Minimum Pediatric Clinical Competencies- California
Roz Hartman
May 17, 2012
Assumptions:
1. Pediatric nursing educational experience shall include clinical experience with
actual client. It might also include innovative teaching strategies that complements
clinical experience.
2. An acute inpatient care experience is not necessary to attain the minimum level
competencies in pediatric nursing.
3. The majority of competencies can be met in any of the following settings:
simulation, live patient: out-patient, or live patient: in-patient. It is up to the
program to choose the setting from the available sites in the community to meet
the program objectives.
4. Live patient: in-patient is defined as acute care, in patient hospital setting.
5. Live patient: out-patient is defined as skills lab, simulation with a real person, skills
lab with a real person, clinic, doctor’s office, school, urgent care, mom/baby classes,
call center, come and go surgery center, or other setting with an infant, child or
adolescent client.
6. Simulation: is defined as activities, which mimic the reality of a clinical environment
and are designed to demonstrate assessment, procedures, and clinical decision
making or nursing care through techniques such as role playing, interactive
modalities and use of mannequins. The simulation must be adequate and designed
to meet the competency that is being assessed. For example, respiratory
assessment must be practiced with simulators that have both breath sounds and
chest excursion.
7. Some competencies may be better addressed in simulation due to the risks of the
procedure or the constraints of the clinical setting, i.e. setting up IV lines, titrating
IV meds, participating in a code. Schools will adhere to BRN 25% simulation
regulation.
8. Actual clinical care of a pediatric client is necessary for students to have a realistic
view of pediatric nursing and gain authentic experiences in a real simulation;
THEREFORE, when available, settings with a live pediatric client including family
will be utilized.
9. For each competency, relevant safety measures learned in other specialties will be
applied to the pediatric population such as standard precautions, safety check lists,
HIPAA, rights of medication administration, etc.
10. Skills that do not require a pediatric adaptation are not included in the list, ie,
competencies such as collaboration with the multidisciplinary team, identification of potential
harms and how to bring this to attention of the team/organization (safety), professional
boundaries, and EBP/quality improvement competencies -identifying
problem/measure/plan/intervene/evaluate(remeasure). .
11. Prerequisite for pediatric rotation: BLS certification for health care professional.
Competency The registered nurse is a member of the multi-disciplinary team who is able to
manage and provide holistic health care to a pediatric population within the context of the
family to reach an optimal level of wellness
COMPETENCY STATEMENTS
Competencies may be met in any of the settings
that are checked. If the column is not checked a
competency might be demonstrated and
practiced in this setting but not met.
A. Demonstrates knowledge,
assesses and addresses physical
needs
Simulation= Any
setting without a
live client
Outpatient
Setting with a
live client
In patient
setting with
a live client
A1 Collect medical history of pediatric
client.
A2 Perform developmentally
appropriate physical exam that screens
for normal and abnormal findings.
A3 Assess/ address age specific
developmental needs of infants and
children.
A4 Assess/address cardiovascular
status
X
X
X
X
X
X
X
X
X
X
A5 Assess/address respiratory status
X
X
X
A6 Assess address neurosensory status
X
X
X
A7 Assess/address GI status
X
X
X
A8 Assess/address genitourinary
status
X
X
X
A9 Assess/address musculo-skeletal
status
X
X
X
A10 Assess/address
endocrine/metabolic status
X
X
X
A11Assess/ address immunologic
status (including immunization status)
X
X
X
X
X
X
A12 Assess/address reproductive
status
A13 Assess/ address integumentary
status
X
A 14 Assess/address nutritional status
X
X
X
X
A 15 Assess/address pain/pain
management
X
X
X
A 16 Assess/address risk for sepsis
X
X
X
B1 Assess/address learning needs of
child/family
X
X
X
B2 Assess/address spiritual needs
X
X
X
B3 Assess/address cultural
needs/ethnicity/diversity
X
X
X
B4 Address/ assess emotional support
child/ family
X
X
X
B6 Assess/report child/family abuse
X
X
B7 Assess /address loss and grieving in
child/family with sudden illness,
trauma, chronic or terminal illness
B8 Assess/address child/family coping
with trauma/sudden illness/
hospitalization/chronic /terminal
illness.
X
X
X
X
X
X
C1 Document client care
X
X
X
C2 Determine age appropriate level of
care
X
X
X
C3 Formulate a care plan
X
X
X
C4 Provide a developmentally safe and
X
X
X
B Assess and Address Psychosocial
Needs
C. Coordinate Patient Care
sensitive care environment
(implements facility security protocol,
seizure, aspiration, falls, restraints, and
infection control) following client
safety goals.
C5 Advocate for child/family in ways
that promote their self-determination,
integrity and ongoing growth and
development. (NLN )
X
X
X
C6 Make judgments in practice,
X
substantiated with evidence, that
integrate nursing science in the
provision of safe, quality care and
promote the health of clients within a
family and community context (nursing
judgment).NLN
X
X
C7 Examine the evidence that underlies X
clinical practice to challenge the status
quo, question assumptions and offer
new insights to improve the care of
child/family. NLN
X
X
C8 Implement the role as a nurse in
ways that reflect integrity,
responsibility, ethical practice and
evolving identity as a nurse committed
to evidence-based practice, caring,
advocacy, and safe, quality care for
diverse clients within a family and
community context. NLN
X
X
X
C9 Implement care following Standards X
of Competent Performance as outlined
in the Nursing Practice Act
D. Perform/Assist with Patient Care
Procedures
X
X
D1. Maintain airway and/ or trach care
D2 Recognize unstable pediatric client,
initiate and participate in a code, rapid
response team
X
X
X
X
D3 Administer/titrate oxygen
X
X
X
D4 Insert/maintain/discontinue IV
lines
X (INSERT,
MAINTAIN, OR
DISCONTINUE)
D5 Monitor/maintain tubes/drains
X
X(MAINTAIN
X
OR
(MAINTAIN
DISCONTINUE) OR
DC)
X
X
D6 Administer tube feedings
X
X
X
D7 Insert/maintain and/or discontinue
feeding tubes
D8 Perform pulse oximetry.
C9 Measure temperature, obtain
accurate VS and demonstrate
knowledge of pediatric norms
X
X
X
X
X
X
X
X
C10 Obtain specimens on child: urine
bag, diapers, etc.
E. Administer Medications and
Fluids
X
X
X
E1 Calculate safe pediatric dose of
medication
X
X
X
E2 Evaluate fluid needs, recognize fluid X
disturbances, and initiate fluid
resuscitation.
E3 Prepare and administer intravenous X
fluids in a developmentally appropriate
manner.
X
X
X
X
E5 Prepare and administer
medications in a safe and
developmentally appropriate manner.
X
X
X
X
X
X
X
X
E6 Assist with blood administration,
blood draws, heelstix, and blood
cultures
X
F. Supervise/Provide Direct Care
F1 Feed child
F2 Weigh infant, child
X
F3 Measure infant length, chest, and
head circumference
F4 Assist with elimination: diapers,
urine bags, toilet training
F5 Measure intake and output: weigh
diapers
F6 Restrain child for safety and
comfort to facilitate exam or to carry
out procedures.
X
X
X
X
X
X
X
X
X
G1 Teach patients and families about
injury prevention, safety, normal
growth and development, behavioral
expectations, disease processes and
outcomes of procedures (Any age child
including newborn), health screening
and immunization schedule.
X
X
G2 Utilize age-appropriate
communication strategies with
assigned children and their families
X
X
G3 Identify developmentally
appropriate play activities and
environments for children of all ages
X
X
G Teach/Communicate with patients
and families