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Abstract

curriculum -MENTOR (Making Every New Trainee Our Responsibility) (Piech JD, Fire Engineering, 2004). Methods: MENTOR is a structured, one year program for new APPs. The program begins with a pre-test to assess baseline ICU knowledge. The first quarter consists of weekly scheduled lectures and activities along with direct clinical supervision by a senior APP or MD. The second through fourth quarters evolve to biweekly educational activities with progressive clinical autonomy by the APP. At the conclusion of each quarter, the new APP will undergo a performance review to assure quarterly objectives are met and to identify any educational needs. At the completion of the program, a post-test is given and clinical and procedural competence will be determined. Results: Within the upcoming year, six new SICU APPs will formally enter the MENTOR program above. Expected outcomes with implementation of the program include: improvement in critical care knowledge evidenced by post-test scores and clinical evaluation, procedural competence and hospital credentialing complete at one year, competency in overall critical care management, improved APP retention/reduced turnover rates, and improved employee satisfaction. Conclusions: The MENTOR curriculum is a roadmap for skill acquisition as well as competency training of APPs. Other expected outcomes with specialty trained APPs include improved: hospital and ICU length of stay, performance measure compliance, communication, and decreased morbidity, mortality and readmission rates.Learning Objectives: Pneumothorax in the ICU can be a life-threatening event if it is not diagnosed and treated in a timely manner. There are often significant delays from the time a chest xray order is placed until the film is taken, uploaded, and read by radiology. Compared to plain films, ultrasound (US) has been shown to be more sensitive in the detection of pneumothorax. In addition, US has limited radiation, minimal cost, can be rapidly performed, and can be interpreted at bedside by the clinician. Critical care providers vary in the amount of training they receive in lung US. Purpose: To determine if the comfort and knowledge level of nurse practitioners/physician assistants (NP/PAs) in the use of US to detect pneumothorax can be increased by a short intervention. Methods: Teaching intervention for NP/PAs was targeted for evening shift change in order to reach as many persons as possible. Subjects took a pre-test which asked them about their overall comfort level and formal training in US as well as four knowledge questions on lung US. An EM/CCM physician with formal training in US gave a 10-15 minute presentation on the basics of using US to detect a pneumothorax. This was followed by a hands-on demonstration using a volunteer to show normal lung sliding. Finally, a post-test was administered. The intervention lasted about 30 min. Results: Fourteen NP/PAs participated. Their yr in clinical practice ranged from 36 yr to less than one year. Initial comfort with lung US was based on a scale of 1 to ...