance
5. Provides counseling
6. Promotes healthy environments
7. Incorporates community needs, strengths, and resources into practice
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8. Applies principles of epidemiology and demography in clinical practice
9. Demonstrates critical thinking and diagnostic reasoning skills in clinical decision making
10. Obtains a health history from the patient
11. Performs a physical examination
12. Differentiates between normal, variations of normal and abnormal findings
13. Employs screening and diagnostic strategies
14. Analyzes data to determine health status
15. Develops differential diagnosis
16. Formulates a diagnosis
17. Prioritizes health needs/problems
18. Formulates an evidence-based action plan
19. Initiates therapeutic interventions
20. Manages the health/illness status over time
21. Prescribes medications within legal authorization
22. Counsels the patient on the use of complementary/alternative therapies
23. Evaluates outcomes of care
24. Communicates effectively using professional terminology, format, and technology
25. Provides for continuity of care
DOMAIN 2: The Nurse Practitioner-Patient Relationship
The nurse practitioner demonstrates competence in the nurse/patient relationship when
she/he:
26. Attends to the patient’s responses to changes in health status and care
27. Creates a climate of mutual trust
28. Provides comfort and emotional support
29. Applies principles for behavioral change
30. Preserves the patient’s control over decision making
31. Negotiates a mutually acceptable plan of care
32. Maintains confidentiality and privacy
33. Respects the patient’s inherent worth and dignity
34. Uses self-reflection to further a therapeutic relationship
35. Maintains professional boundaries
DOMAIN 3: The Teaching-Coaching Function
The nurse practitioner demonstrates competence in the teaching-coaching function when she/he:
36. Assesses the patient's educational needs
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Advanced Practice Provider Orientation
37. Creates an effective learning environment
38. Designs a personalized plan for learning
39. Provides health education
40. Coaches the patient for behavioral changes
41. Evaluates the outcomes of patient education
DOMAIN 4 Professional Roles
The nurse practitioner demonstrates competence in the professional role when she/he:
42. Demonstrates evidence-based approaches to care
43. Delivers safe care
44. Functions in a variety of roles
45. Communicates personal strengths and professional limits
46. Advocates for the advanced practice role of the nurse
47. Markets the nurse practitioner role
48. Participates as a member of health care teams
49. Collaborates with other health care providers
50. Consults with other health care providers
51. Advocates for the patient
52. Acts ethically
53. Incorporates current technology
54. Evaluates implications of health policy
55. Participates in policy making activities
56. Provides leadership
57. Accepts personal responsibility for professional development
DOMAIN 5: Managing and Negotiating Health Care Delivery Systems
The nurse practitioner demonstrates competence in managing and negotiating health care delivery systems when she/he:
58. Incorporates access, cost, efficacy and quality when making care decisions
59. Demonstrates current knowledge of health care system financing as it affects delivery of care
60. Analyzes organizational structure, functions, and resources to affect delivery of care
61. Practices within an authorized scope of practice
62. Applies business strategies
63. Evaluates the impact of the health care delivery system on care.
64. Participates in all aspects of community health programs
65. Advocates for policies that positively affect health care
66. Negotiates legislative change to influence health care delivery systems
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DOMAIN 6: Monitoring and Ensuring the Quality of Health Care Practice
The nurse practitioner demonstrates competence in monitoring and ensuring the quality of health care practice when she/he:
67. Monitors quality of care
68. Assumes accountability for practice
69. Engages in continuous quality improvement
DOMAIN 7: Culturally-Sensitive Care
The nurse practitioner demonstrates competence in culturally-sensitive care when she/he:
70. Prevents personal biases from interfering with the delivery of quality care
71. Provides culturally sensitive care
72. Assists patients of diverse cultures to access quality care
73. Incorporates cultural preferences, values, health beliefs and behaviors into the management plan
74. Assists patients and families to meet their spiritual needs
75. Incorporates patient’s spiritual beliefs in care
Discuss and review with your supervising MD or preceptor the Advanced Practice Procedures which you will be performing in
your area.
 Most ICU areas will require Moderate Sedation, Central line placement, Arterial line placement and Post Pyloric Feeding
Tube Placement. Other Advanced Procedures are dependent on ICU requirements.
 Each procedure must have an approved protocol and checklist for performance.
 The advanced practice provider must request specific privileges to perform advanced procedures independently. The
applicant is required to maintain a procedural log as evidence of performance.
 The supervising MD and preceptor observing the applicant performing the procedure must attest that the applicant is
competent to perform the procedure independently.
 Once an applicant has successfully performed the required amount of procedures under supervision, the application for
Advanced Practice Procedures is completed and submitted to Provider Support Services for review.
 Refer to the CAPNAH website to view a sample Application for Special Privileges with the list of approved advanced
practice procedures, number required to apply for initial privileging and number of procedures required annually to
maintain competency. -http://www.mc.vanderbilt.edu/documents/CAPNAH/files/Advanced%20Procedures_VUH_2010-07-09-SAMPLE.pdf
 You will receive a letter of confirmation of privileges once been approved
Presentation of your file at Joint Practice Credentialing Committee. This peer review committee reviews all completed credentials
files for advanced practice providers and makes recommendations for approval. The Committee meets monthly.
Presentation of your file at Medical Center Medical Credentialing Committee. Recommendations for the Joint Practice Committee
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Advanced Practice Provider Orientation
are taken to the Children’s Hospital Credentials Committee if applicable and then to the Medical Center Credentialing Committee.
The Committee meets monthly.
Receive Letter of Notice. Once all committees and the Board of Trust have approved the requested privileges, a letter of Notice is
sent to the advanced practice provider applicant.
Obtain your Advanced Practice Provider ID Badge. Credentialed advanced practice nurses must obtain a navy blue identification
card from the ID card office. Format hint: First line: Name, highest degree followed by board certification; Second line: Title (i.e.
Assistant in … or Nurse Practitioner) Third line: Division/Department
Review the Advanced Practice Provider Professional Performance Evaluation Process:
 Ongoing Evaluation – Continuous monitoring of maintenance of licensure/certification, compliance with VUMC training
modules, charting, productivity, outcome measures and 6-8 month evaluation of competency in six areas: Patient Care,
Medical/Clinical Knowledge, Practice-based Learning and Improvement, Interpersonal and Communication Skills,
Professionalism and Systems-Based Practice. The process can involve electronic review, discussion with any or all of the
following: supervising MD, consulting MDs, administrative personnel, nursing and peers.
 Focused Evaluation – Completed when additional information or period of evaluation is needed to confirm competence in
specific areas. Always completed 6 months after new hire and when applying for new privileges. Can be triggered from an
ongoing evaluation or if other concerns arise regarding practitioner’s competence. The process can involve electronic
review, simulation, monitoring of clinical practice patterns, discussion with any or all of the following: supervising MD,
consulting MDs, administrative personnel, nursing and peers.
Make a list of regularly occurring educational opportunities (i.e. grand rounds, M&Ms, lectures, etc.)
Practice utilization of EMR (Star Panel): Finding labs, reports, note templates, saving documents to a file, amending notes,
accessing sign out tool/team summary, etc. Sign up for additional training if needed. *Reminder that while in provisional status,
all orientee notes must be reviewed by the preceptor and a statement must be made on the document that the preceptor has
reviewed and approved the document.
Practice utilization of other electronic software applicable to your practice area (i.e. IMPAX, KM Portfolio, Quill, etc.). Seek
additional training if needed.
Review your area’s requirements for and method of documentation (i.e. History and Physical, Progress Note, Discharge Summary)
Review your area’s admission and discharge process. Reminder that all admission and discharge documentation notes must be
countersigned by the supervising physician or physician designee within 24 hours.
Review your department orientation manual and checklist. Attend orientation classes as applicable.
Review the Orientation Evaluation tool. This tool is completed both midway and at the end of orientation to customize your
Copyright © 2011 by Vanderbilt University Medical Center
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Advanced Practice Provider Orientation
orientation to your learning needs.
Complete the “Fundamentals of Critical Care Support” FCCS Instructor Course. Email Beverly
Fletcher for dates/times – beverly.s.fletcher@vanderbilt.edu. When applicable, this course may be
funded from your continuing education account.
Attend the Critical Care Nurse Practitioner Orientation Week –
Next course February 28-March 4
Attend the Critical Care Nurse Practitioner Mini Conferences, Simulation Training and Procedural
Training when offered.
Go to the VUH Advanced Practice Critical Care Website for regular updates –
https://www.mc.vanderbilt.edu/root/vumc.php?site=ccapp&doc
Critical Care Specific Learning Objectives
Needs
Improvement
Meets
Expectations
Lab data/ABG analysis. Know normal limits of standard laboratory tests. Recognizes signs and symptoms of
abnormal values. Develops differential diagnoses. Interprets data correctly. Identifies causes. Initiates
appropriate orders. Assesses for response. Consult MD appropriately.
Radiology/CXR analysis. Identify body structures/conditions. Verify line/tube placement.
Electrocardiogram interpretation. Recognize EKG changes associated with medical conditions. Recognize
arrhythmias and/or appropriately seeks consultation.
Ventilator Management. Appropriately orders Mode, Fi02, TV, Rate, PS and Peep. Identifies situations that
require CXRs and ABG analysis. Recognizes cause and need for ventilator adjustments. Consults MD/RT
appropriately. Recognizes trends. Able to direct weaning.
Pulmonary Artery Catheter Management. Demonstrates a working knowledge of hemodynamics (preload,
afterload, contractility, normal values). Makes correct diagnoses. Initiates appropriate orders. Assesses response
to interventions. Consults MD appropriately.
Vasoactive Infusion Management. Initiates vasoactive infusions appropriately. Manages titration of gtts
according to plan. Recognizes need to modify treatment plan. Consults MD appropriately.
Pathway Medications. Identify appropriate situations/times to start medications associated with
disease/surgical pathway.
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Advanced Practice Provider Orientation
Home Medications. Identify when home medications should be held and when they are appropriate to continue
For the following clinical situations, the Advanced Practice Provider demonstrates understanding and competence in the
management of the disease process. Interprets abnormal labs, diagnostics and signs/symptoms. Initiates appropriate
tests and treatment orders. Assesses interventions for response. Consults MD appropriately.
Needs
Improvement
Meets
Expectations
Blood Glucose Management
Arrhythmias
Acute Respiratory Insufficiency/Failure.
Infectious Diseases
Acute Renal Insufficiency/Failure
Acute Coronary Syndrome
Bleeding
Metabolic Acidosis
Sepsis/MODs
Low Cardiac Output Syndrome
Cardiogenic Shock
Hypo/Hypertension
Malnutrition
Stroke
Pulmonary embolism
Hypo/Hypervolemia
Electrolyte Disturbances
Please copy the following links to your web browser to go to the
Society of Critical Care Medicine Adult ICU Training Modules.
Try to complete 2-3 modules per week.
Completed
http://www.learnicu.org/Fundamentals/RICU/Pages/AICUModules.aspx
Acute Kidney Injury
http://sccmmedia.sccm.org/video/AICU/1.-Acute-Kidney-Injury/player.html
Airway Management
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Advanced Practice Provider Orientation
http://sccmmedia.sccm.org/video/AICU/2-Airway-Management/player.html
Arrhythmias Part 1
http://sccmmedia.sccm.org/video/AICU/3-Arrhythmias-Part-1/player.html
Arrhythmias Part 2
http://sccmmedia.sccm.org/video/AICU/3-Arrhythmias-Part-2/player.html
Arrhythmias Part 3
http://sccmmedia.sccm.org/video/AICU/3-Arrhythmias-Part-3/player.html
Arterial Blood Gases
http://sccmmedia.sccm.org/video/AICU/4-Arterial-Blood-Gases/player.html
Cardiogenic Shock
http://sccmmedia.sccm.org/video/AICU/5-Cardiogenic-Shock/player.html
Mechanical Ventilation Basics
http://sccmmedia.sccm.org/video/AICU/6-Mechanical-Ventilation-Basics/player.html
Mechanical Ventilation Advanced
http://sccmmedia.sccm.org/video/AICU/7-Mechanical-Ventilation-Advanced/player.html
Infectious Disease
http://sccmmedia.sccm.org/video/AICU/8-Infectious-Disease/player.html
Sedation
http://sccmmedia.sccm.org/video/AICU/9-Sedation/player.html
Shock
http://sccmmedia.sccm.org/video/AICU/10-Shock/player.html
Homeostasis Problems
http://sccmmedia.sccm.org/video/AICU/11-Homeostasis-Problems/player.html
Venous Thromboembolism
http://sccmmedia.sccm.org/video/AICU/12-Venous-Thromboembolism/player.html
Pulmonary Embolism
http://sccmmedia.sccm.org/video/AICU/13-Pulmonary-Embolism/player.html
Hypothermia
http://sccmmedia.sccm.org/video/AICU/14-Hypothermia/player.html
Nutrition
http://sccmmedia.sccm.org/video/AICU/15-Nutrition/player.html
Critical Care Aspects of Chronic Hepatic Failure
http://sccmmedia.sccm.org/video/AICU/16-Criticial-Care-Aspects-of-Chronic-Hepatic-Failure/player.html
Critical Care for Older Adults
http://sccmmedia.sccm.org/video/AICU/17-Critical-Care-for-Older-Adults/player.html
Endocrine
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Advanced Practice Provider Orientation
http://sccmmedia.sccm.org/video/AICU/18-Endocrine/player.html
Ethics
http://sccmmedia.sccm.org/video/AICU/19-Ethics/player.html
Medical Errors
http://sccmmedia.sccm.org/video/AICU/20-Medical-Errors/player.html
Burns
http://sccmmedia.sccm.org/video/AICU/21-Burns/player.html
Critical Temperature Related Illnesses
http://sccmmedia.sccm.org/video/AICU/22-Critical-Teperature-Related-Illnesses/player.html
Sepsis and Septic Shock
http://sccmmedia.sccm.org/video/AICU/22-Sepsis-and-Septic-Shock/player.html
Guidelines for Sepsis Management
http://sccmmedia.sccm.org/video/AICU/23-Guidelines%20for%20Sepsis%20Management/player.html
Muscular System ICU Care
http://sccmmedia.sccm.org/video/AICU/24-Muscular-System-ICU-Care/player.html
Neurological Emergencies
http://sccmmedia.sccm.org/video/AICU/25-Neurological-Emergencies/player.html
ICU Pharmokinetics
http://sccmmedia.sccm.org/video/AICU/26-ICU-Pharmacokinetics/player.html
Pregnancy
http://sccmmedia.sccm.org/video/AICU/27-Pregnancy/player.html
Obstetric ICU Care
http://sccmmedia.sccm.org/video/AICU/28-Obstetric%20ICU%20Patient/player.html
Acute Respiratory Distress Syndrome
http://sccmmedia.sccm.org/video/AICU/29-ARDS/player.html
ICU Skeletal Concerns
http://sccmmedia.sccm.org/video/AICU/30-ICU-Skeletal-Concerns/player.html
ICU Surgical Issues
http://sccmmedia.sccm.org/video/AICU/31-ICU-Surgical-Issues/player.html
Cardiac Surgery ICU Post Op Care
http://sccmmedia.sccm.org/video/AICU/32-Cardiac-Surgery-Postop-Care/player.html
Principles of Transplantation in ICU
http://sccmmedia.sccm.org/video/AICU/33-Tranplant-Patients-in-ICU/player.html
Ultrasound Guided CVP Placement
http://sccmmedia.sccm.org/video/AICU/34-Ultrasound-Guided-CVP-Placement/player.html
Critical Care Trial Updates 2008
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Advanced Practice Provider Orientation
http://sccmmedia.sccm.org/video/AICU/35-Critical-Care-Trial-Updates-2008/player.html
VUH Advanced Practice Critical Care – Orientation Evaluation
360 Global Evaluation Tool
Name of Practitioner being evaluated:
The competency performance standards are listed with behaviors that would
demonstrate skill within each competency. Document the skill level for each
behavior and document the overall skill level for that competency in the comment
section.
The NP systematically assesses the critically ill patient’s health status and
develops a plan of care.
 Completes physical examination of the patient in a comprehensive and timely
manner.
 Documents assessment data appropriately for progress notes, using appropriate
terminology and format.
 Uses and incorporates the assessment as well as multiple sources of data into the
development of the plan of care and can prioritize this plan based on the
information.
 Demonstrates basic knowledge of anatomy, physiology and pathology in assessment
and plan of care.
 Selects and orders appropriate diagnostic tests to aid in diagnosis based on the
assessment and history.
 Correctly interprets diagnostic data gathered from the patient and incorporates
these findings into the plan of care.
 Demonstrates a basic understanding of normal and abnormal values.
 Demonstrates the ability to make independent judgments when developing the plan
of care.
 Writes progress notes that contain the assessment and comprehensive plan of care.
Copyright © 2011 by Vanderbilt University Medical Center
Date:
Preceptor Comments: Please include rationale for evaluations
of 1. Give examples, if possible, that demonstrate how the NP
does not meet the outcome expected. Also provide examples
that demonstrate a score of 4.
Self-Evaluation
Preceptor Rating
1 2 3 4 N/A
1 2 3 4 N/A
Orientee’s comments:
Preceptor’s comments:
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Advanced Practice Provider Orientation
The NP demonstrates competency in the admission and initial management
of the critically ill patient.
 Obtains a complete health history.
 Recognizes important variables from the history and includes them in the plan of
care.
 Initiates appropriate admission orders.
 Identifies specific potential and actual problems based on knowledge of
pathophysiology.
 Initiates proper diagnostic studies based on assessment and history.
 Exhibits ability to identify common abnormalities and diseases, describes
pathophysiology and matches symptoms to disease processes.
 Reports abnormal findings in a timely manner and documents response in progress
notes.
 Prioritizes problems appropriately and incorporates the assessment in the plan of
care.
 Responds rapidly and appropriately to immediate problems or signs of clinical
deterioration.
 Documents relevant problems and management appropriately in the progress note.
The NP develops an individualized plan of care for critically ill patient
 Provides direct care management and treatment within the scope of the NP role.
 Promotes optimal care through multidisciplinary collaboration.
 Initiates appropriate consultations and documents in progress note.
 Uses appropriate clinical evaluation and laboratory tests.
 Understands the uses of different ventilator modalities and plans appropriate
ventilator management.
 Initiates individualized and appropriate phamacotherapeutics.
 Inputs orders in a timely manner.
Copyright © 2011 by Vanderbilt University Medical Center
Self-Evaluation
2 2 3 4 N/A
Orientee’s comments:
Self-Evaluation
1 2 3 4 N/A
Orientee’s comments:
Preceptor Rating
1 2 3 4 N/A
Preceptor’s comments:
Preceptor Rating
1 2 3 4 N/A
Preceptor’s comments:
17
Advanced Practice Provider Orientation
The NP evaluates the patient’s response to the plan of care.
 Periodically evaluates the patient’s therapeutic response to interventions and
documents in progress notes.
 Evaluates drug therapy. Demonstrates knowledge of commonly used drugs.
 Revises plan of care based on diagnostic studies, assessment, and consultation and
documents these changes.
The NP demonstrates proficiency in technical skills.
 Identifies risks and benefits of procedural interventions and list pertinent clinical
indicators for the procedure.
 Correctly carries out technical skills and procedures according to protocols.
 Demonstrates sterile technique.
 Monitors and evaluates patient’s clinical status prior to, during and after procedure.
 Documents completed procedure in a note that includes rationale, procedure and
evaluation.
The NP communicates data that reflects the critically ill patient’s status.
 Writes orders that are clear and concise.
 Presents patient’s data in clinical rounds. Report is organized, clear and succinct. All
relevant data are reported.
 Documents the assessment, plan, and evaluation of care in the progress note.
 Provides clear verbal and written reports of changes in patient’s condition to all
appropriate healthcare team members.
 Communicates verbally with clarity and attention to detail pertinent to continuity
during sign-out.
Copyright © 2011 by Vanderbilt University Medical Center
Self-Evaluation
1 2 3 4 N/A
Orientee’s comments:
Self-Evaluation
1 2 3 4 N/A
Orientee’s comments:
Self-Evaluation
1 2 3 4 N/A
Orientee’s comments:
Preceptor Rating
1 2 3 4 N/A
Preceptor’s comments:
Preceptor Rating
1 2 3 4 N/A
Preceptor’s comments:
Preceptor Rating
1 2 3 4 N/A
Preceptor’s comments:
18
Advanced Practice Provider Orientation
The NP demonstrates responsibility for own practice.
 Manages an appropriate caseload and completes work in clinical time allotted.
 Brings appropriate questions to preceptor.
 Takes responsibility for correcting knowledge deficits, using multiple resources to
answer questions and augment team members’ knowledge.
 Takes responsibility for finding opportunities to work on skill requirements.
 Accepts guidance and constructive criticism in a professional manner, recognizing
the need for help.
The NP shows leadership in the NP role.
 Demonstrates self-reliance by attempting to find answers on own.
 Takes responsibility for expanding knowledge base and experiences.
 Actively participates in clinical rounds by asking questions, commenting, and bringing
up ideas regarding the condition or management of patients under discussion.
 Discusses new treatment options and research, demonstrating a basic knowledge of
research design, measurement techniques, and statistical methods.
 Demonstrates awareness of own strengths, identifies areas of growth in developing
the NP role identity, and progresses toward goal.
 Demonstrates modeling of NP role and is beginning to establish credibility.
 Is courteous and respectful to all team members.
 Develops relationships with multidisciplinary team members promoting mutual
Copyright © 2011 by Vanderbilt University Medical Center
Self-Evaluation
1 2 3 4 N/A
Orientee’s comments:
Self-Evaluation
1 2 3 4 N/A
Orientee’s comments:
Preceptor Rating
1 2 3 4 N/A
Preceptor’s comments:
Preceptor Rating
1 2 3 4 N/A
Preceptor’s comments:
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Advanced Practice Provider Orientation
respect and trust.
Mid-Orientation Evaluation
Areas of Strength:
Opportunities for Growth:
Specific Goals:
Copyright © 2011 by Vanderbilt University Medical Center
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Advanced Practice Provider Orientation
Orientee’s signature:
Date:
Preceptor’s signature:
Date:
Final Orientation Evaluation
Areas of Strength:
Opportunities for Growth:
Specific Goals:
Copyright © 2011 by Vanderbilt University Medical Center
21
Advanced Practice Provider Orientation
Orientee’s signature:
Date:
Preceptor’s signature:
Date:
360 Global Evaluation Tool
Purpose of this evaluation
This evaluation tool is designed to evaluate the NP during orientation. It is designed to highlight areas in which the NP is progressing satisfactorily
and areas that require improvement. The NP over the course of the orientation is expected to demonstrate sufficient professional ability to
practice competently and independently. The preceptor oversees the orientation, assesses the completion of the orientation program.
Definition of Ratings
N/A: Not applicable. No opportunity or insufficient experience for evaluation.
(1): Below expected skill level: Consistently requires substantial assistance or supervision to perform task adequately.
(2): Basic skill level: Performs tasks with basic skill and with moderate amount of assistance or supervision.
(3): Intermediate skill level: Performs tasks with skill and is able to interpret findings with minimal assistance or supervision.
(4): High skill level: Performs with proficiency and skill, interprets with consistently accurate judgment, does not need assistance or supervision.
Helpful Contact Information:
Name
Center for Advanced Practice Nursing
and Allied Health -- CAPNAH
Provider Support Services
April Kapu, Asst. Dir. AP, CC
ICU Medical Director
ICU Unit Manager
ICU NP Phone
Phone
322-4664
Email
322-3573
343-1465
Copyright © 2011 by Vanderbilt University Medical Center
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Advanced Practice Provider Orientation
Copyright © 2011 by Vanderbilt University Medical Center
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