iRubric: Mechanical Ventilator Initiation. Oral Test 1 rubric

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Mechanical Ventilator Initiation. Oral Test 1

Evaluation of the following objectives: 1. Recognize the pertinent aspects of the patients condition. 2. Plan an appropriate ventilation strategy for the patient. 3. Make therapeutic adjustments to normalize ABG 4. Assess the effectiveness of the adjustments you make to the ventilator settings.

Rubric Code: CXX7394

By campbecj

Draft

Public Rubric

Subject: Medical

Type: Exam

Grade Levels: Undergraduate

Preparation Gathers all known available patient information.
	Advanced Performs all aspects with no mistakes, shows advanced critical thinking and application where applicable. through verbal explanation of his/her actions. 5 pts	Proficient Able to perform all aspects with minor mistakes / self-corrects on non-critical aspects 4 pts	Minimally Below Standards Able to perform basic aspects of scenario area, Does not verbalize or verbalizes incorrect justification for actions 3 pts	Not Proficient Did not perform this item at all, or incorrectly performs this item. 1 pts
Data Gathering 1. Reviews provided patient information, asks pertinent questions of information .	Advanced review information in < 2 minutes. Recognize & verbalize ALL pertinent information used to initiate mechanical ventilation.	Proficient review information in < 2 minutes. Recognize and verbalize SOME pertinent information used to initiate mechanical ventilation	Minimally Below Standards review information in > 2 minutes. Recognize and verbalize SOME/ ALL pertinent information used to initiate mechanical ventilation	Not Proficient Does not perform any of the initial steps required in the skill listed
Equations & Calculations Performs all tasks necessary to safely initiate mechanical ventilation.
	Advanced Performs all aspects with no mistakes, shows advanced critical thinking and application where applicable 10 pts	Proficient Able to perform all aspects with minor mistakes / self-corrects on non-critical aspects 7 pts	Minimally Below Standard Able to perform some, but not most of the basic aspects of the task, requires some intervention 4 pts	Not Proficient Unable to perform without significant interventions 1 pts
Calculations 1. Calculates IBW. 2. Calculates Minute Volume Target 3.Calculates FiO2 4. Calculates IBW 5. Determines BSA	Advanced Uses correct equations to determine IBW. Uses correct equations to determine target Ve Performs the calculation correctly. Applies correction % to Ve for patients condition	Proficient Uses correct equations to determine IBW. Uses correct equations to determine target Ve. Able to perform all aspects of caluclations with minor mistakes / self-corrects on non-critical aspects	Minimally Below Standard Uses correct equations to determine 1 of IBW or Target Ve uses inaccurate or unable to recall correct equation or to perform calculation.	Not Proficient Unable to perform any of the initial steps required in the skill listed.
Initiate Mechanical Ventilation 1. Able to identify appropriate mode and rationale for mode selection. 2. Sets mode with appropriate parameters: a) Tidal Volume b) Frequency c) Mindful of PIP d) Flow/ I:E e) Flow Waveform Pattern
	Advanced Performs all aspects with no mistakes, shows advanced critical thinking and application where applicable 50 pts	Proficient Able to perform all aspects with minor mistakes / self-corrects on non-critical aspects 35 pts	Minimally Below Standards Able to perform some, but not most of the basic aspects of set tasks, requires some interventions 25 pts	Not Proficient Unable to perform without significant interventions 10 pts
Mode Selection 1. Able to identify appropriate mode and rationale for mode selection. 2. Sets mode with appropriate parameters: a) Tidal Volume, is appropriate, set by IBW with appropriate mL/kg for disease or disorder. b) choose appropriate RR for patient condition. c) Ventilating pressures are within a safe level d) Flow, I:E, are appropriate e) Flow Waveform Pattern is appropriate and verbally justifies why it was chosen	Advanced Performs ALL elements with no assistance and in a reasonable period of time	Proficient Performs a minimum of 4 elements with no correction/intervention or self-corrects non-critical aspects	Minimally Below Standards Performs a minimum of 3 elements with no correction/intervention or self-corrects non-critical aspects	Not Proficient Fails to perform at least 2 elements without intervention or correction. Unable to identify critical components (using safe ventilating pressures)
Alarms Ensures appropriate alarms are set to ensure patient safety.
	Advanced Performs all aspects with no mistakes, shows advanced critical thinking and application where applicable 10 pts	Profiecient Able to perform all aspects with minor mistakes / self-corrects on non-critical aspects 7 pts	Minnimally Below Standards Able to perform some, but not most of the basic aspects of set tasks, requires some interventions 4 pts	Not Proficient Unable to perform without significant interventions 1 pts
Set Alarms 1. Set alarms within appropriate levels. 2 Understands what why each alarm is needed and what type of situation may cause the alarm to activate.	Advanced Sets all alarm limits appropriately. Able to justify why the limit is set in such a way. Apnea Alarm parameters are set appropriately	Profiecient Sets MOST alarm limits appropriately. Able to justify why the limit is set in such a way. Apnea Alarm parameters are set appropriately	Minnimally Below Standards Sets FEW alarm limits appropriately. Unable to justify why the limit is set in such a way. Apnea Alarm parameters are not set appropriately	Not Proficient Unable to perform any of the initial steps required in the skill listed.
Intervention Demonstrate knowledge of how ventilation variables can have significant effects on one another.
	Advanced Performs all aspects with no mistakes, shows advanced critical thinking and application where applicable 15 pts	Proficient Able to perform all aspects with minor mistakes / self-corrects on non-critical aspects 10 pts	Minimally Below Standard Able to perform basic aspects of scenario, requires some interventions 5 pts	Not Proficient Unable to perform without significant interventions 1 pts
Variable inter-relationships Manipulate variables to perform any of the following: a) increase/decrease I:E ratio B) increase or decrease Ti C) increase or decrease PIP D) increase or decrease mean airway pressure	Advanced Is able to determine how to adjust one or more variables to achieve a specific outcome, in a timely manner. Is able to rationalize the thought process.	Proficient Is able to determine how to adjust one or more variables to achieve a specific outcome if first attempt is not correct and self corrects on the second attempt. Is able to rationalize the thought process	Minimally Below Standard Is unsure of how to adjust one or more variables to achieve a specific outcome. Appears to be guessing. rationalization of thought process is not correct.	Not Proficient Unable to perform any of the required skills listed.
Ventilator Management Able to demonstrate knowledge of how variables are inter related and how to normalize ventilation and oxygenation in a safe manner for the patient.
	Advanced Performs all aspects with no mistakes, shows advanced critical thinking and application where applicable 10 pts	Proficient Able to perform all aspects with minor mistakes / self-corrects on non-critical aspects 7 pts	Minnimally Below Standards Able to perform basic aspects of scenario, requires some interventions 4 pts	Not Profiecient Unable to perform without significant interventions 1 pts
Makes Therapeutic Changes Makes appropriate ventilatory changes based on ABG results and monitored ventilation values a) Makes appropriate oxygenation changes based on SpO2 or ABG. B) Reviews SPO2, & ABG to ensure therapeutic changes were effective. c) ensures optimal target minute volume is achived. d) ensures ventilation pressures are kept at a safe limit	Advanced Performs AL elements correctly with no assistance or self-corrects.	Proficient Performs a minimum of 2 elements correctly with no correction/intervention or self-corrects non-critical aspects	Minnimally Below Standards Unsure of how to manipulate variables to normalize ABG. Unable to identify critical components.	Not Profiecient Fails to perform at least 2 elements without intervention or correction. Unable to identify critical components

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Basic Level VCV and PCV Ventilator Varialbes

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