A compendium of the steps required to complete 13 essential procedural skills

Reid-McDermott, B., O’Connor, P., Carey, C., Cooney R., Egan, C., Lydon, S., Madden, C., McLoughlin, M., Mongan, O., Parackal Augusthinose, P., Reid, A., Smith, M., & Byrne, D. (2022). A Compendium of the Steps Required to Complete 13 Essential Procedural Skills. The Irish Centre for Applied Patient Safety and Simulation, University of Galway, Galway, Ireland, https://doi.org/10.13025/y79c-e163

Abstract

Entrustable Professional Activities (EPAs) are units of professional practice that capture essential competencies in which trainees must become proficient before undertaking them independently. EPAs provide supervisors with a solid justification for delegating an activity to trainees. A framework of seven EPAs, and associated competencies have been developed for interns in Ireland. These EPAs address all the core activities that interns should be readily entrusted with at the end of the intern year. These EPAs are: EPA 1: Clerk a patient. EPA 2: Request and interpret basic investigations. EPA 3: Perform essential procedural skills. EPA 4: Manage the work of in-patient care. EPA 5: Prescribe and monitor drugs and fluids. EPA 6: Recognise and manage the deteriorating/acutely unwell patient. EPA 7: Handover and discharge a patient. These seven EPAs, and the process used to develop them, are discussed in more detail elsewhere.1,2 The focus of this compendium is to outline the steps required to correctly complete the 13 essential procedural skills that comprise EPA 3, which are: 1. completing an electrocardiogram; 2. blood sampling and blood cultures from central lines; 3. peripheral intravenous cannulation; 4. preparation, reconstitution, dilution and administration of IV drugs; 5. arterial blood gas sampling; 6. nasogastric tube insertion; 7. urinary catheter insertion; 8. venepuncture; 9. blood cultures from a peripheral vein; 10. sterile field set up; 11. sterile glove application; 12. hand hygiene; 13. donning and doffing PPE. The steps required to perform each of these procedures were developed by subject matter experts from the Irish Centre for Applied Patient Safety and Simulation (ICAPSS). They identified these steps based upon their own clinical experience and a review of published materials on these procedures. This compendium provides a detailed outline of procedures 1 to 10 above. Setting up a sterile field is described as a step in the urinary catheter insertion procedure. Sterile glove application is described as a step in the skills of blood sampling and cultures from a central lines and urinary catheter insertion. Hand hygiene is a required step which is described in all procedures. Donning and doffing is a new addition since the Covid-19 pandemic and is described as a standalone procedure despite it being required to execute the other procedures where personal protective equipment (PPE) is part of the infection control requirements. It is important to indicate that there is often more than one correct way to complete these procedures. Our goal was to identify ‘one correct way’ to complete these procedures to support standardisation in how these procedures are both taught and assessed. It is hoped that this compendium will be useful for others teaching, and learning, how to carry out these 13 essential procedural skills.

Publisher

University of Galway

Rights

CC BY-NC-ND 3.0 IE

cbn

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General Practice (Reports)