Nursing Trainee:___________________________Trainee / Faculty Copy
Complete CHS/UAB Requirements: (complete and give certificates to preceptor)
_____ Information Handbook for Non-COA Nurses
_____ UAB Diversity Training
Provide to Nursing Faculty:
_____ Semester schedule
______ fall _____ spring _____ summer
_____ Nursing Clinical Skills Evaluation Checklist
_______ Pre-Training ________ Post-Training
_____ Post-Training Program Relevance Report
_____ Post-training Faculty Effectiveness Evaluation
_____ Semester Record of Clinical and Activity Report
_____ fall _______ spring _______ summer
Clinical skills:
______ Locate and record needed information in patient chart
______ Obtain history (including current and chronic problems, sleep and feeding
issues, growth and development progress, family and social history)
from family, chart, or computer sources in a timely fashion
______ Perform physical exam with focus on pulmonary condition
______ Organize and present pertinent history, physical exam, lab/test findings,
assessment and plan (including follow-up) to physician
______ Consult with other disciplines as needed
______ Prescribe medications (including dosage, teaching, etc.)
______ Provide patient/family education and follow-up plan to family
______ Initiate referrals to community providers
______ Communicate (dictation or phone) with referring physician, school,
home care as needed.
______ Record in clinical log to reflect a variety of patients’ ages and diagnosis
Identify key issues for PNP care for the following common clinical situations by reading/viewing PNP, pulmonary or pediatric textbook information, family education literature, or 1-2 journal articles (published in the last 5 years);
______ Primary care for the child with special health care needs
______ Asthma
______ Bronchopulmonary Dysplaisa (BPD)
______ Cystic Fibrosis (CF)
______ Sleep Problems including sleep hygiene
______ Pulmonary Complications of Neuromuscular Disease
______ Technology Dependent Conditions (home oxygen, apnea monitor, BiPap,
CPAP, home ventilator, suction, tracheostomy, gastrostomy, cough assist)
______ Growth or Developmental Delays
______ Transition to adult care
______ Smoking cessation counseling
______ Aerosolized medications
______ Metered Dose Inhalers (MDIs) and Dry Powder Inhalers (DPIs)
______ Chest PT or other forms of airway clearance (vest, PEEP, etc.)
______ GE Reflux precautions
Observe/interact with other disciplines to increase ability to functioning on an interdisciplinary team:
______ Physician
______ Nutritionist
______ Respiratory therapist
______ Social Worker
______ Other _________________________
Observe the following procedures:
______ Pulmonary Function Testing and Spirometry
______ Bronchoscopy
______ Sweat Test
______ Sleep Study
______ Infant PFTs
______ Other _________________________
Complete the following Leadership Projects:
______ Videotaped Interview Skills
______ Family Case Study
______ System of Care Project, Agency ______________________________
______ Continuing Education Offering
______ Formal Presentation, Topic __________________________________
______ Review Health People 2020 Document
______ PPC Cultural Competency Modules
______ Health Disparities Poster
Attend Seminars:
______ Research Roundtable (monthly)
______ Interdisciplinary Case Study
______ MCH Network Project Seminars
______ Grand Rounds (Attend a minimum of 3 on topics of interest)
Other clinical experiences/observations :
______ Other CHS Specialty clinics including adolescent clinic
______ Community Outpatient Settings (CRS, ADPH, primary care offices)
______ Inpatient Pulmonary Units