Competency Profile for the Saskatchewan Association of ... · the values of truth, honesty, and trustworthiness, and shall observe the standards of conduct set out in the Code of

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Competency Profile for the Saskatchewan Association of Licensed

Practical Nurses Copyright © Government of Alberta (Canada) 2015

Copyright and Terms of Use This material, including copyright and marks under the Trade-marks Act (Canada), is owned by the Government of Alberta and protected by law.

Permission StatementThis material may not be used, reproduced, stored or transmitted without prior permission from the Government of Alberta. For information with respect to permission or licensing contact:

Executive DirectorHealth Human Resource Planning & Strategy Branch Professional Services & Health Benefits Division Alberta Ministry of Health10th floor, ATB Place North Tower 10025 Jasper AvenueEdmonton, AB T5J 2N3 Phone: 780-415-2749Fax: 780-415-1094

Disclaimer“This material is provided “as is” without warranties or conditions of any kind, either express or implied. To the fullest extent possible under applicable law, the Government of Alberta disclaims all warranties and conditions, expressed or implied, including but not limited to, implied warranties or conditions of fitness for a particular purpose, non-infringement or other violation of rights. Under no circumstances shall the Government of Alberta be liable for any direct, indirect, special, punitive, incidental or consequential damages arising out of the use or in ability to use this material.”

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Introduction

Purpose of the Profile

This Profile describes the competencies within the Scope of Practice of LPNs in Saskatchewan.

There are many stakeholders who will use the document, for a variety of purposes:

• It is a practical tool for use by educators to aid in the design and maintenance of educational programs and curriculum development;

• Licensed Practical Nurses use the Profile throughout their career as they plan and review their professional and career development;

• Employers and managers rely on the Profile for performance management and appraisal, continuing education, and policy/ procedure/ role development;

• Members of the public, other health care professionals, governments, internationally educated professionals and other stakeholders may use the Profile to obtain guidance regarding the practice and competencies of LPNs.

The competency profile is not intended to serve as a job description, policy manual, or a

legislative practice document.

Living Document

The Profile is not inclusive of all potential competencies required of LPNs in Saskatchewan and

is meant to be a “living document.” The Profile will evolve and change as nursing practice,

environment and technology change. Over time, the Competency Profile will be updated as

necessary.

Updates are inevitable and may result from:

Correction of errors;

Changes in best practice;

Technical, organizational and regulatory change of the profession; and

Recognition of new uses for the Competency Profile.

Legislative Authority

The Licensed Practical Nurse (LPN) profession in Saskatchewan is regulated by the Saskatchewan Association of Licensed Practical Nurses (SALPN). The purpose of professional regulation is to protect the public from risk and reduce harm to those a profession serves. LPNs are regulated since the service LPNs provide can pose a risk to the public if performed incompetently, unethically, or by unqualified individuals.

The SALPN has been delegated the authority to regulate the practical nursing profession by the Government of Saskatchewan through The Licensed Practical Nurses Act, 2000.

This SALPN Competency Profile provides comprehensive detail of the basic competencies, additional competencies, and specialized areas of practice that practical nurses are authorized to perform and apply. Contact the SALPN [email protected] if you require further clarification.

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The SALPN Regulatory Bylaws state the following:

19. All members shall ensure that they work within their educational preparation, level of

competence and scope of practice and comply with the standards of practice set out in the

Standards of Practice for Licensed Practical Nurses approved and adopted by Canadian

regulatory agencies as of April 1, 2013.

20. All members shall conduct themselves in an honorable and ethical manner, upholding

the values of truth, honesty, and trustworthiness, and shall observe the standards of

conduct set out in the Code of Ethics for Licensed Practical Nurses in Canada, approved

and adopted by Canadian Regulatory Agencies as of April 1, 2013.

Practice Guidelines and other references, such as the Competency Profile, are provided to assist

the LPN with practicing in accordance to the Licensed Practical Nurses Act and SALPN

Regulatory Bylaws.

LPN Accountability and Responsibility:

LPNs are accountable to:

a. the public to provide safe, competent, and ethical care

b. their employer to work within role descriptions and policies and procedures

c. the SALPN to comply with the Code of Ethics and Standards of Practice.

LPNs are responsible to ensure competence in practice;

LPNs are responsible to ensure that their nursing knowledge is current, and that they

possess the necessary knowledge, skills, abilities, critical thinking, attitudes, and

clinical judgment to fulfill their role;

LPNs are responsible to identify when they require assistance, or when an assignment

or situation is beyond their individual or professional scope of practice, competency

level, education, or consultation is not available;

LPNs are responsible to ensure fitness to practice ensuring they have the necessary

physical, mental, and emotional capacity to practice safely and competently;

LPNs are required to maintain appropriate licensure status

o Practicing

o Non-practicing certification;

LPNs are required to enhance competence, fulfilling an annual obligation of

continuing education;

LPNs are responsible to maintain practice hours and meet the regulatory requirement

of 1250 registered working hours per five-year period.

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Competencies

After graduation from an approved Practical Nursing program and successful completion of the

Canadian Practical Nurse Registration Exam (CPNRE), registrants are entry-level practitioners.

They can be expected to practice in accordance with the “Entry-to-Practice Competencies for

Licensed Practical Nurses”. The Entry-to-Practice competencies can be found on the SALPN

website at:

http://www.salpn.com/images/Member/Entry_Practice_Comps/IJLPN_Entry_to_Practice.pdf

Entry level (Basic) competencies, taught in the basic program, are included in the SALPN

Competency Profile and are indicated in regular text. Entry level competencies have been

validated to be contained in the foundational Practical Nursing program in Saskatchewan offered

by Saskatchewan Polytechnic.

Through education, workshops, or in-service, LPNs can obtain additional knowledge, skill, and

ability beyond that provided in the Practical Nursing program. Competencies obtained in this

manner are referred to as Additional Competencies. The additional competencies in the

Competency Profile are supported by the foundational knowledge base in the Practical Nursing

program. These competencies are indicated in the Competency Profile with grey shading.

Additional competencies obtained by the LPN must be supported by foundational practical

nursing knowledge and applied for the purposes of providing care, promoting health and

preventing illness to be compliant with the Licensed Practical Nurses Act. LPNs can develop

expertise in an area of practice; however continuing education and additional competencies

enhance competence within the LPN professional designation only.

The individual scope of practice or individual competencies of each LPN are unique and

influenced by nursing experience, continuing education, professional development, attitude, and

utilization in employment. The individual scope of practice cannot exceed the professional scope

of practice as determined by legislation.

LPNs will, in most circumstances, advance from Novice to Expert (see Appendix) during their

practice through mentorship, work experience, and socialization in the nursing profession.

Factors such as advances in medical technology, presentation of new evidence in best practice,

changes in patient demographics, and promotion of lifelong professional learning, provides

meaningful enhancements to the knowledge-base and expertise of the practicing LPN.

Professional competencies are inter-related, therefore, no individual section in the Profile

can be considered in isolation of another.

Specialized areas of LPN practice exist in Saskatchewan and are encompassed within the

SALPN Regulatory Bylaws. For information regarding the specialized areas of practice, please

reference the SALPN Practice Guidelines at www.salpn.com.

http://www.salpn.com/images/Member/Entry_Practice_Comps/IJLPN_Entry_to_Practice.pdf

http://www.salpn.com/

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Utilization of Competencies

LPN competencies are applied within the LPN context of practice. Professionals must

collaboratively work together and support all other professionals to utilize scope of practice

appropriately, and to provide safe, competent, and ethical care.

A combination of three distinct factors comprise the LPN context of practice and are explained

below.

Client Factors:

1. Complexity: The degree to which a client’s condition and/or situation is

characterized or influenced by a range of variables (e.g., multiple medical

diagnoses, impaired decision- making ability, challenging family dynamics).

2. Predictability: The extent to which a client’s outcomes and future care

requirements can be anticipated.

3. Risk of negative outcome(s): The likelihood that a client will experience a

negative outcome as a result of the client’s health condition or as a response

to treatment.

LPNs can autonomously care for clients who are less complex, more predictable and at

lower risk for negative outcomes. The more complex the care requirements, the less

predictable and the higher risk for negative outcomes, increases the need for consultation

and collaboration with other health professionals. In this situation, the LPN provides care

in the team setting. As the need for consultation increases due to patient complexity,

unpredictability and higher risk for negative outcomes, the additional support must be available

for ongoing assessment and support and may be required to provide the full spectrum of care.

Nurse Factors:

The factors that affect an LPN’s ability to provide safe and ethical care to a given client

include experience, leadership, decision-making and critical-thinking skills. Other factors

include the application of knowledge, knowing when and how to apply knowledge to make

evidence-based decisions, and having the required resources available to consult as needed.

Upon completing entry-level education, LPNs continue to develop their knowledge and skills

as they gain experience. They also build on their education to develop and maintain the specific

competencies required to meet the needs of clients in their areas of practice. If an LPN changes

areas of practice, they may need to refresh competencies or develop new competencies.

Identifying the practice expectations within these key areas can help nurses make decisions

within the provision of care.

An LPN seeks consultation with another health care professional when a situation demands

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expertise that is beyond their individual competence. Consultation involves seeking advice or

information from a more experienced or knowledgeable nurse or another health care

professional. The amount of consultation required is determined by the complexity of the client,

care needs, the nurse’s individual competence and scope of practice. The practice setting

influences the availability and accessibility of these consultation resources.

LPNs must be clear when consulting and determine an appropriate course of action. Unless a

decision is made to transfer care, the LPN seeking consultation retains accountability for the

client’s care, including actions, decision making, or lack thereof.

Consultation results in one of the following:

a) The LPN receives advice and continues to care for the client

b) The LPN transfers an aspect or aspects of care to the consultant, or

c) The LPN transfers all aspects of the client’s care to the consultant.

When any care is transferred from one nurse to another nurse or professional, the

accountability for that care must also be transferred.

Environmental Factors:

Environmental factors include practice supports, consultation resources and the

stability/predictability of the environment. Practice supports and consultation resources support

LPNs in clinical decision-making. There may be an impact upon the stability of the

environment when large volumes of patient turnover occur.

There is a correlation between environmental stability and the need for ongoing consultation

and collaboration. The less available the practice supports and consultation resources are, the

greater the need for more in-depth nursing competencies and skills in the area of clinical

practice, decision-making, critical thinking, leadership, research utilization and resource

management.

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Acknowledgement

The Saskatchewan Association of Licensed Practical Nurses would like to acknowledge the

College of Licensed Practical Nurses of Alberta (CLPNA) for their assistance and permission to

utilize their Competency Profile. The CLPNA’s support and expertise has been immensely

valuable throughout this development process.

The SALPN would like to acknowledge the many individuals who participated in the

development of the original and revised competency document for LPNs. The process involved

consultation with individuals, groups, and numerous LPN focus groups. The participants

represented health authorities, private employers, clinical nurse educators, nurse managers, nurse

leaders and licensed practical nurses from across the province.

Thank you to everyone involved for the time, expertise, attention to detail, and commitment to

creating this document. The result of this inclusive process is a Competency Profile that will

guide LPN practice in Saskatchewan.

SALPN Contact

For more information, please contact:

Saskatchewan Association of Licensed Practical Nurses

700A- 4400 4th Ave

Regina, SK S4T 0H8

Phone: (306) 525-8077 or (306) 525-8029

Email: [email protected]

Website: www.salpn.com

Fax: (306) 347-7784

mailto:[email protected]

http://www.salpn.com/

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Glossary of Terms

Accountability: The obligation to answer for the professional, ethical, and legal

responsibilities of one’s activities and actions and or inactions.

Act: A written ordinance made by a parliament or legislative body.

Acuity: The degree of severity of a client’s condition and/or situation.

Advocate: To actively support a cause; to support others in speaking for themselves or

to speak on behalf of a group or on behalf of those who cannot speak for themselves.

Client: The client is the person or persons with whom the nurse is engaged in a professional

therapeutic relationship. The client may include a family member of and/or substitute decision-

makers for the individual client. The client may also be a family, group, entire community or

population. In some settings, other terms may be used such as patient, resident, or health care

consumer.

Client-Centered Care: An approach in which clients are viewed as whole persons; it is not

merely about delivering services where the client is located. Client centered care involves

advocacy, empowerment, and respecting client’s autonomy, voice, self-determination, and

participation in decision-making.

Clinical Judgment: Reasoning processes that rely on critical thinking to reflect the complex,

intuitive and conscious thinking strategies used to make nursing decisions.

Collaboration: Working together with one or more members of the health care team, each of

whom makes a unique contribution toward achieving a common goal. Collaboration is an

ongoing process that requires effective communication between the members of the health care

team and a clear understanding of the roles of the individuals involved in the collaboration

process. Nurses collaborate with clients, other nurses, and other members of the heath care team

in the interest of client care.

Community: A group of people living in one place, neighborhood or district, or sharing

common characteristics/interests which bind them together, or having common health needs. The

term community (when used to describe a client) does not mean providing care to an individual

in the community. Nursing practice aimed at the community as a client involves assisting

communities to identify, articulate and successfully manage its health concerns. It is collective or

common good, instead of an individual’s health.

Community-based Nursing: Nursing care directed toward a specific population or

group within the community, defined by the “philosophy of the practice” rather than the

physical setting. Care may be provided to individuals or groups, and is designed to meet

the needs of people as they move between and among health care settings.

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Compassion: A multi-dimensional concept consisting of three key elements:

recognizing another person’s suffering, empathizing with that person’s pain, and acting

in a way to ease the suffering.

Competence: The ability to integrate and apply the knowledge skills and judgment required to

practice safely and ethically in a designated role and practice setting and includes both entry

level and continuing competency.

Competency: The integrated knowledge, skills, judgement and attributes required of a LPN to

practice safely and ethically in a designated role and setting.

Competencies: Statements describing the expected performance that reflects the

integration of knowledge, skills, judgment, and professional attributes required in a

given nursing role, situation, or practice setting.

Complexity: The degree to which a client’s condition and/or situation is characterized or

influenced by a range of variables (e.g., multiple medical diagnoses, impaired decision- making

ability, challenging family dynamics).

Consultation: Seeking advice or direction for a more experienced or knowledgeable nurse, or

other health professional. The clients care needs, the nurses job description, and the nurse’s

individual competence, influence both the amount of consultation required and who to involve in

the consultations. The resources available in the practice environment influence the opportunity

for consultation.

Context of Care: Conditions or factors that affect the practice of nursing, including client

population (e.g., age, diagnostic grouping), location of practice setting (e.g., urban, rural), type

of practice setting and service delivery model (e.g., acute care, community), level of care

required (complexity, predictability, and risk of negative outcomes), staffing (number,

competencies); and availability of other resources (practice and consultation resources, and

stability and predictability of the environment).

Critical Thinking: Is an active and purposeful problem-solving process requiring the nurse to

advance beyond the performance of skills and interventions and provide care based on evidence-

informed practice. It involves identifying and prioritizing risks and problems, clarifying and

challenging assumptions, checking for accuracy and reliability of information, weighting

evidence, recognizing inconsistencies, evaluating conclusions and adapting thinking.

Critical Inquiry: the process of exploring methods used to construct nursing knowledge and

utilize evidence to inform clinical decision making.

Delegation: The transferring of responsibility for the performance of an activity or task

while retaining accountability for the outcome.

Determinants of Health: The social, economic, environmental and behavioral factors

that contribute to health status. Examples include income and social status, social

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support networks, education, employment and working conditions, social environments,

physical environments, personal health practices and coping skills, healthy child

development, biology and genetic endowment, health services, gender, and culture.

Entry to Practice Competencies: competencies that describe the knowledge skill, judgment and

attitude required of beginning practitioners to provide safe competent and ethical nursing care.

Environmental Factors: all that is internal and external to the person and is characterized by the

physical, spiritual, political, cultural, social, ethical, technological and intellectual dimensions.

Individuals do not exist in insolation, but rather interact with and relate to other individuals,

families and communities within a constantly changing society. As such, they influence and are

influenced by the environment.

Evidence Informed Practice: Practice that is based on successful strategies that improve

client outcomes and that are derived from a combination of various sources of evidence,

including client perspective, research, national guidelines, policies, consensus

statements, expert opinion, and quality improvement data.

Fitness to Practice: The qualities and capabilities of LPNs relevant to their capacity to

practice safely. This includes, but is not limited to, freedom from cognitive, physical,

psychological, or emotional conditions, or a dependence on alcohol or drugs, that

impairs their ability to practice nursing safely and effectively.

Inter-professional Team: the provision of comprehensive health services to clients by multiple

health professionals who work collaboratively to deliver quality care with and across settings.

Leadership: The process of influencing people to accomplish common goals. The

attributes of leadership include self-awareness, commitment to individual growth, ethical

values and beliefs, presence, reflection and foresight, advocacy, integrity, intellectual

energy, being involved, being open to new ideas, having confidence in one’s own

capabilities, and a willingness to try to guide and motivate others.

Leadership is not limited to formal leadership roles.

Manage: To oversee; administer; run.

Monitor: Constant checking on a patient’s condition, either personally or by means of a

mechanical monitor; ongoing measurement of performance of a health service.

Participate: To take part in. Participation is not an independent act; the nurse works in

partnership with others. When participating, the nurse contributes but is not the sole provider of

the services being delivered.

Perform: To carry out a procedure. Performing occurs after the decision to carry out a procedure

has been made.

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Predictability: The extent to which a client’s outcomes and future care requirements can be

anticipated.

Predictable Outcomes: Something that is easy to foresee or anticipate, i.e., outcomes that

reasonably be expected to follow an anticipated path with respect to timing and nature.

Recognize: Acknowledge the existence of; identify from knowledge.

Research: Systematic inquiry that uses orderly scientific methods to answer questions

or solve problems.

Responsibility: The characteristics of reliability and dependability. It implies an ability

to distinguish between right and wrong. Responsibility includes a duty to perform

actions adequately and thoughtfully.

Scope of Practice: Health care professionals optimizing the full range of their roles,

responsibilities and functions that they are educated, competent, and authorized to perform.

Self-reflective Nursing Practice: The nurse purposefully recalls and examines situations or

actions that have occurred in the past to discover its purpose or meaning (reflection-on-actions)

and examines her/his own behavior and that of others while in a situation (reflection-in-action).

Reasoning processes that rely on critical are also important dimensions of the nurse’s reflective

practice, as well as the systematic use of the nursing process to invoke complex intuitive and

conscious thinking strategies that are part of all clinical decision-making in nursing.

Spiritual: A concept that is unique to each individual, which depends on a person’s

culture, development, life experiences, and beliefs and ideas about life. It enables a

person to love; have faith and hope; seek meaning in life; and nurture relationships with

others. It offers a sense of being connected intrapersonally, interpersonally and with a

higher power.

Stakeholder: A person, group or organization that is invested in the practice of

practical nursing and client health care. Examples include the public, nurses, other

health care providers, employers, and educators

Therapeutic Nurse-client Relationship: A professional relationship that ensures the client’s

needs are first and foremost. The relationship is based on trust, respect, and intimacy, and

requires the appropriate use of the power inherent in the LPNs role. The professional relationship

between the nurse and clients is based on a recognition that clients (or designates) are in the best

position to make decisions about their lives when they are active and are informed participants in

the decision-making process.

Unpredictable Outcomes: Are client health outcomes that cannot reasonably be expected

to follow an anticipated path with respect to timing and nature.

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Unregulated Care Providers: Paid providers who are neither registered nor licensed

by a regulatory body. They have no legally defined scope of practice. Unregulated care

providers may not have mandatory education or practice standards. Unregulated care

providers include health care aides, care attendants, home support workers, community

health representatives among others.

Values: The beliefs about the shared worth or importance of what is desired and

esteemed within the Practical Nursing profession that practical nurses strive to uphold.

REFERENCES:

College of Licensed Practical Nurses of Manitoba (2016). Entry Level Competencies for the Licensed Practical

Nurse in Manitoba. Winnipeg, MB. Author

College of Licensed Practical Nurses of Nova Scotia (2012). Continuing Competency Profile for Licensed Practical

Nurses of Nova Scotia. Halifax, NS. Author

Canadian Nurses Association (2012). Staff mix: Decision-making framework for quality nursing care. Ottawa,

ON: Author.

College of Licensed Practical Nurses of BC (2015). Scope of practice for Licensed Practical Nurses. Burnaby,

BC: Author.

College of Nurse of Ontario (2008). Practice guideline for the utilization of RNs and RPNs.

Toronto, ON: Author.

College of Nurses of Ontario (2011). RN and RPN practice: The client, the nurse and the environment. Toronto,

ON: Author.

College of Registered Nurses of Nova Scotia and the College of Licensed Practical Nurses of Nova Scotia. (2012).

Guidelines: Effective utilization of RNs and LPNs in a collaborative practice environment. Halifax, NS: Author.

Licensed Practical Nurses Association of Prince Edward Island, the Association of Registered Nurses of Prince

Edward Island, & PEI Health Sector Council (n.d.). Exemplary care: Registered nurses and licensed practical

nurses working together. PEI: Author.

Lillibridge, J., Axford, R., and Rowley, G. (2000). The contribution of nurses’ perceptions and actions in defining

scope and stabilizing professional boundaries of nursing practice. Collegian, 7(4), 35-39.

Monitoring. (n.d.) Farlex Partner Medical Dictionary(2012).

Recognize. (n.d.) Oxford Disctionaries (2016).

Registered Nurses Association of Ontario (2006). Client Centered Care Practice Guideline. Toronto. ON: Author.

View the Specialized Areas of Practice Practice Guideline for more information.

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Licensed Practical Nurses of Saskatchewan – Competency Profile Table of Contents

page

A: Professionalism ................................................................................................. 1

A1: Legislation and Regulation ..................................................................................................... 2

A2: Licensed Practical Nurse Scope of Practice ............................................................................ 3

A3: Professional Standards of Practice .......................................................................................... 4

A4: Professional Ethics .................................................................................................................. 5

A5: Accountability and Responsibility .......................................................................................... 7

A6: Professional Boundaries .......................................................................................................... 9

A7: Fitness to Practice ................................................................................................................. 10

A8: Professional Development .................................................................................................... 11

B: Leadership……………………………………………………………………………………………... 13

B1: Informal Leadership................................................................................................................ 14

B2: Formal Leadership.................................................................................................................. 16

B3: Manager/Administrator.......................................................................................................... 18

C: Nursing Knowledge.........................................................................................21

C1: Anatomy and Physiology..................................................................................................... 22

C2: Microbiology........................................................................................................................ 23

C3: Pathophysiology..................................................................................................................... 24

C4: Medical Terminology........................................................................................................... 26

C5: Growth and Development..................................................................................................... 27

C6: Nutrition................................................................................................................................. 28

C7: Pharmacology....................................................................................................................... 29

C8: Social Science and Humanities ............................................................................................. 31

C9: Best Practices and Research .................................................................................................. 34

D: Nursing Process .............................................................................................. 35

D1: Assessment ........................................................................................................................... 36

D2: Nursing Diagnosis ................................................................................................................. 38

D3: Planning ................................................................................................................................ 39

D4: Implementation ..................................................................................................................... 40

D5: Evaluation ............................................................................................................................. 41

E: Safety ............................................................................................................... 43

E1: Urgent and Emergent Situations ............................................................................................ 44

E2: Protective Equipment ............................................................................................................ 45

E3: Infection Prevention and Control .......................................................................................... 46

E4: Client Safety.......................................................................................................................... 48

E5: Workplace Safety .................................................................................................................. 49

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F: Communication and Interpersonal Skills .................................................... 51

F1: Effective Communication ..................................................................................................... 52

F2: Collaborative Team Practice ................................................................................................. 53

F3: Therapeutic Nurse-Client Relationship ................................................................................. 54

F4: Health Teaching and Coaching ............................................................................................. 55 F5: Legal Protocols, Documenting and Reporting....................................................................... 56

F6: Accept, Transcribe and Initiate Orders .................................................................................. 57

F7: Conflict Management ............................................................................................................ 58

G: Nursing Practice ............................................................................................. 59

G1: Critical Thinking and Critical Inquiry ................................................................................... 60

G2: Clinical Judgment and Decision Making ............................................................................... 61

G3: Time Management ................................................................................................................ 62

G4: Admission and Discharge...................................................................................................... 63

G5: Activities of Daily Living ..................................................................................................... 64

G6: Nutrition/Hydration............................................................................................................... 65

G7: Elimination ........................................................................................................................... 66

G8: Peritoneal Dialysis ................................................................................................................ 67

G9: Basic Foot Care ..................................................................................................................... 68

G10: Basic Wound Care ................................................................................................................ 69

G11: Advanced Wound Care ......................................................................................................... 71

G12 Phlebotomy for the Purpose of Drawing Blood ................................................................... 74

G13: Client Centered Care ............................................................................................................. 75

G14: Complementary and Alternative Therapies ........................................................................... 76

G15: Post Mortem Care ................................................................................................................. 77

H: Respiratory Care ............................................................................................ 79

H1: Airway Management ............................................................................................................. 80

H2: Oxygen Therapy ................................................................................................................... 81

H3: Suctioning ............................................................................................................................. 82

H4: Respiratory Interventions ...................................................................................................... 83

H5: Tracheostomy Care ............................................................................................................... 84

H6: Chest Tubes .......................................................................................................................... 85

I: Surgical ............................................................................................................ 87

I1: Surgical Nursing ................................................................................................................... 88

I2: Surgical Nursing Interventions ............................................................................................. 89

I3: Endoscopy ............................................................................................................................ 91

I4: Post Anesthetic Recovery ..................................................................................................... 93

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J: Orthopedics ..................................................................................................... 95

J1: Orthopedic Nursing............................................................................................................... 96

J2: Orthopedic Nursing Interventions ......................................................................................... 97

J3: Traction and Immobilizers .................................................................................................... 98

K: Neurological/Neurosurgical ......................................................................... 101

K1: Neurological Nursing .......................................................................................................... 102

K2: Neurological Nursing Interventions .................................................................................... 103

K3: Managing C-Spine .............................................................................................................. 105

K4: Advanced Neurological Nursing Interventions ................................................................... 106

L: Cardiovascular .............................................................................................. 107

L1: Cardiovascular Nursing ...................................................................................................... 108

L2: Cardiovascular Interventions .............................................................................................. 109

L3: Advanced Cardiovascular Interventions ............................................................................. 111

M: Maternal/Newborn Care ................................................................................ 113

M1: Maternal/Newborn Nursing ................................................................................................... 114

M2: Prenatal Care ......................................................................................................................... 115

M3: Knowledge and Assessment of Labor ................................................................................... 117

M4: Assist with Managing Labor ................................................................................................. 118

M5: Assist with Delivery .............................................................................................................. 119

M6: Neonatal Resuscitation ........................................................................................................ . 120

M7: Labor and Delivery of Non-Viable Fetus ............................................................................ . 122

M8: Post-Partum Care ................................................................................................................ . 123

M9: Newborn Care ..................................................................................................................... . 125

N: Pediatrics ....................................................................................................... 127

N1: Pediatric Nursing ................................................................................................................. 128

N2: Pediatric Care and Interventions ......................................................................................... 129

N3: Pediatric Pain Management ................................................................................................. 131

O: Mental Health and Addiction ...................................................................... 133

O1: Mental Health and Addiction Care ...................................................................................... 134

O2: Mental Health and Addiction Assessment and Intervention ................................................ 136

O3: Aggressive Behavior ........................................................................................................... 139

P: Emergency Care ........................................................................................... 141

P1: Emergency Nursing ............................................................................................................. 142

P2: Triage .................................................................................................................................. 144

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Q: Gerontology ................................................................................................... 145

Q1: Gerontology Nursing........................................................................................................... 146

Q2: Gerontology Care and Interventions ................................................................................... 148

Q3: Cognitive Care .................................................................................................................... 152

Q4: Dementia Care .................................................................................................................... 154

Q5: Assessment and Planning in Continuing Care ..................................................................... 156

R: Palliative Care .............................................................................................. 159

R1: Palliative Principles and Values .......................................................................................... 160

R2: Physical Changes ................................................................................................................ 161

R3: Physical and Psychosocial Care .......................................................................................... 162

R4: Post Mortem Care ............................................................................................................... 164

S: Rehabilitation ................................................................................................ 165

S1: Rehabilitation Nursing ........................................................................................................ 166

T: Community Based Care ............................................................................... 169

T1: Knowledge of Community Based Care .............................................................................. 170

T2: Nursing Process and Community Based Care .................................................................... 172

T3: Health Promotion ................................................................................................................ 174

T4: Client Services .................................................................................................................... 175

T5: Community Health Teaching and Coaching ....................................................................... 177

T6: Community Wellness ......................................................................................................... 178

T7: Clinic Nursing ..................................................................................................................... 180

T8: Case Management ............................................................................................................... 181

U: Oncology ........................................................................................................ 183

U1: Oncology Nursing ............................................................................................................... 184

U2: Oncology Interventions ....................................................................................................... 185

V: Occupational Health and Safety .................................................................. 187

V1: Occupational Health and Safety Nursing ............................................................................ 188

W: Medication Administration ......................................................................... 191

W1: Principles of Pharmacology ................................................................................................ 192

W2: Medication Preparation and Administration ....................................................................... 195

W3: Nitrous Oxide ...................................................................................................................... 197

W4: Immunizations .................................................................................................................... 198

xvii


page

X: Infusion Therapy .......................................................................................... 201

X1: Principles of Infusion Therapy............................................................................................ 202

X2: Peripheral Intravenous Therapy .......................................................................................... 203

X3: Hypodermoclysis (HDC) .................................................................................................... 204

X4: Central Venous Catheter Care ............................................................................................. 205

X5: Blood and Blood Products .................................................................................................. 207

X6: Epidural and Spinal Infusions ............................................................................................. 209

X7: Parenteral Nutrition ............................................................................................................. 210

Y: Educator ........................................................................................................ 211

Y1: Adult Learning Principles ................................................................................................... 212

Y2: Design and Delivery of Education ...................................................................................... 213

Z: Peri-Operative Specialized Area of Practice ................................................ 216Z1: Authorization and Standards................................................................................................ 217Z2: Knowledge and Application...................................................................................... ...........218Z3: Knowledge and Application of Scrub Role......................................................................... 219Z4: Knowledge and Application of Circulating Role........................................................ ..........220Z5: Knowledge and Application to the Anesthesia Provider............................................ ..........221Z5: Knowledge and Application of Pre-Operative Phase................................................. ............224

AA:

AA1: Critical Thinking and Clinical Judgment in the Hemodialysis Nursing Role...................... 228AA2: Critical Thinking and Clinical Judgment of the Dialysis Client.................................. ...........230

Hemodialysis Specialized Area of Practice ................................................... 227

AA3: Initiation, Monitoring and Discontinuation of Dialysis Treatment.............................. ...........232AA4: Understanding the Mechanics of Dialysis and Related Equipment.......................... ...........233

BB:

BB1:

BB2:

Orthopedic Specialized Area of Practice ...................................................... 235

BB3:

Knowledge and Application of Orthopedic Specialty................................................ ...........236

BB4: Application and Monitoring of Traction................................................................... ............240

Application of Orthopedic Devices.......................................................................... ............238Cast and Splint Care................................................................................................... ..........239

xviii

Saskatchewan Association of Licensed Practical Nurses, Competency Profile for LPNs, 3rd Ed. 1

A: Professionalism

Major Competency Area: A

Professionalism

Competency: A-1

Legislation and Regulation

Date: January 16, 2017

2 Saskatchewan Association of Licensed Practical Nurses, Competency Profile for LPNs, 3rd Ed.

A Licensed Practical Nurse will:

A-1-1 Demonstrate knowledge and understanding of the Licensed Practical Nurses

Act, 2000 and regulation of the Licensed Practical Nurse (LPN) profession.

A-1-2 Demonstrate knowledge and understanding of the role of the Saskatchewan

Association of Licensed Practical Nurses (SALPN) under the Licensed

Practical Nurses Act, 2000:

establish, maintain and enforce standards for education, registration,

continuing competence, investigation and discipline

establish, maintain and enforce standards of practice and code of ethics

govern and regulate members in a manner that protects and serves the public

provide direction to the practice of the profession

A-1-3 Demonstrate knowledge and understanding of key components of the SALPN

Regulatory Bylaws:

categories of membership

continuing competence

discipline process

examination

registration

professional conduct

specialized areas of practice


Professionalism

Competency: A-2

Licensed Practical Nurse Scope of Practice




A-2-1 Demonstrate knowledge of the scope of practice as outlined in the Licensed

Practical Nurses Act, 2000.

A-2-2 Demonstrate understanding of the Licensed Practical Nurses Act, 2000 LPN

Practice Definition:

Interpretation

2 In this Act:

(i) “Practice as a licensed practical nurse” means

to provide services, within the education and training

of licensed practical nurses, for the purposes of providing

care, promoting health and preventing illness;

A-2-3 Demonstrate knowledge of the SALPN documents that guide and interpret

LPN scope of practice.


Professionalism

Competency: A-3

Professional Standards of Practice Date: January 16, 2017



A-3-1 Demonstrate knowledge and understanding of the Canadian Council for

Practical Nurse Regulators/Saskatchewan Association of Licensed Practical

Nurses Standards of Practice for Licensed Practical Nurses in Canada:

professional accountability and responsibility

knowledge-based practice

service to the public and self-regulation

ethical practice

A-3-2 Demonstrate knowledge and understanding of the principles that provide the

foundation on which the Standards of Practice were developed:

LPNs are self-regulating and accountable for providing safe, competent,

compassionate, ethical care

LPNs are autonomous practitioners working collaboratively within healthcare

in the delivery of nursing care

LPNs practice is client centered and includes individuals, families, groups and

communities

LPN standards are broadly based and address variations in client needs,

provider competencies, experience and environmental factors

LPN standards allow for growth in the profession to meet changing

approaches, treatments and technologies within the healthcare system

LPN standards encourage leadership through self-awareness and reflection,

commitment to individual and professional growth, and promotion of the best

possible service to the public


Professionalism

Competency: A-4

Professional Ethics Date: January 16, 2017



A-4-1 Demonstrate knowledge and understanding of the Canadian Council for

Practical Nurse Regulators/Saskatchewan Association of Licensed Practical

Nurses Code of Ethics for Licensed Practical Nurses in Canada:

five ethical principles

o responsibility to public

o responsibility to client

o responsibility to profession

o responsibility to colleagues

o responsibility to oneself

A-4-2 Demonstrate knowledge and ability to align the Code of Ethics to guide

practice and behavior with:

professional standards

competencies

employer policies

legal requirements

A-4-3 Demonstrate knowledge and ability to apply ethical principles to decision

making including:

client centered care

cultural diversity

fitness to practice

honesty and integrity

inter-professional collaboration

moral distress (self and others)

personal beliefs and bias

privacy and confidentiality

professional boundaries

professionalism and accountability

social determinants of health

therapeutic nurse-client relationship

use of technology/social media

Competency: A-4 Page: 2

Professional Ethics



A-4-4 Demonstrate knowledge and ability to assess and manage ethical dilemmas

and seek assistance when necessary.


Professionalism

Competency: A-5

Accountability and Responsibility Date: January 16, 2017



A-5-1 Demonstrate knowledge of legal accountability for one’s own nursing

practice including:

understand concept of duty of care

o reasonable and prudent decisions

o avoiding issues of neglect or abandonment of care

arrive for work on time

inappropriate transfer/ termination of care

recognizing need for assistance or handoff of care

responsible for fitness to practice

o maintain physical, mental, emotional well being

duty to self-report to SALPN including:

o personal incapacity impairing fitness to practice

o criminal charges, guilty plea or verdict

o under investigation, subject of proceeding, discipline by another regulator

A-5-2 Demonstrate knowledge and application of principles and accountabilities

involved with self-regulation:

client-provide safe, competent, ethical care

employer-work within role expectations, policies and procedures

regulatory body-maintained standards and guidelines, ethical code, scope of

practice, continuing competence

A-5-3 Demonstrate knowledge and ability to identify when assignment of care is

beyond individual competence or outside scope of practice including:

research evidence to guide practice

consult with inter-professional team

collaborate as necessary

maintain or hand off care as necessary

Competency: A-5 Page: 2

Accountability and Responsibility



A-5-4 Demonstrate knowledge and ability to apply concepts of professional

autonomy throughout practice including:

accountable for one’s own actions and behaviors

best practices and research

independence as appropriate

moral decision making

self-managed competence

A-5-5 Demonstrate knowledge and ability to maintain confidentiality with client,

colleagues, staff, team and organization including:

adhere to policy, procedures, guidelines, standards, Legislation

identify breaches in confidentiality

manage all client information appropriately (verbal, written, electronic)

recognize and manage risks

A-5-6 Demonstrate and practice self-reflection, self-awareness and self-care

including:

recognize personal beliefs and biases

develop and maintain personal health and wellness

provide non-judgmental, empathetic, compassionate care

establish and maintain therapeutic and professional boundaries

support inter-professional team

engage in ongoing professional development


Professionalism

Competency: A-6

Professional Boundaries Date: January 16, 2017



A-6-1 Demonstrate knowledge and ability to effectively establish, maintain and

manage professional boundaries including:

nurse-client, family and others

nurse-colleague

nurse-supervisor

nurse-employer

A-6-2 Demonstrate knowledge and ability to recognize and maintain appropriate

boundaries related to:

beginning, maintaining, ending relationship

caring for family/friends

casual, friendship, romantic, sexual

chastising, coercion, favoritism

conflict of interest

giving/receiving gifts

inappropriate financial or personal benefit

inappropriate physical contact

limited self-disclosure

psychological abuse/disruptive behaviors

social media interactions

A-6-3 Demonstrate knowledge of risks associated with improper use of social media

including:

breach of privacy/confidentiality

compromise public safety/trust in nurses

undermine individual nursing careers

inappropriate use during work hours

A-6-4 Demonstrate knowledge and ability to recognize, intervene and report

boundary violations of self or others.


Professionalism

Competency: A-7

Fitness to Practice Date: January 16, 2017



A-7-1 Demonstrate knowledge and ability to maintain physical, mental and

emotional health to ensure safe, competent and ethical practice.

A-7-2 Demonstrate knowledge of components affecting fitness to practice including:

addiction

cognition

coping mechanisms

family and environmental issues

inappropriate behaviors

mental health

physical ability

psychological well being

sensory perception

stress management

socialization

A-7-3 Demonstrate knowledge and ability to take responsibility and self-manage

fitness to practice to ensure client safety including:

participate in wellness activities

maintain positive self-esteem and attitude

manage work-life balance

access employee assistance programs/counseling

self-report and withdraw from care as appropriate


Professionalism

Competency: A-8

Professional Development Date: January 16, 2017



A-8-1 Demonstrate ability to adopt curiosity and initiative for learning and

professional growth to facilitate transition from novice to expert practitioner.

A-8-2 Demonstrate commitment to life-long learning through accessing and

completing ongoing professional development including:

reflect and identify career options and pathways

attend workshops and conferences

participate in employer education

participate in the SALPN Continuing Education Portfolio (CEP) Program

A-8-3 Demonstrate knowledge and ability to participate in continuous quality

improvement and evidence informed changes to nursing practice within the

employment setting.

A-8-4 Demonstrate commitment to participate in activities at a local, regional,

provincial, professional and national level to promote health and wellness

throughout the health system.


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https://salpn.com/wp-content/uploads/Specialized-Area-of-Practice-Practice-Guideline.pdf


B: Leadership

Major Competency Area: B

Leadership

Competency: B-1

Informal Leadership


B



B-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout decision making in nursing practice.

B-1-2 Demonstrate knowledge and ability to apply leadership theories throughout

nursing practice.

B-1-3 Demonstrate characteristics and attributes of an effective leader including:

authenticity

collaboration

compassion/empathy

confidence

cultural competence

emotional intelligence

interpersonal skills

integrity

morals and ethics

motivation

optimism

persuasiveness

professionalism

selflessness

self-mastery

system thinker

trustworthy

visionary

B-1-4 Demonstrate knowledge and ability to model professionalism including:

accountability

appearance

attitude

behavior

collaboration

Competency: B-1 Page: 2

Informal Leadership



B-1-4 Demonstrate knowledge and ability to model professionalism including:

(cont’d)

competence

dependability

effective resource utilization

lifelong learning

professional communicator

responsibility

self-reflective practice

work ethic

B-1-5 Demonstrate knowledge and ability to assess, reflect and recognize own

strengths and limitations as a leader to achieve optimum personal and

professional growth.

B-1-6 Demonstrate knowledge and ability to assign, educate and supervise

regulated provider/healthcare aide/unregulated provider/nursing students

including:

implement standards for assignment of care

ensure continuity of care

provide mentorship, coaching and guidance

evaluate and reassign as necessary

B-1-7 Demonstrate knowledge and ability to assess, influence and effectively

manage change.

B-1-8 Demonstrate knowledge and ability to elicit support and commitment from

others to achieve a common goal.

B-1-9 Demonstrate knowledge and ability to assess difficult situations and

effectively manage conflict.

B-1-10 Demonstrate knowledge and ability to network, mentor and support others.

B-1-11 Demonstrate knowledge and ability to follow appropriate channels of

communication and reporting according to agency policy.


Leadership

Competency: B-2

Formal Leadership





inquiry within a formal leadership role in nursing practice.

B-2-2 Demonstrate knowledge and ability to apply nursing care delivery model,

policies and procedures of employer.

B-2-3 Demonstrate knowledge and ability to supervise a team and assign client care

based on:

client needs

education and competence of team members

environmental supports

level of care required

roles and responsibilities of team members

B-2-4 Demonstrate knowledge and ability to provide leadership in establishment

and revision of goals, priorities and nursing intervention.

B-2-5 Demonstrate knowledge and ability to model exemplary leadership practices

including:

change management

client advocacy

collaboration

concise communication

conflict management

emergency response

resource utilization

strategic thinking

support and mentor staff

system thinking

time management


Formal Leadership



B-2-6 Demonstrate knowledge and ability to organize and lead case conferences,

meetings and report.

B-2-7 Demonstrate knowledge and commitment to organizational planning through

committee and task force involvement.


Leadership

Competency: B-3

Manager/Administrator





inquiry within the role of manager/administrator of an organization.

B-3-2 Demonstrate knowledge and ability to lead and guide an organization

including:

delegate duties and responsibilities appropriately

identify and model the vision, mission, values and goals

influence and mentor staff, colleagues, boards and others

involve staff and colleagues in decision making

lead, guide, participate in strategic planning

model leadership characteristics

network with internal and external experts/stakeholders

organize and facilitate meetings

promote continuing competence opportunities

seek continual quality improvement

understand trends and necessary future changes

B-3-3 Demonstrate knowledge and ability to identify and manage risks within an

organization including:

differentiate between legal, ethical, quality, safety, staffing and emergent risks

intervene effectively to prevent, eliminate or minimize risks

identify and address policy needs

implement education and support

communicate effectively to staff, colleagues, boards and others

involve external experts as necessary


Manager/Administrator




inquiry in the human resource management role including:

career pathway development

collective agreements

disability management

interpreting legislation and regulation

job descriptions, policies, procedures

job interviews

performance appraisals and management

retention and recruitment

security and confidentiality of personnel information

team dynamics

wages and benefits

B-3-5 Demonstrate knowledge and ability to implement prudent fiscal management

as manager/administrator within an organization including:

align fiscal strategy with vision, mission, values and goals

assess, develop and manage budget

collect, analyze and report financial data

ensure a system of internal controls to safeguard resources




C: Nursing Knowledge

Major Competency Area: C

Nursing Knowledge

Competency: C-1

Date: January 16, 2017 Anatomy and Physiology



C-1-1 Identify the structures and functions of the body.

C-1-2 Describe the anatomical organization of the body.

C-1-3 Describe the cellular chemistry and organization of the body.

C-1-4 Describe cellular functions: protein synthesis, cell division and movement of

substances across the cell membrane.

C-1-5 Explain how cells are organized into tissue, organs and systems of the body.

C-1-6 Identify the structure and explain the function of body systems:

cardiovascular system

circulatory system

digestive system

endocrine system

genitourinary system

immune system

integumentary system

lymphatic system

musculoskeletal system

nervous system and special senses

reproductive system

respiratory system

C-1-7 Identify the components of blood and blood products.

C-1-8 Describe the major body processes of:

homeostasis

metabolism

reproduction


Nursing Knowledge

Competency: C-2

Microbiology Date: January 16, 2017



C-2-1 Explain characteristics of micro-organisms and their role in the transmission

of disease.

C-2-2 Describe and differentiate pathogens and non-pathogens.

C-2-3 Describe and differentiate bacteria, viruses and fungi.

C-2-4 Describe the normal micro-organisms within the human body.

C-2-5 Describe conditions for growth and transferability of micro-organisms.

C-2-6 Explain the concept of asepsis.

C-2-7 Explain the principles of disease prevention and health promotion.

C-2-8 Describe the concept of infection prevention and control.

C-2-9 Explain the relationship between microbiology as it relates to pharmacology.


Nursing Knowledge

Competency: C-3

Date: January 16, 2017 Pathophysiology



C-3-1 Define pathophysiology as the science of physiological and psychological

disease processes within the human body.

C-3-2 Identify and describe pathophysiological processes including:

acute conditions/disorders

chronic conditions/disorders

complications

etiology (cause of disease)

manifestations (signs and symptoms)

pathophysiology (disease process)

C-3-3 Identify the etiology, pathophysiology and complications of common health

problems for all body systems.

C-3-4 Describe body responses to disease including:

carcinogenesis

cellular/tissue/organ/system level

genetic

immunity/autoimmunity

inflammation

psychological

stress

C-3-5 Describe the processes of inflammation, infection and healing.

C-3-6 Explain types of trauma such as:

addictions

burns

fractures

hemorrhage

mental health

Competency: C-3

Page: 2

Pathophysiology



C-3-6 Explain types of trauma such as: (cont’d)

multisystem failure

neurological

psychological

shock

surgical

C-3-7 Explain common medical management in relation to pharmacology, surgery,

anesthesia and treatments.

C-3-8 Describe diagnostic tests commonly used in healthcare.


Nursing Knowledge

Competency: C-4

Date: January 16, 2017 Medical Terminology



C-4-1 Identify meanings of common prefixes, suffixes and root words used in

reporting and documenting.

C-4-2 Identify employer approved abbreviations.

C-4-3 Use appropriate medical terminology in reporting and documentation.

C-4-4 Apply agency policy regarding use of abbreviations and medical terminology.


Nursing Knowledge

Competency: C-5

Date: June 1, 2015 Growth and Development



C-5-1 Explain theories of human growth and development across the life span.

C-5-2 Describe the stages of growth and development across the life span.

C-5-3 Describe significant physical, psychological, social, cognitive, moral, spiritual

and cultural developments across the life span.

C-5-4 Describe how factors of environment, genetics, culture, lifestyle, religion and

maturation influence growth and development.

C-5-5 Describe the process of learning across the life span.

C-5-6 Describe the stages of death, dying, grief and the grieving process.


Nursing Knowledge

Competency: C-6

Date: January 16, 2017 Nutrition



C-6-1 Describe the importance of nutrition to health and recovery.

C-6-2 Identify the functions, major sources and daily requirements for common

nutrients including:

carbohydrate

fat

fiber

minerals

protein

vitamins

C-6-3 Identify Canada’s Food Guide and/or special dietary requirements for

healthy and chronic conditions across the life span.

C-6-4 Identify factors that affect nutrition and hydration.

C-6-5 Identify indicators of adequate and inadequate nutrition and hydration.

C-6-6 Describe methods to assess nutrition and hydration status including:

body mass index

diet history

food allergies

general appearance

height and weight

intake/output

lab values

perception of body image

skin turgor

socio-economic challenges

swallowing

waist circumference

C-6-7 Describe the purpose and elements of therapeutic diets/ dietary restrictions.

C-6-8 Identify when to consult with a dietician/nutritionist.


Nursing Knowledge

Competency: C-7

Date: January 16, 2017 Pharmacology



C-7-1 Define pharmacology.

C-7-2 Describe the process of pharmacokinetics and pharmacodynamics across the

life span.

C-7-3 Identify classifications, generic and trade names of drugs and appropriate

pharmacological resources.

C-7-4 Describe the principles of pharmacology management including:

assessment

controlled substances

documentation

policy and procedures

safe handling (storage, transport, disposal)

the rights

C-7-5 Identify the common routes of medication administration.

C-7-6 Recognize high/low/expected lab values related to pharmacology.

C-7-7 Describe effects of drugs including:

adverse reaction

allergic reaction

body system impact

drug interactions

side effects

synergistic effects (additive and antagonistic).

therapeutic effects

C-7-8 Describe the signs, symptoms and treatment of anaphylaxis.

Competency: C-7 Page: 2

Pharmacology



C-7-9 Identify common systems of measurement in medication administration.

C-7-10 Identify formulas to calculate medication dosages.

C-7-11 Differentiate between intentional and unintentional drug use and

dependence.

C-7-12 Differentiate between physiological and psychological dependence.

C-7-13 Identify common drug/medication legislation and standards.

C-7-14 Identify roles and responsibilities of inter-professional team related to

pharmacology.


Nursing Knowledge

Competency: C-8

Date: January 16, 2017 Social Science and Humanities



C-8-1 Describe fundamentals of nursing knowledge that encompass human caring

related to arts, science and humanitarianism including:

experiences

phenomena

processes

C-8-2 Understand foundations of English language and literacy:

comprehension

content

grammar

mechanics

organization

rhetorical analysis

writing skill and style

C-8-3 Identify effective communication strategies to engage with individuals,

groups and communities:

interpersonal

professional

therapeutic

C-8-4 Identify foundational concepts of personal health and wellness related to

individuals, groups and communities including:

addictions

communicable disease control

immunization

mental health/stress management

neglect/abuse

nutrition/physical activity

population health

prevention/wellness

sexual activity/family planning

violence


Social Science and Humanities



C-8-5 Describe foundations of health and wellness of self and others across the

lifespan:

environmental

psychological

physical

social

spiritual

C-8-6 Describe determinants of health and impact on individual health and

wellness.

C-8-7 Understand foundations of psychology in relation to human behavior and

development across the lifespan including:

behavior

cognition and intelligence

conditioning and learning

emotion and motivation

memory

perception

sensation

states of consciousness

stress and health

psychological health and illness

C-8-8 Understand the concept of advocacy through promotion of wellness behavior

and practices for:

individuals

groups

communities

C-8-9 Demonstrate knowledge of foundations of sociology related to social behavior

and relationships across the lifespan:

social

biological

emotional

political


Social Science and Humanities



C-8-9 Demonstrate knowledge of foundations of sociology related to social behavior

and relationships across the lifespan: (cont’d)

cultural

cognitive

spiritual

C-8-10 Demonstrate knowledge and ability to apply foundations of sociology to

ethical nursing practice.


Nursing Knowledge

Competency: C-9

Date: January 16, 2017 Best Practices and Research



C-9-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry in validation and application of research:

applicability

consistency of data

ethical, political, professional issues

identifiable bias

method and sources

relevance

trustworthiness

C-9-2 Demonstrate knowledge and ability to implement best practices and research

into evidence informed practice.

C-9-3 Demonstrate knowledge and ability to participate in the involvement of

clients, families and inter-professional team in formalized research.

C-9-4 Demonstrate ability to collaborate with research team to plan, conduct and

evaluate nursing research.


D: Nursing Process

Major Competency Area: D

Nursing Process

Competency: D-1

Date: January 16, 2017 Assessment



D-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout health assessment.

D-1-2 Demonstrate knowledge and ability to assess client considering multiple data

sources including:

current status

historical information

objective data

subjective data

D-1-3 Demonstrate knowledge and ability to identify primary and secondary

sources of data.

D-1-4 Demonstrate knowledge of methods of data collection and assessment tools.

D-1-5 Demonstrate knowledge and ability to perform a holistic health assessment:

psychosocial

o cultural

o developmental

o economic

o emotional

o environmental

o mental

o social

o spiritual

physiological

o biological

o cognitive

o functional

o physical

Page: 2

Competency: D-1

Assessment



D-1-6 Demonstrate knowledge and ability to perform and interpret:

• vital signs• blood glucose level

• elimination

• hydration

• pain• oxygenation• allergies and sensitivities• level of consciousness• specimen collection

• Including:o ARO (Antibiotic Resistant Organism) swabso Nasophayngeal swabso Tissue and wound swabso Stool sampleso Urine sampleso Blood

D-1-7 Demonstrate knowledge and ability to relate assessment findings to nursing

practice.

kmickleborough

Highlight


Nursing Process

Competency: D-2 Date: January 16, 2017 Nursing Diagnosis



D-2-1 Demonstrate knowledge related to domains addressed in development of

nursing diagnosis.

D-2-2 Demonstrate knowledge and ability to differentiate a nursing diagnosis from

a medical diagnosis.


inquiry to generate nursing diagnosis using data from comprehensive holistic

assessment:

identify actual and potential concerns/health issues

research and validate components of client issues and concerns

apply nursing diagnosis framework

D-2-4 Demonstrate knowledge and ability to communicate nursing diagnosis with

client, family and inter-professional team.

D-2-5 Demonstrate knowledge and ability to document nursing diagnosis and

determine expected outcomes and plan.

D-2-6 Demonstrate knowledge and ability to compare actual outcomes with

expected outcomes and review and modify plan of care based on changing

needs.

D-2-7 Demonstrate knowledge and ability to communicate, consult and collaborate

with inter-professional team.


Nursing Process

Competency: D-3 Date: January 16, 2017 Planning




inquiry throughout planning of care.

D-3-2 Demonstrate knowledge and ability to collaborate with the client and family

throughout planning of care.

D-3-3 Demonstrate knowledge and ability to develop a plan of care based on client

needs, priorities, expectations and values.

D-3-4 Demonstrate knowledge and ability to anticipate potential barriers to

achieving plan of care.

D-3-5 Demonstrate knowledge and ability to utilize best available data, resources

and evidence to develop a plan of care.

D-3-6 Demonstrate knowledge and ability to communicate and collaborate with

inter-professional team throughout planning of care.


Nursing Process

Competency: D-4

Date: January 16, 2017 Implementation




inquiry throughout implementation of plan of care.

D-4-2 Demonstrate knowledge and ability to collaborate with client and family

throughout implementation of plan of care.

D-4-3 Demonstrate knowledge and ability to implement a plan of care based on

client needs, priorities, expectations and values.

D-4-4 Demonstrate knowledge and ability to anticipate potential barriers to

implementation of plan of care.


and evidence throughout implementation of plan of care.


inter-professional team throughout implementation of plan of care.


Nursing Process

Competency: D-5

Date: January 16, 2017 Evaluation




inquiry throughout evaluation of plan of care.

D-5-2 Demonstrate knowledge and ability to collaborate with client and family

throughout evaluation of plan of care.

D-5-3 Demonstrate knowledge and ability to evaluate plan of care based on:

client needs, priorities, expectations and values

client response to care

client progress

challenges and barriers


and evidence throughout evaluation of plan of care:

assess quality/effectiveness of care

measure level of care required

determine family/social support system

D-5-5 Demonstrate knowledge and ability to revise plan of care based on

evaluation.


inter-professional team throughout evaluation of plan of care.




E: Safety

Major Competency Area: E

Safety

Competency: E-1

Date: January 16, 2017 Urgent and Emergent Situations



E-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry in application of nursing process throughout urgent or emergent

situations.

E-1-2 Demonstrate knowledge and ability to recognize, participate and/or manage

urgent or emergency preparedness situations according to agency policy

including, but not limited to:

bomb threat/suspicious package

cardiac arrest/medical emergency

chemical spill/hazardous material

evacuation

fire

hostage

mass casualty incident

missing person

severe weather

shelter in place/air exclusion

violence/aggression

E-1-3 Demonstrate knowledge and ability to differentiate and rank priority needs

in an urgent or emergent situation.

E-1-4 Demonstrate knowledge and ability to communicate and collaborate with

inter-professional team in an urgent or emergent situation.

E-1-5 Demonstrate knowledge and ability to evaluate response following urgent or

emergent situations.

E-1-6 Demonstrate knowledge and ability to manage and/or participate in

debriefing following urgent or emergent situations.

E-1-7 Demonstrate knowledge and ability to report and document throughout

urgent or emergent situations according to agency policy.


Safety

Competency: E-2

Date: January 16, 2017 Protective Equipment



E-2-1 Demonstrate knowledge of importance of personal protective equipment

(PPE) and workplace safety equipment.

E-2-2 Demonstrate knowledge and ability to properly don, doff and dispose of

personal protective equipment.

E-2-3 Demonstrate knowledge and ability to utilize workplace safety equipment

according to agency policy.


Safety

Competency: E-3

Date: January 16, 2017 Infection Prevention and Control



E-3-1 Demonstrate knowledge and ability to apply concepts of infection prevention

and control to reduce transmission of pathogenic micro-organisms.

E-3-2 Demonstrate knowledge and ability to apply principles of aseptic or sterile

technique appropriate to client care.

E-3-3 Demonstrate knowledge and ability to apply principles of routine/ standard

precautions including:

bio-medical waste and sharps handling

environmental cleaning

hand hygiene

handling client specific items and equipment (including technological devices)

point of care risk assessment

personal protective equipment

o gloves

o gowns

o masks and eye protection

respiratory hygiene

visitor management

E-3-4 Demonstrate knowledge and ability to apply exposure precautions according

to agency policy:

airborne

contact

droplet

E-3-5 Demonstrate knowledge and ability to immediately manage and report

incidents of exposure including:

body fluid exposure

equipment failure

needle stick injuries

Competency: E-3

Page: 2 Infection Prevention and Control



E-3-6 Demonstrate knowledge and ability to apply best practices for single use,

client owned and multi-client reusable medical devices.

E-3-7 Demonstrate knowledge and ability to prepare multi-client reusable medical

devices for specialized cleaning, disinfection and sterilization according to

agency policy.


Safety

Competency: E-4

Date: January 16, 2017 Client Safety



E-4-1 Demonstrate knowledge and ability to maintain safety principles that apply

to self, client, inter-professional team and others.

E-4-2 Demonstrate knowledge and ability to promote and implement a culture of

safety through shared:

attitudes

goals

practices

values

E-4-3 Demonstrate knowledge and ability to assess, plan and manage client safety

throughout care delivery including:

adverse reactions

chemical, physical and environmental restraints

error prevention practices

managed risk waiver

E-4-4 Demonstrate knowledge and ability to accurately report and document client

safety issues according to agency policy and Legislation.


Safety

Competency: E-5

Date: January 16, 2017 Workplace Safety



E-5-1 Demonstrate knowledge and understanding of the Occupational Health and

Safety Act, Regulation and Code (OH&S).

E-5-2 Demonstrate understanding and responsibility to comply with agency policies

and OH&S Act, Regulation and Code to achieve workplace safety.

E-5-3 Demonstrate accountability to safety of self, client and others by effectively

contributing and adhering to safety culture:

attend OH&S orientation and training programs

recognize workplace hazards and controls

report unsafe conditions as per employer policy

report workplace incidents of injury as per Workers’ Compensation Act

E-5-4 Demonstrate knowledge and ability to utilize controls to identify and reduce

risk of physical injury of self and others including:

hazard and exposure assessment (chemical, biological)

safe handling and use of tools and equipment

safe lifting and transferring of loads (patient, equipment)

use of personal protective equipment (footwear, eyewear, headwear, and

hearing protection as necessary)

E-5-5 Demonstrate knowledge and ability to utilize strategies to identify and reduce

risk of psychological injury of self and others including:

employer policy and procedure

non-violent crisis intervention, conflict management

procedure for reporting and documenting

rights and responsibilities under legislation

safe and appropriate responses to incidents or potential incidents

support services available in the event of an incident involving violence or

harassment

workplace violence and harassment risk factors




F: Communication and Interpersonal Skills

Major Competency Area: F

Communication and Interpersonal Skills

Competency: F-1 Date: January 16, 2017 Effective Communication



F-1-1 Demonstrate knowledge and ability to apply verbal and non-verbal

communication techniques to create therapeutic relationships including:

respectful tone and manner

active listening

paraphrasing and reflecting

seek clarification

timeliness

adjust style as necessary

write clearly and accurately

F-1-2 Demonstrate knowledge and ability to apply verbal and non-verbal

techniques to establish effective communication with inter-professional team

and others.

F-1-3 Demonstrate knowledge and ability to adapt communication techniques to

address barriers including:

cognitive

cultural

developmental

emotional

functional

language

mental

social

spiritual



Competency: F-2 Date: January 16, 2017 Collaborative Team Practice



F-2-1 Demonstrate knowledge and ability to work toward a collective vision

through inter-professional collaboration as outlined in:

Standards of Practice for Licensed Practical Nurses in Canada

Inter-professional Competency Framework (Canadian Inter-professional

Health Collaborative, 2010)

employer policy

F-2-2 Demonstrate knowledge and respect for role of self and other providers in

the healthcare system.

F-2-3 Demonstrate knowledge and ability to engage client, family and others as

partners in client centered care.

F-2-4 Demonstrate knowledge and understanding of principles of team dynamics

and group processes to create positive workplace environment.

F-2-5 Demonstrate knowledge and ability to practice effective interpersonal

communication.

F-2-6 Demonstrate knowledge and ability to utilize a standardized communication

tool to enhance communication process such as:

SBAR situational briefing model:

o S-situation

o B-background

o A-assessment

o R-recommendation

F-2-7 Demonstrate knowledge and ability to address and effectively manage

conflict.



Competency: F-3 Date: January 16, 2017 Therapeutic Nurse-Client Relationship



F-3-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry in application of the nursing process throughout the therapeutic

nurse-client relationship.

F-3-2 Demonstrate knowledge and ability to practice in accordance with

professional Legislation, regulation, standards and guidelines of nursing

practice.

F-3-3 Demonstrate knowledge and ability to use appropriate communication

techniques to establish, maintain and close the therapeutic nurse-client

relationship related to:

advocacy

cultural competence

empathy and empowerment

health teaching and coaching

supportive measures and intent

trust and respect

F-3-4 Demonstrate knowledge and ability to define and maintain professional and

personal boundaries related to:

giving/receiving gifts

caring for family/friends

conflict of interest

limited self-disclosure

understanding interpersonal relationships

F-3-5 Demonstrate knowledge and ability to recognize and address barriers to an

effective therapeutic nurse-client relationship related to:

breach of confidentiality

personal behavior

personal bias

power imbalance



Competency: F-4 Date: January 16, 2017 Health Teaching and Coaching



F-4-1 Demonstrate knowledge of factors that influence teaching and learning

including:

access to resources

determinants of health

learning styles and preferences

F-4-2 Demonstrate knowledge and ability to apply health teaching and coaching

principles to achieve effective learning related to:

goal setting

motivational practices

positive psychology

F-4-3 Demonstrate ability to apply nursing knowledge and clinical expertise

throughout health teaching and coaching related to:

application of best practices

evidence informed approach to care

sharing of resources

F-4-4 Demonstrate knowledge and ability to develop and deliver an individualized

teaching and coaching plan to foster client decision making, self-efficacy and

navigation of the healthcare system.

F-4-5 Demonstrate knowledge and ability to evaluate teaching, coaching and

learning outcomes.



Competency: F-5 Date: January 16, 2017

Legal Protocols, Documenting and Reporting



F-5-1 Demonstrate professional accountability and responsibility to ensure

adherence to legal protocols and documenting and reporting guidelines.

F-5-2 Demonstrate knowledge and ability to ensure accurate, concise and complete

documentation.

F-5-3 Demonstrate knowledge and ability to adhere to applicable legal protocols

and Legislation affecting client.

F-5-4 Demonstrate knowledge and ability to adapt documenting and reporting

according to specific practice setting requirements and agency policy.

F-5-5 Demonstrate knowledge and ability to obtain informed consent throughout

care delivery as appropriate and according to agency policy.

F-5-6 Demonstrate knowledge and ability to manage, report and document refusal

of treatment or self-discharge.

F-5-7 Demonstrate knowledge and ability to appropriately report and collaborate

within inter-professional team.



Competency: F-6 Date: January 16, 2017 Accept, Transcribe and Initiate Orders



F-6-1 Demonstrate knowledge and ability to accept, transcribe and initiate orders

from authorized health professional(s) according to agency policy related to:

electronic

phone

verbal

written

F-6-2 Demonstrate knowledge and ability to contact authorized health

professional(s) to clarify a suspected unsafe or questionable order:

confirm accuracy and completeness

discuss potential actions and/or interactions

share concerns related to clients changing needs



Competency: F-7 Date: January 16, 2017 Conflict Management



F-7-1 Demonstrate knowledge and ability to recognize common sources of conflict

in self and others including:

beliefs, values, and biases

expectations

financial concerns

individual differences

professional roles

F-7-2 Demonstrate knowledge and ability to intervene immediately in urgent

situations involving conflict related to:

safety of patient(s)

safety of self or others

F-7-3 Demonstrate knowledge and ability to focus on the problem/issue not the

individual(s).

F-7-4 Demonstrate knowledge and ability to manage conflict effectively by

identifying:

problem/issue

subjective interest/investment

intentional and unintentional contributions

mutual options/possible resolutions

objective criteria

F-7-5 Demonstrate knowledge and ability to consult with appropriate

professional(s) as required in situations of conflict.


G: Nursing Practice

Major Competency Area: G

Nursing Practice

Competency: G-1

Date: January 16, 2017 Critical Thinking and Critical Inquiry



G-1-1 Demonstrate knowledge of importance of critical thinking and critical

inquiry to nursing practice.

G-1-2 Demonstrate knowledge of how critical thinking and critical inquiry

influence clinical judgment and decision making.

G-1-3 Demonstrate ability to utilize critical inquiry to expand critical thinking

through analysis, discernment and reflective reasoning related to:

actions

assumptions

beliefs

conclusions

ideas

principles

G-1-4 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the decision making process:

identify facts

prioritize risks and problems

analyze best available evidence

clarify and challenge assumptions

identify and analyze the context

identify anticipated outcome


Nursing Practice

Competency: G-2


Clinical Judgment and Decision Making



G-2-1 Demonstrate importance of clinical judgment and decision-making in

nursing practice and inter-personal relationships.

G-2-2 Demonstrate knowledge and ability to integrate evidence informed practice

in clinical judgment and decision making:

identify concern

reflect on prior knowledge, experience and intuition

assess potential for inaccurate judgments and decisions

establish a plan to achieve desired outcomes

implement the plan

evaluate effectiveness of process and assess outcomes

alter plan to achieve desired outcomes if required

review and suggest alternatives to policy and procedures

reflect on knowledge gained and impact on professional practice

G-2-3 Demonstrate knowledge and ability to communicate and collaborate with

inter-professional team as necessary throughout the decision making process.


Nursing Practice

Competency: G-3

Date: January 16, 2017 Time Management



G-3-1 Demonstrate knowledge and ability to manage time effectively.

G-3-2 Demonstrate knowledge and ability to prioritize and respond to client care

needs related to the following factors:

emergent – immediate threat to survival or safety

urgent – problems requiring immediate intervention

less urgent – problems requiring non-immediate intervention

non-urgent – anticipated problems in future

G-3-3 Demonstrate knowledge and ability to seek guidance and assistance from

inter-professional team as necessary.

G-3-4 Demonstrate knowledge and ability to assess and monitor own fitness to

practice while prioritizing care.

G-3-5 Demonstrate ability to respect inter-professional team in decisions of

personal time management including:

arriving for work on time

collaborating in care delivery

conducting self professionally

limiting personal activities to personal time (social media, texting, personal

calls)

managing breaks effectively

remaining until transfer of care is complete to avoid abandonment of care

G-3-6 Demonstrate knowledge and ability to adapt to unexpected demands.


Nursing Practice

Competency: G-4

Date: January 16, 2017 Admission and Discharge



G-4-1 Demonstrate knowledge and ability to perform admission and discharge

procedures including:

comprehensive client assessment and history

medication reconciliation

advanced care planning/goals of care

advocate for client needs

processing orders

managing transfers and referrals

health teaching and coaching

documenting and reporting


Nursing Practice

Competency: G-5

Date: January 16, 2017 Activities of Daily Living



G-5-1 Demonstrate knowledge and ability to assess client functional status to

independently perform self-care including:

basic:

o dressing

o functional mobility/lift and transfer

o ambulation/range of motion

o personal hygiene and grooming

o feeding/hydration

o toilet hygiene

instrumental:

o care of others, pets

o communication (telephone, technology)

o community mobility

o financial management

o health and medical interventions

medication management

o home management

housework

meal preparation

routine maintenance

shopping

sidewalk clearing

G-5-2 Demonstrate knowledge and ability to assess client inability to achieve

independent self-care including:

physical and cognitive impairments

gaps in support system

homelessness


Nursing Practice

Competency: G-6

Date: January 16, 2017 Nutrition/Hydration



G-6-1 Demonstrate knowledge and ability to assess and provide nutrition/hydration

by multiple routes:

enteral

gastrostomy

hypodermoclysis

intravenous

jejunostomy

nasogastric

nasojejunal

oral

G-6-2 Demonstrate knowledge and ability to insert, manage and remove a

nasogastric tube.

G-6-3 Demonstrate knowledge and ability to reinsert and manage established

gastrostomy tube.

G-6-4 Demonstrate knowledge and ability to perform basic chewing and swallowing

assessment and manage associated client care needs.

G-6-5 Demonstrate knowledge and ability to administer, monitor and regulate

Parenteral Nutrition.

Note: LPNs are not authorized to insert devices using a guide-wire or stilette.


Nursing Practice

Competency: G-7

Date: January 16, 2017 Elimination



G-7-1 Demonstrate knowledge and ability to manage elimination needs including,

but not limited to:

urinary:

o bladder scanning

o catheter flush o continuous bladder irrigation

o distension

o double J stent

o incontinence

o inserting and removing urethral and coude catheter o ileal conduit (urinary diversion)

o nephrostomy

o re-inserting established suprapubic catheter

o residual urine

o retraining o urethrostomy

o urostomy

o vaginal pessary

bowel:

o digital stimulation

o enema

o fecal disimpaction

o nasogastric tube

o ostomies

irrigation

o rectal tubes

o suppository

G-7-2 Demonstrate knowledge and ability to utilize devices and equipment related

to elimination needs.

Note: LPNs are not authorized to insert devices using a guide-wire or stilette.


Nursing Practice

Competency: G-8

Date: January 16, 2017 Peritoneal Dialysis



G-8-1 Demonstrate knowledge of indications and risks associated with peritoneal

dialysis.

G-8-2 Demonstrate knowledge and ability to monitor and manage peritoneal

catheter site.

G-8-3 Demonstrate knowledge and ability to perform procedures involved in

peritoneal dialysis:

initiate, monitor and discontinue

intra-peritoneal medication administration

G-8-4 Demonstrate knowledge and ability to calculate weekly clearance of urea by

client’s kidneys.

G-8-5 Demonstrate knowledge and ability to provide health teaching and coaching

to client receiving peritoneal dialysis.


Nursing Practice

Competency: G-9

Date: January 16, 2017 Basic Foot Care



G-9-1 Demonstrate knowledge and ability to manage basic foot care for client

including trimming and filing nails.

G-9-2 Demonstrate knowledge of common micro-organisms of the feet including:

bacteria

viruses

fungi

yeast

G-9-3 Demonstrate knowledge of infection prevention and control standards

associated with foot care.

G-9-4 Demonstrate knowledge and ability to assess compromised circulation and its

effects on lower extremities.

G-9-5 Demonstrate knowledge and ability to manage basic foot care in client with

compromised circulation.

G-9-6 Demonstrate knowledge and ability to teach appropriate foot care to client,

family and others.

G-9-7 Demonstrate knowledge and ability to refer client to advanced foot care

professional(s) as appropriate.


Nursing Practice

Competency: G-10

Date: January 16, 2017 Basic Wound Care




inquiry throughout the nursing process related to skin care/wound

management protocols.

G-10-2 Demonstrate knowledge and ability to identify client at risk for recurrence or

exacerbation of skin breakdown.

G-10-3 Demonstrate knowledge and understanding of pathophysiology and etiology

related to principles of wound healing and wound care management such as:

biochemical process related to wound healing

o hemostasis

o inflammation

o proliferation/granulation

o remodeling/maturation

differentiate between acute, chronic and malignant wounds

factors related to optimal healing environment

factors which impede healing

o vascular compromise

o immunodeficiency

o metabolic disease

o connective tissue disorders

o malignancy

o nutritional deficiencies

o psychosocial disorders/self-harm

o adverse effects of medications

o infection, burns, trauma

utilize wound classification and staging tools (Braden scale)

Competency: G-10

Page: 2 Basic Wound Care



G-10-4 Demonstrate knowledge and ability to perform basic wound care utilizing

medical/surgical asepsis as needed:

acute wounds

skin ulceration wounds

ostomy dressings

occlusive dressings

pressure dressings

specialized (wound equipment)

negative pressure therapy (Wound Vac)

wound compresses

wound irrigation

wounds with drain

wounds with packing

G-10-5 Demonstrate knowledge of purpose of wound debridement.

G-10-6 Demonstrate knowledge and ability to assess psychosocial and quality of life

concerns of client and others related to wound care management including:

alterations of body image/lifestyle

attitudes and feelings/beliefs and values

communication difficulties/information needs

involve client and family in care planning/decision making

pain management strategies

patient-centered holistic care


to client, family and others related to wound care management and the

healing process.


inter-professional team.


Nursing Practice

Competency: G-11

Date: January 16, 2017 Advanced Wound Care



G-11-1 Demonstrate knowledge and ability to apply the nursing process in

assessment and management of complex acute, chronic and malignant

wounds related to:

arterial disease

o acute thrombosis

o chronic atherosclerosis

venous disease

o acute deep vein thrombosis (DVT)

o chronic venous insufficiency

o varicose veins

co-morbidities

chronic edema

allergies/sensitivities

complicated post-surgical

diabetes

exudate management/malodorous secretions

functional limitations/compromise

lymphatic system sufficiency/compromise

neuropathic/neurogenic associated pain

tumor necrosis/fungating cancers

vascular insufficiency/compromise

G-11-2 Demonstrate knowledge and ability to perform clinical and technical

vascular assessment of lower limbs including:

complete medical/physical history

o current health status

o previous fractures, investigations, treatments

o prior use of compression therapy

o co-morbidities

o pain (type, location)

o current medications

o family history

Competency: G-11 Page: 2

Advanced Wound Care



G-11-2 Demonstrate knowledge and ability to perform clinical and technical

vascular assessment of lower limbs including: (cont’d)

physical examination

o skin integrity/color/temperature/rubor/blanche

o hair and nail condition/growth pattern

o presence/absence of pulses (femoral, popliteal, posterior tibial, dosalis

pedis)

o presence/absence of varicosities

o mobility/range of motion

o structural deformities

o ankle brachial pressure indices (ABPI)

o photoplethysmography (pulse oximeter)

o Doppler application / interpretation

o neuropathy monofilament testing

G-11-3 Demonstrate knowledge and ability to perform advanced wound care

treatment modalities and wound dressing to promote healing based on:

classification/characteristics of wound

phase of healing

client need and risk factors (allergies/sensitivities/comorbidities/lifestyle)

protection against secondary injury

insulates and moistens wound bed to promote healing

provides effective barrier to microorganisms

prevents maceration/irritation of surrounding tissues

free from particulate/toxins

prevent secondary trauma upon removal of dressing

G-11-4 Demonstrate knowledge of adjunctive therapies often associated with care of

advanced wounds such as:

electrical stimulation

hyperbaric oxygen therapy

compression therapy

Competency: G-11 Page: 3

Advanced Wound Care



G-11-5 Demonstrate knowledge and ability to perform negative pressure therapy

(wound VAC) associated with care of advanced wounds.

G-11-6 Demonstrate knowledge and ability to perform wound debridement as

defined:

Level 1: removal of loose, avascular skin tissue

Level 2: removal of tissue within the dermis and hypodermis (not beyond the

subcutaneous fascia)

G-11-7 Demonstrate knowledge and ability to identify clients at risk for recurrence

or exacerbation of skin breakdown and develop appropriate prevention

strategies.

G-11-8 Demonstrate knowledge and ability to assess psychosocial and quality of life

concerns of client and others related to advanced wound care management

including:

patient-centered holistic care

alterations of body image/lifestyle

attitudes and feelings/beliefs and values

cosmetic effects of dressings

communication difficulties/information needs

coping strategies and available support services

sociocultural issues (marginalization/social isolation)

impact on interpersonal relationships/functional ability

pain management strategies

socioeconomic issues (financial, relational, emotional, spiritual)

expectations/short and long term goals

involve client and family in care planning/decision making


to client, family and others related to advanced wound care management and

the healing process.

G-11-10 Demonstrate knowledge and ability to communicate, consult and collaborate



Nursing Practice

Competency: G-12


Phlebotomy for the Purpose of Drawing Blood




inquiry throughout the nursing process related to phlebotomy.

G-12-2 Demonstrate knowledge of anatomy and physiology related to phlebotomy

technique.

G-12-3 Demonstrate knowledge and ability to perform phlebotomy and manage

blood samples according to agency policy.


related to phlebotomy.



G-12-6 Demonstrate knowledge of use of therapeutic phlebotomy for conditions

including:

hemochromatosis

sickle-cell anemia

polycythemia

G-12-7 Demonstrate knowledge and ability to perform therapeutic phlebotomy



Nursing Practice

Competency: G-13

Date: January 16, 2017 Client Centered Care



G-13-1 Demonstrate knowledge and ability to integrate concepts of client centered

care throughout care delivery including:

client engagement (life history, belief, experiences)

collaborative partnerships

empowering communication

health advocacy, support and empowerment

holistic assessment

obtaining informed consent

ready access and autonomy

respecting client needs, values and preferences

G-13-2 Demonstrate knowledge and ability to identify relationship between client

centered care and outcomes in health management:

anxiety reduction

satisfaction with health outcomes

engagement and empowerment

rights, needs, goals and preferences of client addressed

satisfaction with healthcare system

self-management and self-efficacy


that fosters client decision making and self-efficacy.


client, family, others and inter-professional team to ensure delivery of client

centered care.


Nursing Practice

Competency: G-14


Complementary and Alternative Therapies



G-14-1 Demonstrate knowledge of differences between conventional medicine and

complementary and alternative therapies.

G-14-2 Demonstrate knowledge of common complementary and alternative

therapies such as:

bio-field/energy (Reiki, electro-magnetic, therapeutic touch)

biologically based (dietary supplements, herbal products, vitamins)

manipulative and body based (massage, reflexology, chiropractic)

mind-body (hypnosis, visual imagery, meditation)

whole medical (homeopathy, naturopathy, traditional healing)

G-14-3 Demonstrate knowledge and ability to assess and consider impact of

complementary and alternative therapies on client’s goals of care.

G-14-4 Demonstrate knowledge and ability to assess and consider impact of

complementary and alternative therapies on nursing interventions and plan

of care.

G-14-5 Demonstrate knowledge and ability to assess and consider risk factors

associated with complementary and alternative therapies.

G-14-6 Demonstrate knowledge and ability to recognize and support client’s decision

to supplement or replace conventional care with complementary and

alternative therapy.


Nursing Practice

Competency: G-15

Date: January 16, 2017 Post-Mortem Care



G-15-1 Demonstrate knowledge and ability to assess cessation of vital signs.

G-15-2 Demonstrate knowledge and ability to pronounce death according to agency

policy.

G-15-3 Demonstrate knowledge and ability to notify appropriate individuals.

G-15-4 Demonstrate knowledge and ability to care for the body adhering to infection

prevention and control standards.

G-15-5 Demonstrate knowledge and ability to care for the body adhering to cultural

concerns.

G-15-6 Demonstrate knowledge and ability to manage client valuables.

G-15-7 Demonstrate knowledge and ability to assist with post mortem examination,

organ donation and sample procurement.

G-15-8 Demonstrate knowledge and ability to notify funeral home, prepare

documents, and arrange transfer of body.

G-15-9 Demonstrate knowledge and ability to collaborate with inter-professional

team to provide resources and support to client and others




H: Respiratory Care

Major Competency Area: H

Respiratory Care

Competency: H-1 Date: January 16, 2017 Airway Management



H-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in airway assessment and

management.

H-1-2 Demonstrate knowledge and ability to manage airway issues associated with

acute and chronic conditions.

H-1-3 Demonstrate knowledge and ability to assist in the management of airway

devices including:

oropharyngeal airway (OPA)

o includes insertion and removal

nasopharyngeal airway (NPA)

o includes removal

endotracheal airway (trach)

laryngeal mask airway (LMA)

other respiratory assist devices:

o self-inflating resuscitator (Ambu-bag)

o self-inflating resuscitator via mask

o bilevel positive airway pressure (BiPAP)

o continuous positive airway pressure (CPAP)

H-1-4 Demonstrate knowledge and ability to provide care for client with

mechanical ventilation according to agency policy.

H-1-5 Demonstrate knowledge and ability to provide health teaching and coaching

associated with respiratory disorders including:

activity intolerance

airway management

altered sleep pattern

anxiety

ineffective airway clearance

ineffective breathing pattern

trauma


Respiratory Care

Competency: H-2

Oxygen Therapy Date: January 16, 2017



H-2-1 Demonstrate knowledge and ability to recognize indications and

contraindications for oxygen administration.

H-2-2 Demonstrate knowledge and ability to apply and manage oxygen therapy

devices including:

aerosol mask (simple face mask)

self-inflating resuscitator (bag-valve mask)

nasal cannula

non re-breathing mask

mechanical ventilation

oropharyngeal airway (OPA)

bilevel positive airway pressure (BiPAP) machine

continuous positive airway pressure (CPAP) machine

H-2-3 Demonstrate knowledge and ability to care for client with oxygen therapy

devices including:

laryngeal mask airway (LMA)

nasopharyngeal airway (NPA)

H-2-4 Demonstrate knowledge of safety precautions when utilizing oxygen therapy.


Respiratory Care

Competency: H-3

Suctioning Date: January 16, 2017




contraindications for suctioning.

H-3-2 Demonstrate knowledge and ability to perform suctioning beyond the

pharynx according to agency policy:

appropriate size and lumen of suction catheters

appropriate suction pressure

frequency of suctioning

appropriate depth

H-3-3 Demonstrate knowledge and ability to perform endotracheal suctioning


appropriate size and lumen of suction catheters

appropriate suction pressure

frequency of suctioning

appropriate depth

H-3-4 Demonstrate knowledge and ability to maintain suctioning equipment.


Respiratory Care

Competency: H-4

Respiratory Interventions Date: January 16, 2017



H-4-1 Demonstrate knowledge and ability to provide respiratory interventions.


contraindications for performing chest physiotherapy:

assisted coughing

deep breathing and coughing

incentive spirometer

orthopneic position

percussion (clapping)

postural drainage

vibration

H-4-3 Demonstrate knowledge and ability to evaluate effects of respiratory

interventions.


Respiratory Care

Competency: H-5

Tracheostomy Care Date: January 16, 2017




contraindications associated with tracheostomy tubes.

H-5-2 Demonstrate knowledge and ability to manage tracheostomy care:

• administering nebulized medication into a tracheostomy

• changing tracheostomy dressing

• changing and/or cleaning an inner cannula of a tracheostomy tube

• changing of tracheostomy ties

• cleaning a tracheostomy tube

• changing established tracheostomy• deflating/inflating a tracheostomy cuff

• humidification

• capping a tracheostomy tube

• suctioning

• using manual resuscitator (Ambu bag) H-5-3 Demonstrate knowledge of indications and contraindications of mechanical

ventilation.

H-5-4 Demonstrate knowledge and ability to manage a client with mechanical

ventilation.


Respiratory Care

Competency: H-6

Chest Tubes Date: January 16, 2017



H-6-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in care for client with chest drainage

system.


contraindications for chest tube insertion such as:

hemothorax

pleural effusion

pneumothorax

surgical treatment

tension pneumothorax

H-6-3 Demonstrate knowledge and ability to assist with insertion/removal of pleural

chest tube.

H-6-4 Demonstrate knowledge and ability to maintain an established chest drainage

system.

H-6-5 Demonstrate knowledge and ability to manage chest tube dressing changes.

H-6-6 Demonstrate knowledge and ability to identify complications and

appropriate interventions for client with chest drainage system including:

absence of fluid fluctuation in water seal chamber

apparatus lifted to client’s chest

apparatus malfunction

chest tubes dislodged

continuous bubbling in the water seal chamber

hemorrhage

incorrect tube placement

monitor drainage (amount/colour)

pulmonary edema

signs of infection

subcutaneous emphysema

tube occlusion




I: Surgical

Major Competency Area: I

Surgical

Competency: I-1

Surgical Nursing Date: January 16, 2017



I-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in care of a surgical client.

I-1-2 Demonstrate knowledge of clinical pathways related to surgical procedures

including:

pre-operative

intra-operative

post-operative

anticipated and unanticipated outcomes

I-1-3 Demonstrate knowledge and ability to provide evidence informed, client

centered care in relation to surgical nursing.

I-1-4 Demonstrate knowledge and ability to provide health teaching and coaching

associated with surgical nursing.

I-1-5 Demonstrate knowledge and ability to communicate and collaborate with



Surgical

Competency: I-2

Surgical Nursing Interventions Date: January 16, 2017



I-2-1 Demonstrate knowledge and ability to provide health teaching and coaching

associated with pre and postoperative care including:

deep breathing and coughing

dietary needs and restrictions

discharge education

drains and tubes

incentive spirometer

medication management

mobility and exercise

pain control

advanced care directive

post-operative care and rehabilitation

client expectations

referrals

surgical site and dressing

I-2-2 Demonstrate knowledge and ability to perform preoperative care according

to agency policy including:

confirm oral intake restrictions

ensure client/witness consent

family contact information

preoperative history and assessment

pre-surgical preparation/checklist

transfer client to operating room

Competency: I-2 Page: 2

Surgical Nursing Interventions



I-2-3 Demonstrate knowledge and ability to receive client from recovery room and

perform postoperative care including:

review physician/surgeon orders

initial postoperative assessment related to:

o binders/compression devices

o casts/splints/orthopedic devices

o cognitive status

o dermatome checks

o drainage devices and connections

o dressing/wounds

o infusion therapy

o neurovascular checks

o oxygen saturation

o pain and discomfort

o vital signs

ongoing monitoring for postoperative complications

safety precautions/mobilization/transfer methods

nutrition/elimination needs

pain management:

o pain assessment

o administer analgesics

o monitor patient controlled analgesia (PCA) pump

o monitor a patient post epidural infusion

I-2-4 Demonstrate knowledge and ability to manage a patient with a patient

controlled analgesia (PCA) pump and/or epidural infusion.

I-2-4 Demonstrate knowledge and ability to assess and manage surgical incision

and wound care to facilitate healing:

dressings

empty, remove drains

identify signs and symptoms of infection

irrigation

packing

removal of packing

removal of staples and sutures

wound VAC (vacuum assisted closure)


Surgical

Competency: I-3

Endoscopy Date: January 16, 2017



I-3-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in various procedures associated with

therapeutic and diagnostic endoscopy.

I-3-2 Demonstrate knowledge and ability to perform pre-procedural care

including:

complete health history


admission assessment

pre-procedural checklist

medication administration

I-3-3 Demonstrate knowledge of risks and precautions related to procedural

sedation.

I-3-4 Demonstrate knowledge and ability to perform post-procedural care

including:

observing for signs and symptoms of post-procedural complications including:

o abdominal distention

o abdominal pain

o chest pain

o crepitus

o decrease in client condition

o nausea and vomiting

o perforation

o rectal bleeding

o swelling of throat

o vital signs

pain/comfort management

discharge health teaching and coaching

referral to resources

Competency: I-3 Page: 2

Endoscopy



I-3-5 Demonstrate knowledge and ability to perform client assessment, monitoring

and intervention during various procedures associated with endoscopy.

I-3-6 Demonstrate knowledge and ability to administer procedural sedation


I-3-7 Demonstrate knowledge and ability to assist with various procedures

associated with therapeutic and diagnostic endoscopy according to agency

policy including:

upper/lower gastrointestinal procedures

pulmonary procedures

stabilize scope for the purpose of visualization

manage inflation/deflation of dilation device as directed

submucosal/intramural injection or tattoo-marking medication(s) as directed

manipulate biopsy and retrieval equipment to obtain specimen as directed

manipulate clip device to open, close and release as directed

prepare cautery equipment for use

prepare Hemospray device and deliver Hemospray dose as directed

assist physician with preparation of banding device

prepare and label specimens

I-3-8 Demonstrate knowledge and ability to perform post-procedural equipment

cleaning and preparation for sterilization according to agency policy.

Note: LPNs are not authorized to advance or withdraw (manipulate) scope.


Surgical

Competency: I-4

Post Anesthetic Recovery Date: January 16, 2017



I-4-1 Demonstrate knowledge and ability to receive and manage client from post

anesthetic recovery:

perform initial and continuing client assessment including

o blood loss

o drains

o infusion lines

o level of consciousness

o pain management

o urine output

o vital signs

o wound dressings

monitor blood and manage fluid infusions

respond to client questions and personal needs


change or reinforce wound dressings as necessary

monitor client for changes in condition

report and manage post-operative complications

consult and collaborate with inter-professional team

complete post-operative checklist and documentation

I-4-2 Demonstrate knowledge and ability to assist with the management of clients

for immediate post anesthetic recovery in post anesthetic care unit (PACU).




J: Orthopedics

Major Competency Area: J

Orthopedics

Competency: J-1

Orthopedic Nursing Date: January 16, 2017



J-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in orthopedics.

J-1-2 Demonstrate knowledge of anatomy, physiology and pathophysiology related

to the musculoskeletal system including:

determinants of normal musculoskeletal structure and function

identify symptoms indicating immediate/urgent need for intervention

infection prevention, risks, exposure and management

musculoskeletal illness and trauma

signs and symptoms of musculoskeletal impairment

J-1-3 Demonstrate knowledge and ability to provide evidence informed, client

centered care in relation to orthopedic nursing.

J-1-4 Demonstrate knowledge and ability to provide health teaching and coaching

associated with orthopedic nursing.

J-1-5 Demonstrate knowledge and ability to communicate and collaborate with



Orthopedics

Competency: J-2

Orthopedic Nursing Interventions Date: January 16, 2017



J-2-1 Demonstrate knowledge and ability to assess and manage nursing care for

conditions and injuries of the musculoskeletal system.

J-2-2 Demonstrate knowledge of orthopedic diagnostic tests and nursing

implications such as:

arthrogram

blood tests

bone scan

computed axial tomography (CT scan)

discography

doppler studies

electromyography (EMG) (nerve conduction studies)

magnetic resonance imaging (MRI)

myelogram

X-ray

J-2-3 Demonstrate knowledge and ability to assess and manage ambulation and

immobilization needs including:

braces and splints

canes, crutches, walkers, wheelchairs

external fixators

mechanical lifts

nutritional needs

pain management

physical mobility and ambulation

protective devices

traction


Orthopedics

Competency: J-3

Traction and Immobilizers Date: January 16, 2017



J-3-1 Demonstrate knowledge of indications and contraindications associated with

use of traction and immobilizers.

J-3-2 Demonstrate knowledge and ability to assess and manage client with traction

and immobilization devices such as:

ambulation

cast care

complications (compartment syndrome, compression syndrome, infection,

bleeding, DVT, pulmonary embolism, etc.)

edema

neurovascular status

pain

J-3-3 Demonstrate knowledge and application of pre-formed removable splints and

braces such as:

adjustable knee braces

clam shells

half/back slabs

soft cervical collars

J-3-4 Demonstrate knowledge and ability to cut, form and apply removable resting

splint or immobilizer.

Competency: J-3 Page: 2

Traction and Immobilizers



J-3-6 Demonstrate knowledge and ability to manage nursing care for client with

traction/external fixators including:

bucks

halo

manual

pin site care

skeletal

skin

J-3-7 Demonstrate knowledge of indications and contraindications associated with

care of c-spine injuries.




K: Neurological/ Neurosurgical

Major Competency Area: K

Neurological/Neurosurgical

Competency: K-1

Neurological Nursing Date: January 16, 2017



K-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in neurological nursing.

K-1-2 Demonstrate knowledge and understanding of anatomy, physiology and

pathophysiology related to illness/trauma of the neurological system

including, but not limited to:

determinants of normal neurological function

neurological impairment, shock

neurological illness, trauma and surgery such as:

o intracranial hemorrhage

o increased intracranial pressure

o meningitis

o multiple sclerosis

o neurosurgery

o Parkinson’s Disease

o seizures and epilepsy

o stroke

o transient ischemic attack

o traumatic head injury

K-1-3 Demonstrate knowledge and ability to provide health teaching and coaching

associated with neurological nursing.

K-1-4 Demonstrate knowledge and ability to communicate and collaborate with


Competency: K-2

Neurological Nursing Interventions






K-2-1 Demonstrate knowledge and ability to provide evidence informed, client

centered care in relation to neurological nursing:

ensure and respect client choices in decision making

assess, monitor and evaluate neurological vital signs:

o cranial nerve assessment

o motor assessment

o sensory assessment

o reflex assessment

o Glasgow Coma Scale (GCS)

K-2-2 Demonstrate knowledge and understanding of indications, contraindications

and complications associated with neurological and related diagnostic tests

and procedures such as:

computerized tomography (CT)

CT Angiogram

electroencephalography (EEG)

magnetic resonance imaging (MRI)

ultrasonogram (carotid Doppler, transcranial Doppler)

X-ray

lumbar puncture

myelography

electrocardiography (ECG)

echocardiogram

Competency: K-2

Page: 2 Neurological

Nursing Interventions



K-2-3 Demonstrate knowledge and ability to anticipate and recognize actual or

potential immediate or urgent neurological crisis including:

abnormal respirations

bradycardia

cardiac dysrhythmias

decreased level of consciousness

hypertension

hyperthermia

hypotension

hypothermia

tachycardia

widening pulse pressure

K-2-4 Demonstrate knowledge and ability to recognize signs and symptoms of a life

threatening neurological event and implement interventions according to

agency policy.

Competency: K-3

Managing C-Spine






K-3-1 Demonstrate knowledge and ability to assess for spinal injury.

K-3-2 Demonstrate knowledge of best practices in cervical spine management and

implementation according to agency policy.

K-3-3 Demonstrate knowledge of criteria for spinal immobilization and spinal

precautions including:

neck/back pain with or without nerve involvement

o history of:

degenerative bone disease

falls

head, neck or facial trauma

motor vehicle crash

trauma with intoxication, altered mental status or unconsciousness

K-3-4 Demonstrate knowledge and ability to apply and maintain spinal precautions

including:

application, maintenance and removal of cervical collars (soft, rigid)

assist to stabilize spine with manual and/or mechanical traction

logrolling

thoracic- lumbar- sacral orthosis (TLSO), cervical thoracic orthosis (CTO)

maintain proper spinal/body alignment

transportation precautions

use of spine board/slider board

K-3-5 Demonstrate knowledge and ability to provide nursing care and interventions

specific to client with spinal injury including:

motor power/sensation/neurovascular status

skin care and institute protective measures

wounds, drainage tubes

nutrition/hydration/elimination

intake and output balance

casts

halo traction, jacket and pin site care, thoracolumbosacral orthosis,

comfort measures and pain management

Competency: K-4

Advanced Neurological Nursing Interventions






K-4-1 Demonstrate knowledge and ability to care for client requiring detailed

observation and interventions according to agency policy.

K-4-2 Demonstrate knowledge and ability to assist with and/or provide advanced

neurological assessment, monitoring, care and interventions according to

agency policy including:

12 and 15 lead ECG application and recognition and reporting

acid-base balance

pain management

swallowing assessment

arterial blood gas recognition and reporting

chest assessment and physiotherapy

cognitive functioning assessment

cranial nerve assessment

fluid and electrolyte imbalance monitoring

lumbar drain monitoring

pressure monitoring

central venous pressure monitoring

spinal assessment

ventricular and subdural drain monitoring

K-4-3 Demonstrate knowledge and ability to communicate, consult and collaborate



L: Cardiovascular

Major Competency Area: L

Cardiovascular

Competency: L-1

Cardiovascular Nursing Date: January 16, 2017



L-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in cardiovascular nursing.

L-1-2 Demonstrate knowledge and understanding of anatomy, physiology and

pathophysiology of the cardiovascular system and cardiovascular disease

such as:

determinants of normal cardiac cycle and cardiac conduction pathway

cardiovascular diseases and disorders

o atherosclerosis

o cardiac dysrhythmias

o cardiomyopathy

o heart failure

o hypercholesterolemia/dyslipidemia

o hyper/hypotension

o ischemic heart disease

o peripheral artery disease

determinants of blood pressure and central venous pressure

decompensation, shock, hypovolemic shock, cardiac failure

single and multiple organ system failure

L-1-3 Demonstrate knowledge and ability to provide health teaching and coaching

associated with cardiovascular nursing.

L-1-4 Demonstrate knowledge and ability to communicate and collaborate with


Major Competency Area: L

Cardiovascular

Competency: L-2

Cardiovascular Interventions Date: January 16, 2017



L-2-1 Demonstrate knowledge and ability to provide evidence informed, client

centered care in relation to cardiovascular nursing:

ensure and respect client choices in decision making

assess and monitor:

o hemodynamics

o lab values/biochemical markers

o limb temperature

o peripheral diagnostic and interventional procedures

o renal sufficiency

o venous thromboembolism (sequential compression device therapy)

o vital signs

differentiate normal rhythm and arrhythmia

prepare client for diagnostic tests, procedures, treatments and/or surgery

implement pre/post procedure routines and protocols

L-2-2 Demonstrate knowledge of cardiac equipment:

3 and 5 lead electrocardiogram (ECG)

telemetry equipment

resuscitation equipment:

o automated external defibrillator (AED)

o bag and mask

o crash cart

understand use of:

o external cardiac pacing

o pacemaker sensing, on/off

o 24 hour Holter monitor

o Doppler imagery/echocardiography

o central venous pressure (CVP) and arterial lines

L-2-3 Demonstrate ability to utilize and apply cardiac equipment:

apply 3 and 5 lead electrocardiogram (ECG)

apply telemetry equipment

resuscitation equipment:

o automated external defibrillator (AED)

o bag and mask

o crash cart

Competency: L-2 Page: 2

Cardiovascular Interventions



L-2-4 Demonstrate knowledge and understanding of normal/abnormal lab values

and cardiac markers such as:

Aspartate transaminase (AST)

Creatine Kinase (CK-MB)

Myoglobin (Mb)

Troponin 1 test

L-2-5 Demonstrate knowledge and understanding of indications, contraindications

and complications associated with cardiovascular and related diagnostic tests

and procedures including:

angiogram (radial, femoral)

angioplasty and stents

echocardiogram (trans-thoracic, trans-esophageal)

exercise stress test

L-2-6 Demonstrate knowledge and ability to anticipate and recognize actual or

potential immediate life threatening health crisis such as:

alteration in cardiac output

alteration in vascular tissue perfusion (compartment syndrome)

cardiac arrhythmias

cardiomyopathy

congestive failure

myocardial infarction

shock

L-2-7 Demonstrate knowledge and ability to recognize signs and symptoms of a life

threatening cardiac event and implement or assist with cardio pulmonary

resuscitation according to agency policy.

http://en.wikipedia.org/wiki/Aspartate_transaminase

http://en.wikipedia.org/wiki/Myoglobin

http://en.wikipedia.org/wiki/Troponin_test

Competency: L-3 Page: 3

Advanced Cardiovascular Interventions



L-3-1 Demonstrate knowledge and ability to care for client requiring detailed

observation and interventions including:

hemodynamic monitoring

o central venous pressure monitoring (CVP)

o peripherally inserted central catheter care (PICC)

o arterial line monitoring

non-invasive and mechanical ventilation

L-3-2 Demonstrate knowledge and ability to assist with and/or provide cardiac

procedures, treatments, therapies and recognize abnormal diagnostic and lab

values:

12 and 15 lead ECG application

o recognize and report normal and abnormal rhythm

assist with atrial fibrillation protocol

assist with the monitoring and managing of symptoms of arrhythmia

L-3-3 Demonstrate knowledge and understanding of indications for use of external

cardiac pacing and implanted cardiac devices:

monitor telemetry equipment

apply 24hr Holter monitor

recognize complications of external pacemaker and implantable cardioverter

defibrillator (ICD)

o failure to output

o failure to capture

o sensing abnormalities




M: Maternal/ Newborn Care

Major Competency Area: M

Maternal/Newborn Care

Competency: M-1

Maternal/Newborn Nursing Date: January 16, 2017



M-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in maternal, prenatal, and postnatal

care.

M-1-2 Demonstrate knowledge of human anatomy and physiological changes during

pregnancy.

M-1-3 Demonstrate knowledge and ability to provide health teaching and coaching

associated with maternal and newborn care.



Competency: M-2

Prenatal Care Date: January 16, 2017



M-2-1 Demonstrate knowledge and ability to perform comprehensive health

assessment and history including:

signs and symptoms of pregnancy

last menstrual cycle

expected date of confinement (EDC)

number of pregnancies (gravida, para)

fundal height

routine and non-routine lab results

identify potential risk factors

o health issues

o sexually transmitted infections

o socio-economic issues

o substance abuse

M-2-2 Demonstrate knowledge and ability to perform fetal monitoring:

assess position of fetus (Leopold’s Maneuvers)

perform interventions as appropriate (offer juice/ice water, reposition, provide

oxygen)

auscultation of fetal heart monitoring

M-2-3 Demonstrate knowledge of prenatal care and complications associated with

pregnancy including:

abruptio placenta

ectopic pregnancy

effects of substance abuse

fetal growth issues

gestational diabetes mellitus

hyperemesis gravidarum

hypertensive disorder

malposition of fetus

placenta previa

pre-term labor

sexually transmitted infections/HIV

spontaneous or missed abortion

Competency: M-2

Page: 2

Prenatal Care



M-2-4 Demonstrate knowledge and ability to communicate and collaborate with


M-2-5 Demonstrate knowledge and ability to perform fetal monitoring for non-

stress test and report abnormal findings.



Competency: M-3

Knowledge and Assessment of Labor Date: January 16, 2017



M-3-1 Demonstrate knowledge of stages of labor and delivery:

stage 1 – labor onset to full cervix dilation

stage 2 – full cervix dilation to delivery of baby

stage 3 – delivery of baby to expulsion of placenta

stage 4 – expulsion of placenta to afterbirth recovery

M-3-2 Demonstrate knowledge and ability to perform comprehensive health

assessment and admission specific to maternal nursing including:

last menstrual cycle

expected date of confinement (EDC)

number of pregnancies (gravida, para)

fundal height

auscultation of fetal heart monitoring

routine and non-routine lab results

previous genetic anomalies

prenatal records and history

special tests and treatments

risk factors



Competency: M-4

Assist with Managing Labor Date: January 16, 2017


**LPNs utilizing these competencies will do so in an assistive role**


M-4-1 Demonstrate knowledge and ability to assist authorized professional(s)

during management of labor including:

vaginal exams

artificial rupture of membranes

insertion of internal mode fetal monitoring

epidural anesthesia/analgesia

pharmacological induction

M-4-2 Demonstrate knowledge and ability to assist with ongoing assessment,

monitoring and care of laboring client in collaboration with authorized

professional(s) including:

coach client and partner

infusion therapy


non-pharmacological comfort measures

specimen collection and testing

nitrous oxide

apply external fetal heart monitor



Competency: M-5

Assist with Delivery Date: January 16, 2017




M-5-1 Demonstrate knowledge and ability to assist authorized professional(s) in

delivery process.

M-5-2 Demonstrate knowledge and ability to provide care and initial medications to

newborn.

M-5-3 Demonstrate knowledge and ability to assist authorized professional(s) with

post-delivery complications including:

chills/shock

hemorrhage

seizures

M-5-4 Demonstrate knowledge and ability to provide compassionate care for client,

family and others in event of unexpected still birth or death of newborn.



Competency: M-6

Neonatal Resuscitation Date: January 16, 2017





inquiry throughout the nursing process related to neonatal resuscitation.

M-6-2 Demonstrate knowledge of normal physiological changes of newborn

occurring with birth.

M-6-3 Demonstrate knowledge of pathophysiology of asphyxia and apnea in

newborn.

M-6-4 Demonstrate knowledge and ability to perform care and comprehensive

rapid assessment of newborn:

assess term gestation

assess respiratory effort (breathing or crying)

assess muscle tone

provide warmth

position, clear airway

dry, stimulate, reposition

determine need for resuscitation

M-6-5 Demonstrate knowledge and ability to perform resuscitation of newborn:

provide supplemental oxygen

o free flow

provide positive pressure ventilation (PPV)

monitor oxygen level

M-6-6 Demonstrate knowledge and ability to collaborate with authorized

professional(s) to provide additional resuscitation interventions for newborn

with labored breathing/persistent cyanosis:

provide PPV or continuous positive airway pressure (CPAP)

identify need for intubation

Competency: M-6

Page: 2 Neonatal Resuscitation





endotracheal intubation and continued resuscitation:

perform chest compressions

administer medications as appropriate

M-6-8 Demonstrate knowledge and ability to assess for complications and manage

care for successfully resuscitated newborn:

cardiac abnormalities

feeding problems

fluid management

hypoglycemia

hypotension

metabolic acidosis

organ system injury

pneumonia and other lung complications

pulmonary hypertension

seizures or apnea

temperature management

M-6-9 Demonstrate knowledge and ability to communicate and collaborate with

inter-professional team to provide support to newborn’s family and others

throughout the resuscitation process.



Competency: M-7

Labor and Delivery of Non-Viable Fetus




M-7-1 Demonstrate knowledge and ability to collaborate with authorized

professional(s) to assist with/manage labor in pre-term, non-viable fetal

termination induction:

assist with induction medication protocol

ongoing monitoring and care of laboring client

o non-pharmacological comfort measures

o medication administration

assess cessation of fetal heart

compassion and support for client, family and others

M-7-2 Demonstrate knowledge and ability to collaboration with authorized

professional(s) to assist with/manage delivery of pre-term, non-viable

fetus/neonate:

ongoing monitoring and care of laboring client

o non-pharmacological comfort measures

o medication administration

procure specimens according to agency policy

prepare fetus/neonate for time with client

provide privacy post-delivery for client, family and others

M-7-3 Demonstrate knowledge and ability to manage post-mortem care according

to agency policy.

M-7-4 Demonstrate knowledge and ability to collaborate with inter-professional

team to provide resources and support to client and others.



Competency: M-8

Post-Partum Care Date: January 16, 2017



M-8-1 Demonstrate knowledge of involution process.


inquiry throughout the nursing process in care of post-partum client.

M-8-3 Demonstrate knowledge and ability to provide post-operative care to client

following caesarean section including:

bowel and bladder function

incision care and dressing changes

pain management

post anesthetic/epidural protocols

post-operative hemorrhage

post-surgical precautions

M-8-4 Demonstrate knowledge and ability to recognize and assess post-partum

complications including:

abnormal vital signs

boggy fundus

deep vein thrombosis

difficulty voiding

edema

hemorrhage

large clots or tissue

seizure


in post-natal and newborn care including:

changes in family dynamics

community resources

discharge planning

Competency: M-8

Page: 2

Post-Partum Care




in post-natal and newborn care including: (cont’d)

feeding (breast or bottle)

importance of bonding

importance of hydration, diet and rest

resuming sexual activity/contraception

signs and symptoms of post-partum depression

skin to skin contact with newborn

M-8-6 Demonstrate knowledge and ability to provide advanced health teaching and

coaching as a lactation/breast feeding consultant.



Competency: M-9

Newborn Care Date: January 16, 2017




inquiry throughout the nursing process in care of newborn including:

initial and ongoing assessment

specimen collection and testing

o phenylketonuria (PKU)

o bilirubin

o blood glucose

monitoring intake/output

assessing feeding

M-9-2 Demonstrate knowledge and ability to identify complications in care of

newborn including:

abnormal lab values

abnormal vital signs

feeding issues (tube feeding)

jaundice

physical/genetic anomalies

substance withdrawal

M-9-3 Demonstrate knowledge and ability to recognize signs and symptoms of

newborn distress and respond immediately.


transferring newborn to specialized care.


for discharge of newborn including:

bathing of newborn

cord care

discharge planning/community resources

elimination patterns

feeding (breast or bottle)

importance of bonding

importance of hydration

newborn safety/care seat safety

skin to skin contact with newborn




N: Pediatrics

Major Competency Area: N

Pediatrics

Competency: N-1

Pediatric Nursing Date: January 16, 2017



N-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in pediatric care.

N-1-2 Demonstrate knowledge of stages of growth and development of pediatric

client.

N-1-3 Demonstrate knowledge of pediatric diseases and medical conditions such as:

asthma

cerebral palsy

cleft lip/palate

congenital anomalies

gastrointestinal disorders

respiratory disorders

spectrum disorders (autism, fetal alcohol)

N-1-4 Demonstrate knowledge of Legislation affecting pediatric nursing and client.

N-1-5 Demonstrate knowledge and ability to identify and report signs and/or

symptoms of abuse of pediatric client according to agency policy.

N-1-6 Demonstrate knowledge and ability to provide health teaching and coaching

associated with pediatric nursing.

N-1-7 Demonstrate knowledge and ability to communicate and collaborate with

inter-professional team to provide support and resources to pediatric client,

family and others.


Pediatrics

Competency: N-2

Pediatric Care and Interventions Date: January 16, 2017



N-2-1 Demonstrate knowledge and ability to complete comprehensive nursing

assessment, care, health teaching and coaching in care of pediatric client.

N-2-2 Demonstrate knowledge and ability to provide evidence informed, client

centered care in relation to pediatric nursing:

involve family and caregivers in care

ensure goals of care are realistic and achievable

adapt interpersonal communication

identify and address emotional needs of client, family and others

adjustment to hospitalization

N-2-3 Demonstrate knowledge and ability to assess risk and implement safety

measures or restraints specific to pediatric client according to agency policy.

N-2-4 Demonstrate knowledge and ability to apply principles of pharmacokinetics

and pharmacodynamics specific to pediatric client.

N-2-5 Demonstrate knowledge and ability to adapt care to provide optimum

nutrition for pediatric client:

adaptive devices

allergies/sensitivities/preferences

conducive environment

cultural and religious influences

feeding techniques

nutritional requirements/supplements

sensory deficits

N-2-6 Demonstrate knowledge and ability to assess home environment, family

dynamics and access to resources.

N-2-7 Demonstrate knowledge and ability to collaborate with inter-professional

team to provide resources and support to pediatric client, family and others.

Competency: N-2 Page: 2

Pediatric Care and Interventions



N-2-8 Demonstrate knowledge and ability to provide evidence informed end of life

care for pediatric client integrating palliative principles and values including:

appropriate palliative analgesia

holistic client centered care

open dialogue regarding end of life

spiritual and religious support

symptom management and comfort measures

N-2-9 Demonstrate knowledge and ability to provide compassionate care for the

family in death of a pediatric client.


Pediatrics

Competency: N-3

Pediatric Pain Management Date: January 16, 2017



N-3-1 Demonstrate knowledge and ability to assess pediatric client for pain

considering:

age

behaviors

cultural influence

location and intensity

physiological and psychological factors

previous medication and effectiveness

subjective and objective data

N-3-2 Demonstrate knowledge and ability to adapt pain management and comfort

measures for pediatric client:

physical

psychological

pharmacological




O: Mental Health and Addiction

Major Competency Area: O

Mental Health and Addiction

Competency: O-1

Mental Health and Addiction Care




O-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in mental health and addictions care.

O-1-2 Demonstrate knowledge and application of Legislation pertaining to mental

health and addictions.

O-1-3 Demonstrate knowledge and ability to provide evidence informed, client

centered care in relation to mental health and addiction care:

engage client in plan of care

consider Legislation affecting mentally competent and mentally incompetent

client

role of guardian/trustee

community treatment controls

O-1-4 Demonstrate knowledge and ability to differentiate between mental illness

and mental wellness.

O-1-5 Demonstrate knowledge and understanding of mental health condition/illness

including:

adjustment disorders

alcohol/substance related disorders

Alzheimer’s disease/dementia

anxiety disorders

brain injury

neurocognitive disorders

developmental disorders/spectrum disorders (autism, fetal alcohol)

eating disorders (anorexia nervosa, bulimia nervosa)

learning and behavioral disorders

Competency: O-1

Page: 2 Mental Health

and Addiction Care



O-1-5 Demonstrate knowledge and understanding of mental health condition/illness

including: (cont’d)

mood disorders (unipolar, bipolar, depression)

personality disorders

post-traumatic stress disorder

psychosis

schizophrenia

suicidal ideation

O-1-6 Demonstrate knowledge and ability to understand developmental/childhood

spectrum disorders and potential contribution to mental health and

addiction.

O-1-7 Demonstrate knowledge and ability to provide health teaching and coaching

associated with mental health and addiction care.

O-1-8 Demonstrate knowledge and ability to support client, family and others with

coping strategies and community based resources.

O-1-9 Demonstrate knowledge and ability to communicate, consult and collaborate




Competency: O-2

Mental Health and Addiction Assessment and Intervention




O-2-1 Demonstrate knowledge and ability to perform comprehensive mental health

assessments of client, and family in a variety of healthcare settings.

O-2-2 Demonstrate knowledge of diagnostic tools and parameters in mental health

assessment such as:

Agitated Behavior Scale

Diagnostic and Statistical Manual of Mental Disorders Volume 5 (DSM-5)

Geriatric Depression Scale

Mini Mental State Examination (MMSE)

Montreal Cognitive Assessment (MoCA)

Screening for Distress/suicide risk

Sleep Study

O-2-3 Demonstrate knowledge and ability to recognize signs and symptoms of

changes in mental health including:

behavioral

emotional

intellectual

level of alertness

motor

perception of reality

suicidal ideation

O-2-4 Demonstrate knowledge and ability to assess, monitor and manage signs and

symptoms associated with substance abuse including:

addiction

dependency

intoxication

relapse

substance induced disorders

withdrawal

Competency: O-2

Page: 2 Mental Health and Addiction Assessment and Intervention



O-2-5 Demonstrate knowledge and ability to assess and manage clients with

concurrent conditions in mental health and addiction nursing care.

O-2-6 Demonstrate knowledge and ability to recognize and manage stressors in

mental health and addiction care including:

access to resources/services

adaptability to change

barriers to recovery

behavioral manifestations

contributing factors (social determinants of health)

strategies for managing

stigma

O-2-7 Demonstrate knowledge and ability to recognize and intervene in crisis

situations.

O-2-8 Demonstrate knowledge and ability to implement or assist with psychosocial

interventions in consultation with authorized professional(s) such as:

art and music therapy

behavior modification

cognitive therapy

drug recovery educational programs

family therapy

motivational therapy

occupational therapy

peer/group therapy

positive and negative reinforcement

psychotherapy

Competency: O-2

Page: 3 Mental Health and Addiction Assessment and Intervention



O-2-9 Demonstrate knowledge and ability to apply principles of pharmacokinetics

and pharmacodynamics specific to medication management in mental health

and addiction care.

O-2-10 Demonstrate knowledge and ability to assist with provision of

electroconvulsive (ECT) therapy:

pre and post procedural assessments and care

intraprocedural assessment, monitoring and care

ongoing client observation



Competency: O-3

Aggressive Behavior Date: January 16, 2017



O-3-1 Demonstrate knowledge and ability to identify physiologic determinants and

behavioral predispositions for aggressive behavior to self and others.

O-3-2 Demonstrate knowledge and ability to assess signs of potential aggression and

implement preventative measures.

O-3-3 Demonstrate knowledge and ability to recognize and manage aggressive

behaviors.

O-3-4 Demonstrate knowledge and ability to utilize physical, chemical or

environmental restraints according to agency policy.

O-3-5 Demonstrate knowledge and ability to consider safety of self and others when

managing aggressive behavior.

O-3-6 Demonstrate knowledge and ability to perform post incident management





P: Emergency Care

Major Competency Area: P

Emergency Care

Competency: P-1 Date: January 16, 2017

Emergency Nursing


**LPNs will not independently triage/Canadian Triage Assessment Scale (CTAS) patients, this

process must be done in collaboration with the inter-professional team**


P-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in emergency nursing.

P-1-2 Demonstrate knowledge and ability to perform a comprehensive health

assessment.

P-1-3 Demonstrate knowledge and ability to perform nursing procedures and

interventions in an emergency setting as defined by scope of practice and


P-1-4 Demonstrate knowledge and ability to obtain, assess and monitor diagnostic

tests and lab values according to agency policy.

P-1-5 Demonstrate knowledge and ability to communicate, collaborate and consult

with emergency care team.

Competency: P-1 Page: 2

Emergency Nursing



P-1-6 Demonstrate knowledge and ability to obtain additional education and

certification in emergency assessment, intervention and care including:

emergency assessment certifications

o cardiac life support

o emergency neonatal care

o emergency nursing

o emergency pediatric nursing

o pediatric life support

o trauma nursing

additional certifications

o employer specific certification

o immunization certification

Major Competency Area: P

Emergency Care

Competency: P-2

Triage Date: January 16, 2017


**LPNs will not independently triage/ Canadian Triage Assessment Scale (CTAS) patients, this

process must be done in collaboration with the inter-professional team**


P-2-1 Demonstrate knowledge and ability to provide assistance in a rapid primary

initial assessment utilizing the Canadian Triage and Acuity Scale (CTAS):

Level 1-Rescuscitation-threats of life, immediate aggressive intervention

required

Level 2-Emergency-potential risk to life or limb, rapid medical intervention

required

Level 3-Urgent-conditions could progress to serious problem requiring

emergency intervention

Level 4-Less Urgent-conditions would benefit from intervention in 1-2 hours

to avoid potential deterioration

Level 5-Non-Urgent-invesigations and interventions could be delayed or

referred

P-2-2 Demonstrate knowledge and ability to communicate and collaborate with

inter-professional team in triage assessment.


Q: Gerontology

Major Competency Area: Q

Gerontology

Competency: Q-1 Date: January 16, 2017

Gerontology Nursing



Q-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in gerontological care.

Q-1-2 Demonstrate knowledge of effects of the aging process on anatomy and

physiology related to healthy aging, wellness and restorative care.

Q-1-3 Demonstrate knowledge and ability to provide evidence informed, client

centered care in relation to gerontology nursing:

recognize client as expert in own health experience

respect and incorporate client related life history and experiences into goals of

care

involve family and other supportive individuals in care

ensure goals of care are realistic and achievable

adapt traditional and complementary therapies

communicate and collaborate to provide information, health teaching and

coaching

Q-1-4 Demonstrate knowledge and ability to plan, implement and evaluate healthy

living/aging initiatives for individuals, groups and communities.

Q-1-5 Demonstrate knowledge and ability to assess risk and implement safety

measures specific to gerontological client:

environmental

psychosocial

physiological

Q-1-6 Demonstrate knowledge and ability to apply effective interpersonal

communication skills with gerontological client, accommodating for cognitive

and sensory changes/deficits.

Competency: Q-1 Page: 2

Gerontology Nursing



Q-1-7 Demonstrate knowledge and ability to collaborate with inter-professional

team to provide support and resources to gerontological client, family and

others.

Q-1-8 Demonstrate knowledge of Legislation affecting gerontology nursing

and the gerontological client.


Gerontology

Competency: Q-2

Gerontology Care and Interventions Date: January 16, 2017



Q-2-1 Demonstrate knowledge and ability to create environments and networks

that enable healthy aging and/or convalescence.

Q-2-2 Demonstrate knowledge and ability to assess and recognize chronic disease

and multi system health issues utilizing tools including but not limited to:

activities of daily living (ADLs)

auditory/visual impairment screening

balance and ambulation screening

bowel elimination/impaction assessment

Braden scale

dementia assessment

elder abuse and neglect assessment

exercise plan and activity scale

fall assessment

functional assessment

geriatric depression scale

geriatric physical assessment

lifestyle and behaviours (smoking, obesity, alcohol, substance abuse)

muscle and joint assessment

nutrition assessment

oral health assessment

Resident Assessment Instrument (InterRAI)

urinary incontinence screening

Q-2-3 Demonstrate knowledge and ability to assess pain and provide comfort

measures and pain management including:

history and physical examination

color pain scale

chronic versus acute

Competency: Q-2

Gerontology Care and Interventions Page: 2



Q-2-3 Demonstrate knowledge and ability to assess pain and provide comfort

measures and pain management including: (cont’d)

facial pain scale-revised (FPS-R)

numeric rating scale (NRS)

observed/perceived pain

verbal descriptor scale (VDS)

Q-2-4 Demonstrate knowledge and ability to adapt care to provide optimum

nutrition and hydration to gerontological client considering:

adaptive devices

allergies/sensitivities/preferences

conducive environment


feeding techniques

involvement in meal preparation

nutritional requirements/supplements/dietary changes

oral health and swallowing assessment

referrals for further assessment

sensory deficits

Q-2-5 Demonstrate knowledge and ability to assess and facilitate elimination needs

in gerontological client:

observe signs and symptoms unique to the elderly

recognize the special needs of the cognitively impaired

initiate appropriate interventions

provide bladder and bowel retraining

Q-2-6 Demonstrate knowledge and ability to promote skin integrity and perform

skin assessment and wound care:

basic foot care

prevent skin breakdown (positioning, skin care, hygiene)

observe for signs of breakdown and infection

manage wound

refer to other health professionals as required

Competency: Q-2




Q-2-7 Demonstrate knowledge and ability to apply principles of pharmacokinetics

and pharmacodynamics specific to gerontological client:

manage multiple prescriptions (polypharmacy)


monitor and teach self- medication practice

monitor interactions/adverse reactions

monitor non-pharmaceutical and complementary therapies

Q-2-8 Demonstrate knowledge and ability to identify and manage situations of

abuse of gerontological client including:

financial or material

neglect

physical

psychological or emotional

sexual

Q-2-9 Demonstrate knowledge and ability to assess and identify stressors related to

abuse of gerontological client including:

cultural roles, beliefs and practices

exploitation or dependence

family dynamics and control

fear induced silence and reluctance to report

lack of social services

presence of chronic or debilitating disease

pressure related to caregiver exhaustion

rapid growth of the aging population

substance abuse and addiction

Q-2-10 Demonstrate knowledge and ability to provide health teaching and coaching

to gerontological client, family and others regarding:

decision-making (finances, living arrangements, care requirements)

explanation of client behavior, vital processes and condition change

evidence informed healthy lifestyle:

o fall prevention

o healthy nutrition

o social connectedness/isolation

Competency: Q-2





to gerontological client, family and others regarding: (cont’d)

family dynamics

goals of care and Personal/Advance Directive

guardianship/trusteeship

loss (independence, possessions, home, partner, skills)

mourning and bereavement support

neurocognitive dysfunction

open dialogue regarding palliative care/end of life

promote independence/restorative care

psychosocial/spiritual/pastoral care

quality of life

supports for activities of daily living (ADLs)

Q-2-11 Demonstrate knowledge and ability to provide evidence informed end of life

care, integrating palliative principles and values including:

appropriate sedation and palliative analgesia

comply with Personal/Advance Directive and goals of care

holistic/client centered care

maintain client dignity

management of behavioral disturbances




termination of life sustaining treatments

termination of mechanical support


Gerontology

Competency: Q-3

Cognitive Care Date: January 16, 2017



Q-3-1 Demonstrate knowledge and ability to recognize and assess neurocognitive,

physiological or drug induced dysfunction and symptoms associated with

gerontological client:

delirium

dementia

delusion

depression

memory loss

responsive behaviors

Q-3-2 Demonstrate knowledge and ability to assess and recognize physiological

causes for cognitive changes including but not limited to:

age related changes

brain atrophy

cardiovascular disease (hypertension, myocardial infarction, coronary heart

disease, intermittent claudication, homocysteine)

chronic alcoholism/substance abuse

chronic stress (glucocorticoid release)

constipation

depression

diabetes

fluid/electrolyte imbalance

genetic abnormalities (ApoE-apolipoprotein E epsilon4allele: risk factor for

Alzheimer’s disease)

infection (urinary tract, upper respiratory)

lack of exercise and mobility

low levels of bioavailable estradiol

pain (observed/perceived)

post traumatic stress disorder

sepsis

transient ischemic attack (TIA)/stroke

vitamin D, B12 deficiency

Competency: Q-3

Cognitive Care Page: 2



Q-3-3 Demonstrate knowledge and ability to provide cognitive rehabilitation

activities including but not limited to:

promote enhanced memory to maintain functional cognition

promote and provide social activities:

o intellectual effort

o mental stimulation

encourage healthy behaviors to minimize chronic disease risk

o cardiovascular disease

o diabetes

o hypertension

integrate additional therapies into goals of care:

o music therapy

o occupational therapy

o physiotherapy

o recreation therapy

o restorative care


Gerontology

Competency: Q-4

Dementia Care Date: January 16, 2017




inquiry throughout the nursing process related to dementia care.

Q-4-2 Demonstrate knowledge of principles and practices related to dementia care:

differentiate dementia from cognitive changes of normal aging and delirium

recognize early, middle and late phases of dementia

consider client preferences and social history

recognize and manage ethical issues

collaborate with other health professionals and volunteers in daily care

Q-4-3 Demonstrate knowledge and ability to adapt communication to

cognitive/emotional needs of client with dementia including:

address client by name

avoid arguing, correcting misinformation, confrontation, raising voice

identify nonverbal expressions of physical discomfort and pain

provide simple choices/redirect

utilize verbal encouragers and positive regard

utilize soft approach techniques

Q-4-4 Demonstrate knowledge and ability to recognize and manage distress related

behaviors including:

agitation, pacing, exit-seeking, combativeness, withdrawal and repetitive

vocalizations:

o identify patterns that reveal potential causes or triggers

o protect client from risk

o promote autonomy and independence in activities of daily living

o plan prevention or modification strategies

o document and report circumstances related to distress behaviours

o collaborate with inter-professional team and others

Competency: Q-4

Dementia Care Page: 2



Q-4-5 Demonstrate knowledge and ability to promote an optimal environment for

client with dementia focused on safety and autonomy including:

monitor environmental stimuli

promote physical, social, spiritual and mental health

provide sheltered freedom:

o consistent and individualized routines

o familiar caregivers

o appropriate activities

o promote social interaction

o group activities

o family visits

o reduce isolation

o intergenerational experiences

ensure auditory, visual, mobility and memory aids are utilized

promote reminiscence therapy

limited use of pharmaceutical and physical restraints according to agency

policy


to family and others including:

support family and others to participate in holistic client-centered care

discuss and identify psychological needs and stress

develop strategies to address issues with family dynamics

Q-4-7 Demonstrate knowledge and ability to collaborate with inter-professional

team to provide support and resources to client, family and others.


Gerontology

Competency: Q-5

Assessment and Planning in Continuing Care




Q-5-1 Demonstrate knowledge and ability to communicate and collaborate with

inter-professional team throughout data collection process:

effective interpersonal communication skills

engaging colleagues in data collection

prioritize workload to facilitate scheduling

Q-5-2 Demonstrate knowledge of assessment and care planning tools utilized in

continuing care such as:

Resident Assessment Instrument (RAI)

Minimum Data Set (MDS) 2.0


inquiry throughout the nursing process when utilizing care planning tools in

continuing care.

Q-5-4 Demonstrate knowledge and ability to utilize assessment and care planning

tools as applicable to specific clinical role:

assessor

educator

coordinator/lead

Q-5-5 Demonstrate knowledge and ability to coordinate identified resident care

needs in developing plan of care:

perform initial and ongoing assessments

align data collected with plan of care

adjust plan of care as necessary

Q-5-6 Demonstrate knowledge and ability to manage recording and reporting of

data collected through assessment and care planning tools:

accurate coding of data collected

monitor and audit data collected

effective computer/data entry skills

complete internal and external reports

submit reporting as required

Competency: Q-5

Page: 2 Assessment and Planning in Continuing Care



Q-5-7 Demonstrate knowledge and ability to evaluate collected data and identify:

bench marking

quality assurance measures

feasibility of future program development




R: Palliative Care

Major Competency Area: R

Palliative Care

Competency: R-1

Palliative Principles and Values Date: January 16, 2017



R-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in palliative care:

ongoing assessment of physical symptoms and psychosocial well-being

goals of care decision making

communication and collaboration with client, family, others and inter-

professional team

legal directives and confidentiality

advocacy and appropriate referrals

R-1-2 Demonstrate knowledge and ability to integrate palliative principles and

values in care of client throughout the dying process, across all care settings

including:

whole person care/holistic care

client centered/family focused

o client identifies members of “family”

o client and family needs, expectations, hopes and goals

o recognize each person is unique and valued before and after death

o autonomy and the right to refuse care

o quality of life as defined by the client

based on the dignity and integrity of the therapeutic relationship

knowledge and research based

provided by an inter-professional team


Palliative Care

Competency: R-2

Physical Changes Date: January 16, 2017



R-2-1 Demonstrate knowledge and ability to recognize patterns of decline

associated with the dying process.

R-2-2 Demonstrate knowledge of signs and symptoms associated with dying:

signs when death is imminent

symptoms that are common in last days and hours

R-2-3 Demonstrate ability to provide care for client, family and others when:

death is imminent

at the time of death

following death


Palliative Care

Competency: R-3

Physical and Psychosocial Care Date: January 16, 2017



R-3-1 Demonstrate knowledge and ability to provide psychosocial support

including:

create a safe, nurturing environment

be present in case of pain and suffering

communicate respectfully, empathetically and compassionately

facilitate conversation regarding goals of care

facilitate expression of feelings, needs, hopes, joys and concerns

provide opportunity for client to engage in life review

identify social, cultural, spiritual values affecting grieving and expression of

grief

recognize and normalize loss as a universal experience

understand and normalize grief as a holistic experience

identify situations of complicated grief/existential stress

provide appropriate referral(s)

R-3-2 Demonstrate knowledge and ability to anticipate, assess and manage

symptoms including:

agitation/restlessness

anorexia

constipation

dehydration

delirium

dyspnea

fatigue

oral discomfort

nausea/vomiting

pain

R-3-3 Demonstrate knowledge and ability to enhance physical comfort:

non-pharmacological comfort measures

medications for symptom management

referrals to palliative care specialist/inter-professional team as necessary

Competency: R-3 Page: 2

Physical and Psychosocial Care



R-3-4 Demonstrate knowledge and ability to provide health teaching and coaching

related to physical and psychosocial care of client, family and others

including:

information sharing as appropriate

open conversations about goals of care

support informed decision making

review and clarify client, family and others understanding

R-3-5 Demonstrate knowledge and ability to recognize and respond to needs of

family including:

provide compassionate, non-judgmental support

respect level of participation in care

respect right to access or refuse support services

understand and support role as caregiver and/or decision maker

understand needs to balance work and other responsibilities

respect religious, cultural and traditional beliefs and practices

provide information about services available


Palliative Care

Competency: R-4

Post Mortem Care Date: January 16, 2017



R-4-1 Demonstrate knowledge and ability to pronounce (expected) death and

provide post-mortem care including:

assess cessation of vital signs

record and report time of death

notify next of kin or designate

notify inter-professional team

provide supportive environment for family

provide care of body respecting client/family/cultural wishes

transfer and release of body


S: Rehabilitation

Major Competency Area: S

Rehabilitation

Competency: S-1

Date: January 16, 2017 Rehabilitation Nursing



S-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in rehabilitation.

S-1-2 Demonstrate knowledge of concepts of rehabilitation and restorative care of

client including:

address deficits in physical and/or cognitive status

o acute, episodic, chronic

promote functional restoration

o psychosocial

cultural

developmental

economic

emotional

environmental

mental

social

spiritual

o physiological

cognitive

biological

functional

physical

pain management

o pharmacological

o non-pharmacological

alignment of treatment modalities

S-1-3 Demonstrate knowledge and ability to facilitate a positive rehabilitative

perspective and environment including:

addressing barriers to recovery

client focused

empowering client

Competency: S-1

Page: 2 Rehabilitation Nursing



S-1-3 Demonstrate knowledge and ability to facilitate a positive rehabilitative

perspective and environment including: (cont’d)

encouraging productive lifestyle

engaging family and others

identifying coping mechanisms

managing goals of care and recovery outcomes

promoting self-confidence

S-1-4 Demonstrate knowledge and ability to support self-management of episodic

and chronic pain.

S-1-5 Demonstrate knowledge and ability to provide health teaching and coaching

to client, family and others associated with rehabilitation including:

activities of daily living

adaptive and environmental aids

changes in abilities

communication techniques


family dynamics

functional independence

nutritional needs

psychological issues

S-1-6 Demonstrate knowledge and ability to collaborate with inter-professional

team to prepare client, family and others for transition home.

S-1-7 Demonstrate knowledge and ability to communicate and collaborate with





T: Community Based Care

Major Competency Area: T

Community Based Care

Competency: T-1

Date: January 16, 2017 Knowledge of Community Based Care



T-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in community based care or

individuals, groups and communities:

holistic health assessments

program/outcome planning

implementation of services

evaluation of outcomes and goals

T-1-2 Demonstrate knowledge and ability to practice in accordance with

professional Legislation, Regulation and standards for community based

care.

T-1-3 Demonstrate knowledge of community and primary health principles,

nursing science, social science and humanities into community based care.

T-1-4 Demonstrate knowledge of social determinants of health and how they

impact individuals, groups and communities.

T-1-5 Demonstrate knowledge of concepts of health promotion, protection,

prevention and health maintenance/restoration in community based care.

Competency: T-1

Page: 2 Knowledge of Community Based Care



T-1-6 Demonstrate knowledge to provide community based care to meet health

needs of diverse communities such as:

client homes/lodges/facilities

community and public health centers

correctional facilities

hospices/parish environments

nursing outposts

primary health networks/physician and ambulatory clinics

schools/educational facilities

street clinics/youth centers/group homes

T-1-7 Demonstrate knowledge and ability to provide health teaching and coaching

associated with community based care.

T-1-8 Demonstrate knowledge and ability to communicate, consult and collaborate



Community Health

Competency: T-2

Nursing Process and Community Based Care




T-2-1 Demonstrate knowledge and ability to provide evidence informed client

centered care for individuals, groups and communities in community based

settings including:

advocate for client

assess and manage risk

assess, identify and evaluate goals/outcomes

maintain and restore health

model client centered care

model cultural competence

prevent disease and injury

promote health/rehabilitation/restoration

provide palliation

support client transitions across continuum of care

T-2-2 Demonstrate knowledge and ability to provide leadership at in community

based settings including:

assess and manage resources

create and encourage healthy living environments and networks

implement chronic disease management initiatives

develop health teaching and coaching strategies

implement strategic initiatives

manage risk when working alone/travelling/home visits

model flexibility and innovation

perform assessments in various settings

provide coordination and leadership

provide leadership as manager/administrator

Competency: T-2

Page: 2 Nursing Process and




T-2-3 Demonstrate knowledge and ability to participate in evidence informed end

of life care, integrating palliative principles and values in community based

care including:

holistic, compassionate, client centered care

managing difficult discussions regarding palliation and end of life





Community Health

Competency: T-3

Health Promotion Date: January 16, 2017



T-3-1 Demonstrate knowledge and ability to implement and utilize tools and

strategies to address health promotion for individuals, groups and

communities including:

health concerns of at risk groups

specific social determinant(s) of health

specific health concerns

T-3-2 Demonstrate knowledge and ability to plan and participate in primary,

secondary and tertiary disease prevention activities including:

prevent onset

address risk factors

control and treat progression

rehabilitation/restoration

T-3-3 Demonstrate knowledge and ability to incorporate health promotion into

health teaching, coaching and care:

strengthen skills of individuals to practice healthy behaviors

create healthy social and physical environments to support behaviors


Community Health

Competency: T-4

Client Services Date: January 16, 2017



T-4-1 Demonstrate knowledge and ability to assess safety of self and others by

recognizing and managing obvious and potential safety concerns including:

implement prevention strategies

identify and remove safety hazards

monitor and manage care delivery environment

monitor and manage unsafe/aggressive behavior

T-4-2 Demonstrate knowledge and ability to participate in client and family case

conferences.

T-4-3 Demonstrate knowledge and ability to assign, educate and supervise

healthcare aide/unregulated provider and/or regulated provider in

community based settings:

implement standards for assignment of care

ensure continuity of care

provide mentorship, coaching and guidance

evaluate and reassign as necessary

T-4-4 Demonstrate knowledge and ability to plan, facilitate access to healthcare

services and other members of inter-professional team including:

physician

community pharmacist

social service agencies

home care services

special care nurses (foot care, wound care, chronic disease, navigators)

allied health professionals (physiotherapy, occupational therapy, speech

therapy)

Competency: T-4

Page: 2 Client Services



T-4-5 Demonstrate knowledge and ability to identify and adapt services for at-risk

individuals, groups and communities including, but not limited to:

dependent

disabled

homeless

isolated

immigrants

low socio-economic status

transient and mobile



Competency: T-5

Community Based Care Teaching and Coaching




T-5-1 Demonstrate knowledge and ability to assess, plan, implement and evaluate

evidence informed education and health teaching and coaching for

individuals, groups and communities such as:

apply community health principles and practices

apply empowerment strategies (mutual goal setting, visioning, facilitation)

facilitate and support group development

engage community based resources/experts

engage individuals and groups in consultative process

guide individuals and groups in resolution of issues

organize, advertise, facilitate education services

recognize readiness of groups or community to participate

utilize available resources to support action on health issues

consult and collaborate with inter-professional team


Community Health

Competency: T-6

Community Wellness Date: January 16, 2017




inquiry throughout the nursing process in community wellness.

T-6-2 Demonstrate knowledge and ability to participate in public health population

assessment and evaluation.

T-6-3 Demonstrate knowledge and ability to promote and deliver health wellness

and disease prevention programs to facilitate healthy communities including:

post-partum discharge programs

child/youth health programs

chronic disease management

community wellness

emergency preparedness

injury prevention

screening and disease prevention

o communicable diseases

o breast cancer

o immunization management

implement immunization schedules

travel health protocols

vaccine administration

o tuberculosis clinics

T-6-4 Demonstrate knowledge and ability to provide client centered care to

individuals, groups and communities within the school health program:

client advocacy

collaborate with school staff, students and parents

health and wellness advice and promotion

health curriculum support

infection prevention and control

Competency: T-6 Page: 2

Community Wellness



T-6-4 Demonstrate knowledge and ability to provide client centered care to

individuals, groups and communities within the school health program:

(cont’d)

knowledge of school health priorities and key resources

response to emergency situations

safety policies and procedures

screening, education, referrals, follow-up

immunization protocol and practices




Community Health

Competency: T-7

Clinic Nursing Date: January 16, 2017




inquiry throughout the nursing process in clinic nursing.

T-7-2 Demonstrate knowledge and ability to apply community and primary health

principles in clinic setting.

T-7-3 Demonstrate knowledge and ability to provide clinic nursing services

including:

treatment and interventions

chronic disease management

community rehabilitation

coordination, consultation, referral

disease prevention

healthy living and wellness

primary care services

immunization management

screening (cervical and breast cancer, sexually transmitted infections, allergy

skin test)

T-7-4 Demonstrate knowledge and ability to provide health teaching and coaching

in the clinic setting.


Community Health

Competency: T-8

Case Management Date: January 16, 2017




inquiry throughout the nursing process related to case management.

T-8-2 Demonstrate knowledge of case management principles and processes in

relation to Licensed Practical Nurse scope of practice.

T-8-3 Demonstrate knowledge and ability to model evidence informed client

centered care to client, family, inter-professional team and care agencies.

T-8-4 Demonstrate knowledge and ability to perform advanced responsibilities of

case manager specific to management of client care including:

assess client data to determine service needs

complete client care profile

negotiate client placement

communicate with client, family, placement site

monitor client needs while waiting placement

facilitate smooth transition of client into continuing care placement

o collaborate with transition team

facilitate completion of admission assessment and documentation as required

including:

o ongoing holistic assessment and monitoring

special assessments

Resident Assessment Instrument (InterRAI)

other assessments as appropriate

o personal directives

o power of attorney

o guardianship/trusteeship

o goals of care

o medication reconciliation/medication assistance

develop plan of care/goals of care in collaboration

Competency: T-8 Page: 2

Case Management



T-8-4 Demonstrate knowledge and ability to perform advanced responsibilities of

case manager specific to management of client care including: (cont’d)

perform regular and ongoing reviews and assessments

identify and address unmet client needs

facilitate ongoing communication and support

liaison with acute care if client transferred for episodic illness or injury

ongoing reassessment of plan of care/goals of care

T-8-5 Demonstrate knowledge of and accountability in the advanced case manager

role including:

demonstrate effective time management

manage multiple priorities and issues

care management and client advocacy

facilitate client health teaching and coaching

ensure ongoing accuracy of client health record

collaborate with inter-professional team

collaborate with continuing care agencies and community resources

facilitate open and timely communication

organize and leads case conferences

integrate best practices throughout care

deliver education as appropriate

manage complex situations

mediate and manages conflict

identify issues and barriers in continuum of care

implement clinical judgment to guide problem solving

demonstrate continual leadership development

manage resources effectively




U: Oncology

Major Competency Area: U

Oncology

Competency: U-1

Date: January 16, 2017 Oncology Nursing



U-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process related to oncology.

U-1-2 Demonstrate knowledge and understanding of pathophysiology, disease

progression, treatment and prognosis of cancer found in found in pediatric

and adult clients.

U-1-3 Demonstrate knowledge and ability to provide health teaching and coaching

to client, family and others throughout oncology nursing.

U-1-4 Demonstrate knowledge and ability to communicate, consult and collaborate


Major Competency Area: U

Oncology

Competency: U-2

Oncology Interventions Date: January 16, 2017



U-2-1 Demonstrate knowledge and ability to provide evidence informed, client

centered care in relation to oncology nursing including:

acute and chronic physical changes

changes in body image, self-esteem

co-morbidities

etiology of symptoms

holistic health assessment

pain assessment and management

potential changes in sexual function, intimacy

psychosocial, spiritual and cultural needs

relevant clinical data

self-injection and medication management

side effects and complications

type of cancer and prognosis

U-2-2 Demonstrate knowledge and ability to develop a therapeutic relationship

with client, family and others in support of ethical, informed decision making

and advocacy throughout care.

U-2-3 Demonstrate knowledge and ability to provide care related to progression of

cancer disease process:

clinical presentation (signs and symptoms)

co-morbidities

complications

risk factors/genetic predisposition

prognosis

palliation

surgery (diagnosis/treatment)

treatment modalities

treatment side-effects

U-2-4 Demonstrate knowledge and ability to apply principles of pharmacokinetics

and pharmacodynamics specific to medication management in oncology

nursing.

Competency: U-2 Page: 2

Oncology Interventions



U-2-5 Demonstrate knowledge and understanding of indications, mechanism of

action, risk factors and side effects related to:

biotherapy/hormones

chemotherapeutic agents

combined modalities

complementary and alternative therapies

hematopoietic stem cell transplant

palliative therapies

radiation therapy

surgery (diagnostic/treatment)

U-2-6 Demonstrate knowledge and ability to assist with invasive interventions,

treatments and procedures associated with oncological nursing.

U-2-7 Demonstrate knowledge and ability to assess and monitor clinical

manifestations/risk factors for oncologic urgent and emergent events

including:

antidiuretic hormone secretion syndrome

disseminated intravascular coagulation

hemorrhage

hypercalcemia

malignant bowel obstruction

neoplastic cardiac tamponade

neutropenia

post-surgical complications

sepsis/febrile neutropenia

spinal cord compression

superior vena cava syndrome

tumor lysis syndrome

U-2-8 Demonstrate knowledge and ability to recognize and report oncological

urgent and emergent events and collaborate with inter-professional team as

necessary.

U-2-9 Demonstrate knowledge and ability to support client to navigate the

healthcare system in collaboration with inter-professional team.


V: Occupational Health and Safety

Major Competency Area: V

Occupational Health and Safety

Competency: V-1

Occupational Health and Safety Nursing




V-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process in occupational health and safety.

V-1-2 Demonstrate knowledge of concepts of occupational health and safety

including:

emergency preparedness and response

handling of hazardous materials

health screening and testing


illness/injury prevention and management

managing emergent situations

personal protective equipment

physical and psychological safety

wellness and health promotion

workplace safety

V-1-3 Demonstrate knowledge and understanding of Legislation, Regulation and

standards related to occupational health and safety.

V-1-4 Demonstrate knowledge and ability to communicate and collaborate with

inter-professional team and others.

V-1-5 Demonstrate knowledge and ability to achieve advanced competence in:

audiometric testing

emergency medical response

ergonomic assessment

immunization

industrial first aid

spirometry and pulmonary function testing

substance screening and testing

vision screening

other areas as appropriate and necessary

Competency: V-1

Date: January 16, 2017 Occupational Health and Safety Nursing


V-1-6 Demonstrate knowledge and ability to assess and manage a culture of safety

in an occupational health and safety work environment including:

hazard and exposure assessment (industrial hygiene)

o biological

o chemical

o ergonomic

o psychological

o psychosocial

o physical

program administration, development, delivery, management and evaluation

partner in injury reduction programs

V-1-7 Demonstrate knowledge and ability to manage workplace illness and/or

injury including:

provide immediate emergency response and treatment

report according to Workers Compensation Act

provide support to ill or injured worker

o refer for treatment as appropriate

o collaborate with worker and Workers Compensation Board:

recovery/rehabilitation/retraining

worksite assessment

provision of modified work

return to work planning

perform reasonable cause and post-accident assessments

assess trends in occupational injury/illness

manage trend data

V-1-8 Demonstrate knowledge and ability to provide teaching and coaching within

the work environment related to occupational health and safety including:

deliver OHS orientation and training programs

manage workplace safety

recognize hazards and implementing controls




W: Medication Administration

Major Competency Area: W

Medication Administration

Competency: W-1

Principles of Pharmacology




W-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process related to pharmacology and

medication administration.

W-1-2 Demonstrate knowledge of chemical drug classifications:

animal (hormones, enzymes)

chemical synthesis (antibiotics, steroidal, radioactive)

natural (plant, mineral, herbal remedies)

W-1-3 Demonstrate knowledge and understanding of pharmacological principles

including:

pharmacokinetics

o absorption

o distribution

o metabolism

o excretion

pharmacodynamics

o adverse effect/side effect

o anaphylactic/allergic reaction

o antagonistic effect

o complementary and alternative therapy interactions

o dependency/tolerance/sensitivity

o desired effect

o drug interactions

o drug toxicity

o duration of action

o idiosyncratic reactions

o synergistic effect

o therapeutic duration

Competency: W-1 Page: 2




W-1-4 Demonstrate knowledge of routes for medication administration including:

gastrointestinal (oral, orogastric/gastric, nasogastric, rectal)

inhalational

intra-arterial

intracerebral

intradermal/epicutaneous

intramuscular

intraosseous

intrathecal

intravenous

intravesical

mucous membranes (sublingual, buccal, nasal, optic, otic)

percutaneous (topical, transdermal)

subcutaneous

vaginal

W-1-5 Demonstrate knowledge and understanding of medication action and effect

for client across the lifespan identifying:

contraindications

lab values

nursing implications

risk factors

W-1-6 Demonstrate knowledge and ability to access credible resources for

information and research related to medications prior to administration.

W-1-7 Demonstrate knowledge and ability to apply infection prevention and control

standards in safe storage, handling, removal and disposal of medications

according to agency policy including:

antineoplastic

autoimmune

cytotoxic

hormones

insulin

narcotics

non-cytotoxic hazardous

vasodilators, bronchodilators





W-1-8 Demonstrate knowledge and ability to perform drug counts on controlled

medications according to agency policy including:

maintain accurate record

accurately record addition and/or removal

participate in shift count and accurately record inventory

co-sign waste of controlled medication

W-1-9 Demonstrate knowledge and ability to provide health teaching and coaching

related to medications and medication administration.

W-1-10 Demonstrate knowledge and ability to communicate and collaborate with




Competency: W-2

Medication Preparation and Administration




W-2-1 Demonstrate knowledge and ability to accept, process, verify and initiate

written, verbal, telephone or electronic medication orders based on:

date and time

client name

medication name

dose, route, frequency, duration

authorized prescriber (name, signature, designation)

order is accurate, appropriate and complete

follow-up with authorized prescriber as necessary

W-2-2 Demonstrate knowledge and ability to accurately calculate dosages,

concentrations, rates and volumes using formulas and standards of

measurement associated with medication administration.

W-2-3 Demonstrate knowledge and ability to perform additional client assessment

prior to medication administration.

W-2-4 Demonstrate knowledge and ability to appropriately prepare medications for

administration according to agency policy.

W-2-5 Demonstrate knowledge and ability to apply the “rights” and “checks” of

medication administration to reduce risk of medication error and ensure

client safety.


Medication Preparation and Administration



W-2-6 Demonstrate knowledge and ability to adhere to agency policy and procedure

for safe administration of medication by:

gastrointestinal (oral, orogastric/gastric, nasogastric, rectal)

inhalational

intradermal/epicutaneous

intramuscular

intravenous - continuous, intermittent, IV push (direct)

mucous membranes (sublingual, buccal, nasal, optic, otic)

subcutaneous

percutaneous (topical)

vaginal

intravesicular (bladder instillation)

W-2-7 Demonstrate knowledge and ability to adhere to agency policy when assisting

in the monitoring of a client receiving medication administration by:

intraosseous

intrathecal

intra-arterial

intracerebral

W-2-8 Demonstrate knowledge and ability to provide ongoing assessment,

monitoring and evaluation of medication effectiveness.

W-2-9 Demonstrate knowledge and ability to recognize and manage adverse

medication reactions according to agency policy.

W-2-10 Demonstrate knowledge and ability to recognize and participate in the

management of anaphylaxis in accordance to agency policy.

View the Direct Intravenous Push Practice Document here for more information.

https://salpn.com/wp-content/uploads/Direct-Intravenous-Push-Practice-Guideline-Aug-28-2019.pdf



Competency: W-3

Nitrous Oxide Date: January 16, 2017



W-3-1 Demonstrate knowledge and ability to administer nitrous oxide:

identify risks and precautions

manage adverse reactions

provide ongoing monitoring



Competency: W-4

Immunizations Date: January 16, 2017


W-4-1 Demonstrate knowledge and ability to provide immunizations in

accordance with professional Legislation, Regulation, Standards and

Guidelines.

W-4-2 Demonstrate knowledge of concept of immunity and principles of

communicable disease prevention and control.

W-4-3 Demonstrate knowledge of anatomy, physiology and pathophysiology of

communicable diseases.

W-4-4 Demonstrate knowledge of the action, purpose, uses and nature of common

immunizing/biological agents.

W-4-5 Demonstrate knowledge and ability to identify the factors which affect the

action of immunizing/biological agents.

W-4-6 Demonstrate knowledge and ability to identify side effects, adverse effects,

and contraindications of common immunizing/biological agents, and

report appropriately.

W-4-7 Demonstrate knowledge and ability to adhere to the legal responsibilities,

policy, procedure, and scope of practice in the preparation and

administration of immunizing/biological agents.

W-4-8 Demonstrate knowledge and ability to maintain the cold chain in the

transportation and storage of immunizing/biological agents.

W-4-9 Demonstrate knowledge and ability to review pertinent health information

of client prior to immunization.

W-4-10 Demonstrate knowledge and ability to document assessment and nursing

actions related to risk factors.

View the Immunization Practice Guideline here for more information.


https://salpn.com/wp-content/uploads/Immunization-Practice-Guideline-Aug-28-2019.pdf

Competency: W-4 Date: January 16, 2017

Immunizations


W-4-11 Demonstrate knowledge and ability to perform critical elements to ensure

safety in preparation and administration of immunizing/biological agent.

W-4-12 Demonstrate knowledge and ability to ensure client, family or guardian

has sufficient information to give informed consent for immunization

including:

name of immunizing/biological agent to be administered

disease being prevented

benefits of immunizing/biological agent

common side effects

risks and rare side effects

rationale for 15-30 minute wait following injection

contact for follow-up or emergency

W-4-13 Demonstrate knowledge and ability to record immunizing/biological agent

administration and client’s response.




X: Infusion Therapy

Major Competency Area: X

Infusion Therapy

Competency: X-1

Principles of Infusion Therapy




X-1-1 Demonstrate knowledge and ability to apply critical thinking and critical

inquiry throughout the nursing process related to infusion therapy.

X-1-2 Demonstrate knowledge of principles of infusion therapy related to:

circulatory system

o arterial

o venous

blood and blood products

chemotherapy (assistive role only – LPN’s will not administer IV

chemotherapy)

fluid and electrolyte maintenance, restoration and replacement


medications and nutritional feedings

X-1-3 Demonstrate knowledge of peripheral lines, central lines, implanted ports,

spinals, epidurals and patient controlled analgesia pumps.

X-1-4 Demonstrate knowledge and ability to provide health teaching and coaching

related to infusion therapy.

X-1-5 Demonstrate knowledge and ability to communicate and collaborate with



Infusion Therapy

Competency: X-2

Peripheral Intravenous Therapy




X-2-1 Demonstrate knowledge and ability to perform peripheral infusion therapy:

initiate, monitor, regulate, lock, discontinue

o assemble and prime lines

o calculate infusion rates

o client safety

o evaluation of treatment

o infusion equipment

o administration of fluids and medications

X-2-2 Demonstrate knowledge and ability to maintain patient controlled analgesia

pump (PCA pumps).

monitor

regulate, lock, discontinue

X-2-3 Demonstrate knowledge and ability to manage complications of peripheral

intravenous therapy including:

abnormal lab values

air emboli

allergic reactions

dehydration/hypervolemia

equipment/line problems

fluid/medication error

infection

infiltration

phlebitis/thrombophlebitis


Infusion Therapy

Competency: X-3

Hypodermoclysis (HDC)




X-3-1 Demonstrate knowledge and ability to manage hypodermoclysis:

initiate, monitor, regulate, lock, discontinue

o assemble and prime lines

o calculate infusion rates

o client safety

o evaluation of treatment

o infusion equipment/pumps

o administration of fluids and medications

X-3-2 Demonstrate knowledge and ability to manage complications of

hypodermoclysis including:

allergic reactions

edema



hypervolemia

infection

localized pain

pooling of fluid at site


Infusion Therapy

Competency: X-4

Central Venous Catheter Care



central venous catheter (CVC):

o implanted vascular access device (IVAD)

o non-valved or open ended

o midline catheter (not a CVC)

o percutaneous

o peripherally inserted central catheter (PICC)

o tunneled

o valved or closed ended

X-4-2 Demonstrate knowledge of risks associated with central lines including:

abnormal heart rhythm

blockage

brachial plexus injury

embolus or thrombus

faulty or fractured device

hemorrhage/hematoma

incorrect placement

infection/sepsis

View Practice Guideline: Central Venous Catheters/ Central Lines/ Infusion Therapy for more information.


X-4-1 Demonstrate knowledge of central lines and specific application:

https://salpn.com/wp-content/uploads/CVC-Draft-Practice-Document.pdf

Competency: X-4

Page: 2

Central Venous Catheter Care



X-4-3 Demonstrate knowledge and ability to manage risks associated with removal

of non-tunneled peripherally inserted central venous catheters (PICC)

including:

abnormal heart rhythm

embolus or thrombus

brachial plexus injury

faulty or fractured device

hemorrhage/hematoma

infection/sepsis

X-4-4 Demonstrate knowledge and ability to monitor and manage central venous

catheters according to agency policy including:

dressing changes

cap/tubing change

flush and lock

maintain central venous pressure

administration of fluids

administration of medications (continuous, intermittent, IV push-direct)

occlusion issues

patient controlled analgesia pump (PCA pump)

withdraw blood

X-4-5 Demonstrate knowledge and ability to remove non-tunneled peripherally

inserted central venous catheters (PICC) according to agency policy.


Infusion Therapy

Competency: X-5

Blood and Blood Products Date: January 16, 2017


X-5-1 Demonstrate knowledge of circulatory system and components of blood and

blood products.

X-5-2 Demonstrate knowledge of normal/abnormal lab values pertaining to blood

transfusion.

X-5-3 Demonstrate knowledge of types of transfusions according to composition

and indications for use including:

albumin

cryoprecipitate

Factor 8 (anti-hemophilic factor-AHF)

fresh frozen plasma

immunoglobulin

packed red blood cells

packed white blood cells

plasma expanders

platelets

whole blood

X-5-4 Demonstrate knowledge of blood typing and cross-matching of blood.

X-5-5 Demonstrate knowledge and ability to obtain informed consent

understanding and respecting:

ethical and religious beliefs

legal right to refuse

X-5-6 Demonstrate knowledge and ability to prepare for blood administration

according to agency policy including:

set up and prime infusion

obtain blood or blood products

check blood or blood products with authorized professional

View the Sask Blood Transfusion Competency Manual here for more information.


http://saskblood.ca/sk-transfusion-resource-manual/

Competency: X-5

Page: 2 Blood and Blood Products



X-5-7 Demonstrate knowledge and ability to monitor, administer, regulate and

discontinue blood or blood products.

X-5-8 Demonstrate knowledge and ability to identify a reaction to blood or blood

products according to agency policy including:

anaphylaxis

abdominal status (pain, nausea)

abnormal bleeding

abnormal breath sounds (cough, dyspnea, wheezing)

chest flank or back pain

circulatory overload

elevated blood pressure

embolus

increased temperature

mental state (anxious, drowsy, calm)

sepsis

skin color and appearance (urticaria, jaundice)

urine output and color

X-5-9 Demonstrate knowledge and ability to manage a reaction to blood or blood

products according to agency policy.


Infusion Therapy

Competency: X-6

Epidural and Spinal Infusions Date: January 16, 2017



X-6-1 Demonstrate knowledge of epidural infusions including:

calculate infusion rates

client safety

infusion equipment/pumps

neurological assessment and client monitoring

administration of fluids and medications

pain management

indications and complications

X-6-2 Demonstrate knowledge and ability to recognize and report complications of

epidural and spinal infusion therapy including:

abnormal lab values

allergic reactions



hemorrhage

infection

infiltration

post epidural cerebrospinal fluid leak/headache

X-6-3 Demonstrate knowledge and ability to manage client care post epidural or

spinal regional anesthesia/pain block.

X-6-4 Demonstrate knowledge and ability to maintain epidural infusions.

Note: LPNs are not authorized to initiate or remove epidural and spinal catheters.


Infusion Therapy

Competency: X-7

Parenteral Nutrition Date: January 16, 2017



X-7-1 Demonstrate knowledge of parenteral nutrition according to:

composition:

o dextrose

o amino acids

o protein

o minerals

o fats

o vitamins

o trace elements

indications for use:

o absorption impairment

o inability to tolerate enteral feeding

o gastro-intestinal tract blockage

o nutritional impairments

X-7-2 Demonstrate knowledge and ability to administer, monitor, maintain and

discontinue parenteral nutrition.

X-7-3 Demonstrate knowledge and ability to manage side effects associated with

parenteral nutrition.

X-7-4 Demonstrate knowledge and ability to recognize and report complications

associated with parenteral nutrition including:

convulsion or seizure

hepatic dysfunction (fatty liver disease, jaundice, hepatomegaly,

cholelithiasis)

metabolic imbalance (hyper/hypoglycemia, hyper/hypokalemia,

hyper/hypocalcemia)

nutritional imbalance

poor night vision


Y: Educator

Major Competency Area: Y

Educator

Competency: Y-1

Adult Learning Principles Date: January 16, 2017



Y-1-1 Demonstrate knowledge of adult education philosophies, teaching and

learning strategies, instructional design and program evaluation.

Y-1-2 Demonstrate knowledge and ability to apply adult learning theory

assumptions in classroom, online or through blended delivery of education:

independence (offer minimum instruction/maximum autonomy)

experience (address levels/backgrounds)

readiness (identify needs /prior knowledge)

orientation (describe how/when learning will occur)

motivation (reason for educational activity)

Y-1-3 Demonstrate knowledge and ability to apply effective interpersonal

communication in delivery of adult education including:

adapt communication to individual learner style

manage challenging conversations

practice active listening

program management and evaluation

seek and accept feedback from learners, faculty and others

student management and evaluation

utilize collaboration tools to link learning and social development

Major Competency Area: Y

Educator

Competency: Y-2

Design and Delivery of Education Date: January 16, 2017



Y-2-1 Demonstrate knowledge of a systems approach to guide development of

effective adult education including:

analysis

design

development

implementation

evaluate

Y-2-2 Demonstrate knowledge and ability to complete an analysis of instructional

needs including:

feasibility of education

learner characteristics (age, gender, current subject knowledge, demographics)

learning environment (classroom, online, self-directed)

course description (scope, context, expected performance outcomes)

timeline for development

Y-2-3 Demonstrate knowledge and ability to apply evidence informed practice in

curriculum design and development including:

develop measurable program/learning objectives

assess criteria

identify learning concepts/context

identify learner’s goal and outcome

identify level of learner support

create and assemble course content

review and revise according to feedback

Y-2-4 Demonstrate knowledge and ability to implement adult learning principles in

delivery of adult education including:

theories and philosophies (behaviorism, cognitivism, constructivism, social

learning)

learner needs and goals (new tools, technology support)

Competency: Y-2 Page: 2

Design and Delivery of Education



Y-2-4 Demonstrate knowledge and ability to implement adult learning principles in

delivery of adult education including: (cont’d)

learning/program objectives

self-paced learning

effective learning environment

varied delivery methods (lectures, role play, teamwork, synchronous,

asynchronous)

pedagogy and andragogy

communication/interpersonal skills

teaching and learning strategies

Y-2-5 Demonstrate knowledge and ability to evaluate learning outcomes including:

construct assessment procedures (formative, summative)

maintain confidential, accurate and objective learner records

provide individual support and assistance as required

participate in committees and taskforces for ongoing review and revision of

curriculum



Z: Peri-Operative Specialized Area

of Practice

Major Competency Area: ZPerioperative Care: Specialized Area of LPN Practice

Competency: Z-1

Authorization and StandardsDate: June 25, 2015



Z-1-1 Demonstrate knowledge and application of Canadian Council of Practical Nurse Regulators (CCPNR) approved “Standards of Practice and Competencies for Peri-operative Nursing Care, 2010”.



Competency: Z-2

Knowledge and Application Date: June 25, 2015


Z-2-1 Demonstrate knowledge and ability to apply critical thinking andclinical judgment within the Scope of Practice of a Licensed PracticalNurse in a Peri-operativerole

Z-2-2 Demonstrate the knowledge and ability to practice Licensed Practical Nurse Perioperative Nursing in the operating room:• Role of the LPN in the operating room• Application of nursing process• Admission and transfer of client• Apply principles of asepsis and sterile techniques• Demonstrate an understanding of surgical procedures, and

understanding of policies and procedures• Knowledge of the different disease processes• Understanding of the medications used in pre, intra, and

immediate post-operative care• Anesthesia medications and protocols• Client and health care team safety measures• Assist in the teaching / orientation of new staff• Ordering of supplies, equipment as appropriate• Prepare costing for surgical procedures as appropriate• Policies related directly to the surgical suite (i.e. restricted access

or dress code)• Knowledge of policies and procedure, standards and applicable

legislation (i.e. occupational health and safety)• Documentation and reporting


Competency: Z-3

Knowledge and Application of Scrub Role

Date: June 25, 2015


Z-3-1 Demonstrate knowledge and ability to carry out the requirements of the Licensed Practical Nurse in the perioperative Scrub Role:

Z-3-2 Demonstrate knowledge and ability to perform the competencies of the Licensed Practical Nurse in the Scrub Role:


¶ Apply the principles of asepsis¶ Provide the surgical team with instrumentation and supplies ¶ Anticipate the needs of the surgical team¶ Provide safety and security of the client throughout the surgical procedure.


• Perform surgical scrub procedures• Perform safety checks

o Participate in safe surgery check list as per facility policyo Confirm/validate internal sterility indicators

• Check case cart/supplies• Ensure equipment/instrumentation is available, set up, and in good repair• Prepare efficient sterile set-up• Drape client for procedure• Surgical site marking visible when draping is complete• Knowledge of sequence of events of surgery• Anticipate needs of surgeon• Organize and handle sutures, needles, other sharps, and staples• Manipulate and hand instruments t surgeon and assistants• Observe for inadvertent breaks in sterile technique and assist with corrective action• Identify specimens to circulating personnel and type of testing required• When possible, anticipates unexpected or adverse events and take action• Handle, label and prepare medications and contrasts for administration to the client• Participate in handling and counting of instruments and supplies• Appropriate disposal of hazardous materials• Appropriate disposal of all sharps• Ensure appropriate surgical procedure documentation• Provide skin closure and apply sterile dressing as necessary

• Prepare the room supplies and equipment for a specific operativeprocedure (includes, but may not be limited to, special equipment,positioning devices, sutures, case cart, warming supplies, IV solutions,physician cards)

• Notify all other healthcare professionals who may be required for thesurgical procedure (i.e. pathologist, technicians)

• Access x-rays and diagnostic tests as ordered or required.• Participate in safe surgery checklist

Competency: Z-4

Knowledge and Application of Circulating Role

Date: June 25, 2015


Z-4-1 Demonstrate knowledge and ability to perform as a Licensed Practical Nurse Circulating Role in the preparation of the operating room theatre:


• Identify and assess client• Perform the pre-operative checklist• Transport client to the operating room theatre• Receive client into the operating room theatre and carry out

appropriate checks• Assist surgeon and anaesthesia provider with positioning client safely

on the operating room table• Reassure client and explain procedures• Apply monitor and equipment as required, i.e., ECG, BP, Pulse• Oximetry, other anesthetic equipment• Apply necessary equipment, i.e., tourniquet, drainage systems• Insert urinary catheter and set up drainage as ordered• Prepare irrigation solutions as necessary• Prepare operative site,

o Prepare client skin prior to procedure i.e. antiseptic skin prep• Provide assistance and support to the scrub nurse with draping and

connection to suction, power tools, etc

Z-4-2 Demonstrate ability to prepare client for the surgical procedure as theLPN circulator:


Competency: Z-4


Page: 2


Z-4-3 Demonstrate ability to provide assistance during the operative procedure:• Provide, prepare and label medication for administration to the

client as ordered• Receive and verify specimens by labeling, handling, and

documenting appropriately• Inspect all sterile items for contamination prior to opening• Present open sterile supplies• Present sterile supplies to scrub personnel• Provide appropriate instruments and supplies as needed• Prepare supplies for sterilization- flash sterilization as per facility

policy/procedure• Document client care, specimens, sponge counts, medications

used intraoperatively• Document blood loss, fluid output, and intake as

required or directed• Document any and all unusual incidents with appropriate follow up

action as per facility policy• Assist with vital signs as appropriate• Ensure, along with a second individual, that counts are completed,

documented, and acknowledged to the team• All counts must be performed with two licensed professionals• Monitor sterile technique performed throughout the surgical

procedure• Provide continuous, astute observation of the surgical team

throughout the operative phase while meeting their needs withminimal time delays

• Assist with monitoring and evaluating the physical well-being ofthe client to prevent potential impairment or injury


Z-4-4 Demonstrate ability to provide and assist with procedures and devicesrequired to complete client care following the surgical procedure:• Observe and provide appropriate response to complications and unexpected

events during the surgical procedure i.e., cardiac arrest, hypothermia• Assist in the physical client transfer and post-operative positioning• Affix and observe the dressing post-operatively verifying all drains are

properly connected and secured as well as appropriate documentation iscompleted

• Complete operative record and have scrub personnel review

Competency: Z-4


Page: 3


Z-4-5 Demonstrate ability to provide support and assistance in providingsafety and efficiency for the surgical team and client:• Advocate for client• Assist collaboratively with the co-ordination of the surgical

schedule procedures i.e., sending for patient, surgeons availability,staffing, providing necessary equipment available

• Comply with Workplace Hazardous Materials Information System(WHMIS) regulations

• Apply routine/standard, or additional precautions i.e. airborne,droplet and/or contact precautions

• Carry out appropriate surgical scrub procedures or safety checks,i.e. client identification, allergies, with the circulating nurse

• Check case cart and supplies for completeness• Ensure all equipment and instrumentation is in good repair and

available• Trouble shoot equipment that malfunctions and seek assistance• Facilitates use of accessory surgical equipment, i.e. lasers,

electrocautery units• Recognizes an emergent situation and send for assistance or

supplies as required.• Knowledge and understanding of sterile storage requirements i.e

temperature and humidity levels• Appropriate disposal of hazardous materials• Appropriate disposal of sharps


• Provides supplies to anesthesia provider as required• Supply anesthetic cart, i.e. tubing, appropriate size face mask,

airway and breathing bag depending on the age and size of the client• Provide appropriate endotracheal tubes• Assist the anesthesia provider with the administration of general

anesthetic, epidural, spinal, topical, retrobulbular, local anesthetics,and blocks

• Initiate intravenous and prepare supplies for anesthesia provider• Provide medication to the anesthesia provider when requested• Assist with induction of anesthetic:

o Intubation, fixation, and connection of endotracheal tubeo Cricoid pressure if necessaryo Assist with extubation and reversal of anesthesia

• Provide necessary eye protection, i.e., tape, saline sponge, etc.• Knowledge of the preparation related to insertion of central venous

line (CVP) line, arterial lines, blood warmers• Check blood and blood products identification with two licensed

providers• Assist with transfer of client to Post Anesthetic Recovery Room,

Intensive Care Units, or receiving unit• Restock anesthetic medication as required

Competency: Z-5

Knowledge and Assistance to the Anesthesia Provider

Date: June 25, 2015


Z-5-1 Demonstrate critical thinking and clinical àudgment related to assisting the anaesthesia provider in each of the following competencies.


Z-5-2 Demonstrate knowledge and ability to assist anesthesia provider:


Competency: Z-6Knowledge and Application of

Pre-Operative PhaseDate: June 25, 2015


Z-6-1 Demonstrate knowledge and ability to receive and monitor client inpre-operative phase or pre-surgery care as appropriate:


• Provide explanations and demonstrate a caring attitude to the client and family

• Provide information, materials, and support for client and family• Check each pre-operative chart for completeness as per facility policy:• Accurate identification of client

o Complete charto Historyo Any prior surgerieso Allergy checko Hemoglobin, E.C.G., urinalysis, x-ray as orderedo Consult if requiredo Consent for the surgical procedure

• Seek confirmation of the following from the clients or family:o Nameo Doctoro Operative site/surgical procedureo Surgical site verification and marking (side or laterality) as per

facility policy/procedureo Nothing per moutho Removal of dentures and partialso Identification of prostheses and locationo Identification of implants, i.e. pacemaker, cochlear implanto Removal and or identification, piercings , and knowledge of metal

protocolso Removal of nail polish and false nailso Knowledge of tattoo locationso Pre-existing medical conditions and medications

• Provide the client with warm blankets, pillows, and other comfort measures

• Attach all necessary monitoring devices, i.e., blood pressure, oxygen,E.C.G.


Competency: Z-6Knowledge and Application of

Pre-Operative Phase

Page: 2


Z-6-2 Demonstrate knowledge and ability to receive and monitor client in pre-operative phase or pre-surgery care as appropriate (con't):• Apply all necessary safety measures- safety straps and remain

with the patient• Provide O2 when required or ordered by doctor• Check all fluids levels i.e., intravenous (IV) and drainage unit and

document• Attach patient equipment to electrical outlet if battery supply is low• Assist surgeons and anesthesia provider with physical examinations

of client providing necessary equipment and providing privacy forclient

• Assist anesthesia provider with topical, retrobulbular, local anesthetic,administration of eye medication, initiation of IV site

• Knowledge of code cart, defibrillator, difficult intubation cart/equipment

• Understanding the LPN role in a code situation – code blue, cardiacarrest as per facility policy




AA: Hemodialysis Specialized Area of Practice


Major Competency Area: AAHemodialysis Specialized Area of Practice

Competency: AA -1Critical Thinking and Clinical Judgment in the Hemodialysis

Nursing Role

Date: June 25, 2015



AA-1-1 Demonstrate knowledge of human anatomy and physiology

AA-1-2 Demonstrate knowledge of pathophysiology, symptoms, treatment,

and interventions of acute and chronic renal failure:• Disruption to kidney function

• Normal structure and physiology• Identify multi system failure related to kidney disease• Principles of dialysis - osmosis, diffusion, ultra-filtration• Symptoms related to inadequate dialysis• Treatments related to:

• Peritoneal dialysis• Hemodialysis• Transplant preparation• Diet and fluid restrictions• Sodium, potassium, calcium and phosphorous restrictions

AA-1-3 Demonstrate knowledge and ability to assess for hemodialysiscomplications and nursing interventions including but not limited to:• Hypoxemia

• Exsanguination• Dialyzer reactions• Air embolism• Muscle cramps• Hypotension/Hypertension• Chest Pain• Dysrhythmias• Acute hemolysis• Blood glucose levels• Edema• Ischemic feet• Lab values• Psychosocial assessment• Need for dietary consult


AA-1-3 Demonstrate knowledge and ability to assess for hemodialysis complications and nursing interventions including but not limited to (con't):• Interdialytic weight gains

• Pyrogenic reaction• Dialysis Encephalopathy• Advanced Health Care Directives

• Disequilibrium reaction

Page: 2Competency: AA-1

Critical thinking and clinical judgment in the hemodialysis nursing role.

• Stenosis/Vascular conditions• Arteriovenous fistula, graft, CVC access• Needle placement• Needle manipulation• Understand physiology/complexity/care and potential

complications of vascular access• Flow• Presence of fistula, graft or central line• Presence of bruit• Clotting• Palpate for thrill• Aneurysm• Infection• Knowledge of clients medications – purpose, frequency,

side effects, and correct infusion and administration procedures

AA-2-1 Demonstrate knowledge and assessment of the access for evidence of:

Competency: AA-2

Critical thinking and clinical judgment of the dialysis client

Date: June 25, 2015



• Observe and report client’s physical and emotional conditionand take appropriate action

• Sensitive, diplomatic, empathetic manner

AA-2-2 Demonstrate ability to create an atmosphere that is conductive to patient comfort needs:

• Pre-assessment• Mid-assessment• Post-assessment

AA-2-3 Demonstrate ability to apply nursing process to the care ofthe dialysis client including but not limited to


• Understand pharmacology related to those withrenal disease

AA-2-4 Demonstrate knowledge and ability to provide medications in the dialysis environment, as per agency policy:

AA-2-5 Demonstrate ability to document nursing assessment, treatments, effects, and outcomes and evaluation.

Page: 2Competency: AA-2

Critical thinking and clinical judgment of the dialysis client

AA-2-6 Demonstrate ability to provide health teaching to client and family throughout the process.



Competency: AA -3

Initiation, monitoring and discontinuation of dialysis treatment

Date: June 25, 2015

• Auscultate lungs PRN• Needle site selection• Cannulation techniques• Securing needle• Cannulation problem solving• Removal of needle• Discharge dressing and assessment• Recognize excessive weight gain and know limitations

for fluid removal• Calculate and adjust fluid removal• Assess and correct access difficulties• Assess needling problem• Maintain medical asepsis• Draw blood from access sites – collect, label, send specimens• Monitor vital signs• Respond appropriately to emergency situations• Control bleeding from patient’s access site• Note clotting time• Document and report to appropriate health care team member

AA-3-1 Demonstrate critical thinking and clinical judgment relating to the initiation, monitoring and discontinuation of dialysis treatment ineach of the following competencies:




Competency: AA-4

Understanding the mechanics of dialysis and related equipment

Date: June 25, 2015

• Assess equipment and function, organize repairs andmaintenance as required

• H2O treatment• Conductivity and pH meters• Glucometers• Assemble or assist with assembling equipment, including

hemodialysis machines• Recognize alarm conditions• Order supplies as necessary• Adhere to safety and infection control measures• Components of hemodialysis system - containments

and consequences• Cleaning of the dialysis machine

AA-4-1 Demonstrate knowledge and ability to understand the mechanics of dialysis and related equipment:





BB: Orthopedic Specialized Area of Practice


Major Competency Area: BBOrthopedic Specialized Area of Practice

Competency: BB-1

Knowledge and Application of Orthopedic Specialty

Date: June 25, 2015



BB-1-1 Demonstrate knowledge of human anatomy and physiology of: • body systems• body planes and directions• related terminology

BB-1-2 Demonstrate knowledge of orthopedic medical conditions and treatment:• trauma:

o dislocationso multiple fractureso compartment syndromeo fat embolism

• fractures:o spinalo extremitieso pelviso ribs

• arthritis:o ankylosing spondylituso rheumatoido degenerativeo juvenile

• infection:o osteomyletiso bursitiso general

• tears:o ligamentso tendonso meniscuso soft tissue injury

Competency: BB -1

Knowledge and Application of Orthopedic Specialty

Page: 2


BB-1-2 Demonstrate knowledge of orthopedic medical conditions and treatment (con't):• other:

o muscle injurieso osteoporosiso congenital disorderso kyphosis / scoliosiso contractures /deformitieso growths / tumours

BB-1-3 Demonstrate ability to perform comprehensive assessment of the orthopedic client.

BB-1-4 Demonstrate the ability to recognize a variety of x-ray views such as: • anterior / posterior• axilla• lateral• mandibular• panorex• posterior / anterior• oblique• transverse• tunnel

BB-1-5 Demonstrate ability to teach the use of orthopedic equipment such as:• cane• cast removal equipment• CPM machine (continuous passive motion)• crutches• walker


BB-1-6 Demonstrate ability to measure angles of joints using a goniometer.

BB-1-7 Demonstrate ability to receive verbal and written physician orders pertaining to orthopedics:• accept , transcribe and initiate orders

BB-1-8 Demonstrate knowledge and ability to assist the physician with a variety of treatments and interventions such as:• setting a fracture of a bone• inserting or removing orthopedic devices


Competency: BB -2

Application of Orthopedic Devices

Date: June 25, 2015


BB-2-1 Demonstrate ability to teach the application of orthopedic devices: • acromioclavicular harness• airsplints• ankle brace• ankle foot orthosis• back braces• clavicle strap• elastic support stockings• finger splint• fracture brace• gibney boot• hare’s traction• hinged knee brace• humeral fracture brace• iso-ulnar brace• jones bandage

pavlik harness• sager splint• shoulder immobilizer / sling and swath/ velpeau• soft/ hard cervical collar/ triple ruff• stump wrapping• tibial / femoral braces• tensors / tubigrip• zimmer splint / knee imobilizer



Competency: BB-3

Cast and Splint Care Date: June 25, 2015


BB-3-1 Demonstrate knowledge of construction, application, removal, and teaching of cast and splint care such as:• above elbow• above knee – walking and non-walking• back slabs• below elbow• below knee- walking and non-walking• body casts• cylinder casts• gutter splints• hip spica• patella tendon bearing• plaster vs. fibreglass• sugar tong• spica casts• uni-valve, bi-valve, windowing, trimming• volar labs• wedging



Competency: BB-4

Application and Monitoringof Traction

Date: June 25, 2015


BB-4-1 Demonstrate ability to set-up, apply, assist in application, and monitor manual, skin, and skeletal traction: • balanced suspension• Balkan frame• Bryant or Gallows• Bucks• Gardner Wells• pelvic• Russells or Split Russells• skeletal• skin• skull• Steinmen Pin insertion

BB-4-2 Demonstrate knowledge and application of casts for treatments of fractures, dislocations, and skeletal disorders:

• closed reductions under conscious sedation or use of bier blocks (ATStourniquet)

BB-4-3 Demonstrate ability to assist with application of traction, insertion and removal of pin devices:• Crutchfield tongs• External Fixators• Gardner Wells tongs• Halo devices• Kirschner wires• Steinmen pen


BB-4-4 Demonstrate ability to teach client and family regarding orthopedic treatment and care:• orthopedic condition• equipment and devices• orthopedic procedures• physician orders and treatment plan

Documents

Competency Profile for the Saskatchewan Association of ... · the values of truth, honesty, and trustworthiness, and shall observe the standards of conduct set out in the Code of