Transcript Competency Model for Professional Rehabilitation Nursing

Competency Model for Professional
Rehabilitation Nursing
Behavioral Scenario
for
Competency 1.1: Use Supportive Technology for
Improving Quality of Life for Persons with Disability.
Rebecca S. Koszalinski, PhD, RN, CRRN, CMSRN
Copyright©2015, Association of Rehabilitation Nurses
Competency 1.1
Use Supportive Technology for Improving Quality of
Life for Persons with Disability
Description/Scope: Use of appropriate technology
that improves self-management in Persons with
Disability and/or Chronic Illness
Participates in the
process of determining
the need for assistive or
supportive technology
Uses basic technology
interventions in the
plan of care
Demonstrates
competent use of
technology in the care
of a client
Documents the
outcome of the
technology intervention
Beginner Proficiency
Level Descriptors
Copyright©2015, Association of Rehabilitation Nurses
Behavioral Scenario
A nurse enters a patient room to administer medications and
quickly notices that the patient is in distress. Due to tremor, the
patient requires an assistive high technology spoon to eat.
She is having difficulty placing the spoon
securely in her hand. The nurse watches the
patient repeatedly pick up the spoon, try to
place it in her hand and then drop it to the
tray. The patient is clearly frustrated.
Copyright©2015, Association of Rehabilitation Nurses
Path 1 – Not Proficient
The nurse continues to watch out of the corner of her eye as
she prepares medications. She approaches the patient and
follows the rights of medication administration. Then, she
administers the medications to the patient. The nurse walks
back to her cart and quickly documents the medication pass.
She pauses for a moment at the door and asks if the patient is
done with her tray. The patient looks up with tears in her eyes
and asks for assistance. The nurse states, “Sorry, I don’t know
how to use that spoon. I could send in an aide or you could
wait until your therapist comes to your room. Just do what you
can until then.” The nurse turns and leaves before the patient
can respond.
Copyright©2015, Association of Rehabilitation Nurses
Path 1 – Not Proficient
Observations & Outcomes
1.
2.
3.
The nurse is proficient in noting that the patient is not able to properly place the spoon. The nurse is also
proficient in conducting a proper medication pass. However, the nurse is not proficient in using the patient’s
high-tech assistive technology. The patient is unable to eat her lunch and is told to wait for someone else to help.
This may result in the patient not meeting nutritional needs for the day.
Understanding how to use technology is integral to quality care in the rehabilitation population. Patients are
encouraged to challenge themselves so that they may reach the highest level of rehabilitation possible for each
person. Technology may be used to enhance patient rehabilitation. The consequences of failing to learn how to
use patient assistive technology is that the patients may not be able to reach their highest level of desired
rehabilitation. It also supports a pervasive continuation of nursing knowledge deficit regarding patient needs.
This patient should be nurtured in her efforts to feed herself.
The nurse should learn how to use patient assistive
technology proficiently so that the patient’s needs are
met. This can be done by working with the patient and
therapists to provide optimal support.
Copyright©2015, Association of Rehabilitation Nurses
Path 2 - Proficient
The nurse continues to watch out of the corner of her eye as she
prepares medications. She approaches the patient and follows the
rights of medication administration. Then, she administers the
medications to the patient. The nurse walks back to her cart and
quickly documents the medication pass. She pauses for a moment
and states, “You are really having trouble with that spoon. Could I
help?” The patient looks up with tears in her eyes and says, “Yes,
please. The therapist showed me how but I can’t make it work.” The
nurse states, “Ok, I am not really familiar with this particular
supportive technology so I’d like you to tell me what you know about
it.” The patient states that the therapist also left some information
about how the spoon stabilizes tremor and a link to a short video.
Copyright©2015, Association of Rehabilitation Nurses
Path 2 - Proficient
The nurse pulls a chair near the patient so she can sit at the patient’s
level and says, “Let’s look at the information, pull up the video and see
if we can figure this out.” Once they have discovered how to use the
assistive technology, they briefly discuss the patient’s care plan and all
other needs the patient has for that shift. At the end of the
conversation, the nurse states she will check in regularly and leaves to
document the outcome of the nurse led intervention using assistive
technology.
Copyright©2015, Association of Rehabilitation Nurses
Path 2 – Proficient
Observations & Outcomes
1.
2.
3.
The nurse is exhibiting the use of technology in the plan of care, is demonstrating competent use of
technology in the care of a patient and is documenting the outcomes of using a supportive technology
nurse-led intervention.
Positive outcomes include meeting the patient’s dietary needs and assistance in the use of supportive
technology. The patient is also recognized as a unique and caring individual, is able to participate in the
care plan and may feel empowered. The nurse is more aware of how to best care for the patient.
In order to increase proficiency levels, the nurse can continue
to assess and anticipate the patient’s needs for supportive
technology, establish goals with the inter-professional team for
the use of technology in the plan of care, tailor the technology
to the needs of the patient, and continue to evaluate the
effectiveness of the supportive technology.
Copyright©2015, Association of Rehabilitation Nurses
What Did You Observe?
How did the outcomes of this scenario differ?
Proficient Nurse
Non-Proficient Nurse
- Looked beyond the obvious - Addressed only the most
in order to meet the needs of basic and obvious
the patient
interventions
- Embraced technology
- Communicated uses and
benefits with the patient
- Did not understand the
technology
- Did not show an interest in
learning and addressing the
patient’s need
Copyright©2015, Association of Rehabilitation Nurses
Takeaways
1. The new nurse should embrace technology for the
benefit of the patient. This will impact the patient
through meeting her needs. It will also impact the team as
important information is shared with other nurses and
team members so that optimal care is provided.
2. The patient may require additional assistance in using
supportive technology. Supporting her may result in a
more positive healing experience and increased
likelihood that the patient will continue to use the
supportive technology after discharge.
3. Transition of care may be better facilitated when
everyone on the care team is aware of patient needs and
preferences.
Copyright©2015, Association of Rehabilitation Nurses