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. 2021 May 27;35(1):13–21. doi: 10.1016/j.aucc.2021.02.009

Table 1.

Determination of nursing competencies and skill sets.

Guiding principles
  • 1.

    Ensure patient safety.

  • 2.

    Maximise nursing competencies.

Competency All nurses are responsible for identifying their scope of practice and competency. Competency refers to knowledge and experience in practicing skills.
Capacity Redeployment is dependent on patient census, volume, and acuity.
Complexity Priority is placed on patients/units with the greatest clinical needs.
Care Nurses with the highest advanced training/skill set should provide care for the most complex patients if possible.
Team-based All nurses can contribute to team-based care if appropriately supported and directed.
Tier Current role Competency statement(s) Skill set and suitable assignment(s)
1 Critical care nurse working in the inpatient unit (ICU, CICU, CSICU) for at least 2 years I am competent to provide safe nursing care forallcritically ill patients; I am competent to be a charge nurse; I am competent to be a Team Nursing lead for a grouped assignment.
  • -

    Stable and unstable critically ill patients

  • -

    Complex mechanical ventilation strategies

  • -

    Multiple vasoactive infusions and resuscitation

  • -

    Acute COVID-19

  • -

    Continuous renal replacement therapy

  • -

    Intra-aortic counterpulsation therapy

  • -

    New admissions

  • -

    Cardiac arrest team

  • -

    ± Ventricular assist device

  • -

    ± Extracorporeal membrane oxygenation
2 Critical care nurse working in the inpatient unit (ICU, CICU, CSICU) for 1–2 years I am competent to provide safe nursing care formostcritically ill patients; I am competent to be a Team Nursing lead for a grouped assignment of stable patients.
  • -

    Stable and unstable critically ill patients

  • -

    Mechanical ventilation

  • -

    Multiple vasoactive infusions

  • -

    Resuscitation activities ± support

  • -

    Acute COVID-19

  • -

    ± Continuous renal replacement therapy

  • -

    ± Intra-aortic counterpulsation therapy

  • -

    ± New admissions

  • -

    ± Cardiac arrest team
3 Critical care nurse working in the inpatient unit (ICU, CICU, CSICU) for less than 1 year; critical care nurse working in the outpatient critical care unit∗ with recent (≤2 years) experience in inpatient critical care I am competent to provide safe nursing care forstablecritically ill patients.
  • -

    Stable critically ill patients

  • -

    Basic mechanical ventilation

  • -

    Single low-dose vasoactive infusions

  • -

    Nonacute COVID-19
4 Critical care nurse working in the outpatient critical care unit∗ with remote (>2 years) experience in inpatient critical care I am competent tocontribute to patient careas a member of a Team Nursing assignment
  • -

    Stable critically ill patient

  • -

    Basic mechanical ventilation with support from the RRT/RN

  • -

    Low-dose vasoactive infusions

  • -

    Nonacute COVID-19

  • -

    Assistance for the nurse in negative-pressure rooms
5 Cardiac telemetry nurse; nurse working in outpatient critical care with informal/very remote critical care training I am competent toperform nursing care tasksunder the guidance of a Tier 1–3 critical care nurse; I am competent to care forstable extubated patients receiving minimal oxygenawaiting transfer to the ward.
  • -

    Basic care

  • -

    Documentation of vital signs

  • -

    Basic medication administration

  • -

    Patient monitoring

  • -

    Assistance for the nurse in negative-pressure rooms

ICU: intensive care unit; CICU: cardiac intensive care unit; CSICU: cardiac surgery intensive care unit; RRT: registered respiratory therapist; COVID-19: coronavirus disease 2019.

∗cardiac catheterization laboratory, outpatient cardiac clinics, interventional radiology