PCCS nursing

PCCS National Paediatric Critical Care Nursing Competencies, version 2022 (2022)

Paediatric Critical Care Society · UK · Nurses

• CH-RA Respiratory assessment
• R1 Recording respiratory observations across ages3
• R2 Assessing work of breathing2
• R3 Assessing breathing effectiveness and recognising inadequacy–
• R4 Chest auscultation technique and normal findings1
• R5 Recognising abnormal breath sounds such as wheeze–
• R6 Purpose of the respiratory system–
• R7 The normal breathing cycle–
• R8 Gas exchange and effects of its failure2
• R9 Respiratory illness effects on gas exchange4
• R10 Other systems' influence on breathing, e.g. sepsis1
• R11 Detecting respiratory change and reporting promptly10
• R12 Multidisciplinary planning of respiratory treatment–
• CH-RI Respiratory intervention
• RI 1 Delivering oxygen by mask and nasal cannula5
• RI 2 Oropharyngeal suctioning–
• RI 3 Nasopharyngeal suctioning–
• RI 4 Giving prescribed nebulised drugs–
• RI 5 Positioning to optimise breathing2
• RI 6 Airway humidification and oxygen humidity–
• RI 7 Rationale and assessment for suctioning4
• RI 8 Choice of nebulised medicines by condition2
• RI 9 Why positioning matters for breathing5
• RI 10 Timely recognition of need for respiratory support4
• RI 11 Reporting respiratory intervention needs to team–
• RI 12 Evaluating respiratory interventions–
• CH-RE Respiratory emergency
• RE 1 Head tilt and chin lift manoeuvre1
• RE 2 Jaw thrust manoeuvre1
• RE3 Sizing and inserting oropharyngeal airways6
• RE4 Nasopharyngeal airway use, sizing and risks2
• RE5 Bag-valve-mask ventilation9
• RE6 Anaesthetic bag use and hazards–
• RE7 Causes of respiratory arrest1
• RE8 Physiological consequences of respiratory arrest–
• RE9 Recognising and responding to respiratory arrest2
• RE10 Escalating urgent respiratory concerns–
• CH-CD Chest drains
• CD1 Assisting drain insertion in awake patient–
• CD2 Assisting drain insertion in ventilated patient–
• CD3 Bedside and transport equipment for chest drains–
• CD4 Chest drain site care1
• CD5 Observations and pain assessment with chest drain–
• CD6 Preparing the drainage system–
• CD7 Starting chest drain suction–
• CD8 Indications for chest drain insertion4
• CD9 Nursing role during drain insertion6
• CD11 Required observations for chest drain patients–
• CD12 Principles of chest drain removal–
• CD13 Managing accidental drain dislodgement–
• CD14 Managing a blocked chest drain–
• CD15 Chest drain troubleshooting and escalation–
• CH-HA Haemodynamic assessment
• H1 Assessing and recording pulses–
• H2 Heart sound auscultation–
• H3 Capillary refill and perfusion assessment–
• H4 Three-lead ECG monitoring and alarms–
• H5 Non-invasive blood pressure measurement–
• H6 Arterial line set-up and checks4
• H7 Zeroing arterial line and waveform review5
• H8 Central venous pressure monitoring set-up–
• H9 Body temperature measurement–
• H10 Safe use of warming devices–
• H11 Safe use of cooling devices–
• H12 Age-related heart rate abnormalities1
• H13 Significance of pulse volume–
• H14 Causes of poor peripheral perfusion–
• H15 Sinus rhythm and rhythm abnormalities7
• H16 Normal blood pressure ranges by age1
• H17 Limitations of non-invasive blood pressure–
• H18 Arterial line sites, risks and troubleshooting2
• H19 CVP line sites, values and significance–
• H20 Blood tests relevant to haemodynamic status1
• H21 Temperature ranges and haemodynamic effects–
• H22 Managing abnormal temperature and antipyretics3
• H23 Sharing cardiovascular assessment findings–
• H24 Responding to haemodynamic change8
• CH-HE Haemodynamic emergency
• HE1 Chest compressions across ages14
• HE2 Defibrillator checks and preparation3
• HE3 Pulse palpation technique–
• HE4 Emergency fluid bolus preparation and delivery4
• HE5 Emergency blood product administration5
• HE6 Recognising and responding to haemorrhage3
• HE7 Preparing inotrope and vasopressor infusions2
• HE8 Summoning the cardiac arrest team–
• HE9 Use of fast bleep–
• HE10 Arrest rhythms and treatment algorithms14
• HE11 Cardiovascular emergency drugs2
• HE12 Inotrope risks and nursing limits2
• HE13 Timely action in haemodynamic emergency3
• HE14 Team communication and documentation in emergency2
• CH-NA Neurological assessment
• NA1 Age-appropriate Glasgow Coma Scale assessment3
• NA2 Pupil assessment–
• NA3 AVPU assessment–
• NA4 Recognising raised intracranial pressure signs8
• NA5 Uses and limits of GCS and AVPU–
• NA6 Significance of pupil findings1
• NA7 Raised ICP pathophysiology and management17
• NA8 Brain regions and their functions–
• NA9 Detecting and escalating neurological change3
• NA10 Interpreting and sharing neurological findings–
• NA11 Partnering with parents in neurological assessment1
• CH-S Seizures
• S1 Recognising seizure activity1
• S2 Keeping the seizing patient safe1
• S3 Protocol-based seizure management17
• S4 Giving antiseizure medicines3
• S5 Documenting and reporting seizures–
• S6 Nature and presentation of seizures2
• S7 Physiological effects and dangers of seizures4
• S8 Seizure classification2
• S9 How common antiseizure drugs work2
• S10 Therapeutic drug levels and toxicity–
• S11 Recognising possible seizures and raising alarm2
• S12 Prompt seizure treatment10
• S13 Communicating with family and doctors about seizures–
• CH-F Fluid management
• F1 Calculating maintenance fluid requirements10
• F2 Replacing fluid losses1
• F3 Calculating fluid balance4
• F4 Assessing hydration status–
• F5 Body fluid balance and influences3
• F6 Physiological effects of fluid loss–
• F7 Illness effects on fluid needs4
• F8 Signs of dehydration and fluid overload2
• F9 Reporting hydration findings and fluid planning–
• F10 Escalating abnormal hydration status1
• CH-REN Basic renal care and catheterisation
• REN1 Urinary catheter hygiene–
• REN2 Sampling for renal function tests–
• REN3 Managing urinary retention–
• REN4 Catheterising a female child–
• REN5 Catheterising a male child1
• REN6 Flushing a blocked catheter–
• REN7 Kidney and renal system function–
• REN8 Dehydration effects on the kidneys2
• REN9 Common diuretics and their actions1
• REN10 Causes of urinary retention in children–
• REN11 Male and female urinary anatomy–
• REN12 Indications and contraindications for catheterisation1
• REN13 Complications of catheterisation1
• REN14 Troubleshooting urine output and catheter problems1
• REN15 Escalating signs of renal dysfunction1
• CH-N Nutrition
• N1 Nasogastric or orogastric tube insertion and position checks8
• N2 Supported nasojejunal tube insertion1
• N3 Growth measurements and nutritional history2
• N4 Measuring gastric residual volumes2
• N5 Preparing and giving parenteral nutrition1
• N6 Capillary blood glucose testing3
• N7 Helping dependent patients to eat–
• N8 Meal ordering with families respecting beliefs and needs–
• N9 Indications and contraindications for feeding routes5
• N10 Role of nutrition during illness16
• N11 Nutritional status and morbidity3
• N12 Feed intolerance physiology and signs3
• N13 Monitoring and risks of parenteral nutrition10
• N14 Glucose control and dysglycaemia, especially neonates2
• N15 Feed types, storage and dietitian plans–
• N16 Supporting breastfeeding and expressing mothers–
• N17 Timely feeding using dietitian or out-of-hours protocols3
• N18 Nutritional assessment on admission and follow-up6
• N19 Coordinating suitable food orders with team and family–
• CH-G Gastrointestinal
• G1 Bowel sound assessment–
• G2 Assessing for reflux–
• G3 Bowel washout under surgical direction–
• G4 Stoma bag change and stoma assessment–
• G5 Stoma refeeding–
• G6 Giving bowel preparation–
• G7 Constipation assessment, treatment and prevention–
• G8 Faecal occult blood testing–
• G9 Stool classification using Bristol chart–
• G10 Recognising melaena–
• G11 Common childhood gastrointestinal conditions–
• G12 Surgical stoma indications and types–
• G13 Short gut causes and implications–
• G14 Recognising and reporting changes in GI status–
• G15 Escalating obstruction, perforation or acute abdomen–
• G16 Escalating stoma output or appearance changes–
• CH-PM Psychosocial care, mental health and wellbeing
• PM1 Building therapeutic relationships with children and families7
• PM2 Responding to young people with mental health problems–
• PM3 Behaviour monitoring and escalation–
• PM4 Partnership communication and difficult conversations10
• PM5 Self-care and staff wellbeing7
• PM6 Psychosocial aspects in care planning2
• PM7 Psychosocial impact of hospital admission17
• PM8 Adolescent-specific psychosocial needs3
• PM9 Relevant legal frameworks including capacity and liberty–
• PM10 Neurodiversity and developmental differences in care planning–
• PM11 Health promotion opportunities–
• PM12 Diversity and cultural factors in care planning–
• PM13 Multidisciplinary and external agency roles and referral–
• PM14 Recognising own limits in psychosocial care–
• CH-PA Pain assessment and management
• PA1 Age-appropriate pain assessment tools4
• PA2 Pain assessment in sedated children9
• PA3 Choosing analgesia including non-drug measures15
• PA4 Nature and impacts of pain1
• PA5 Physiological pain responses by age–
• PA6 Selecting suitable pain scores5
• PA7 Treating pain and escalating appropriately3
• CH-E Epidurals
• E1 Reading and recording epidural pump data–
• E2 Checking epidural catheter length at skin–
• E3 Motor and sensory block assessment–
• E4 Locating epidural guidance–
• E5 Epidural anatomy and concept–
• E6 Epidural medications and purpose–
• E7 Epidural risks and side effects–
• E8 Local anaesthetic toxicity recognition–
• E9 Epidural observation and monitoring schedule–
• E10 Managing and escalating epidural problems–
• E11 Ensuring adjunct medication with epidurals–
• CH-P Patient or nurse controlled analgesia
• P 1 Operating local PCA/NCA pumps as user–
• P 3 Programme checks and hourly PCA recordings–
• P 4 PCA syringe changes–
• P 5 Accessing PCA prescriptions and policies–
• P 6 PCA/NCA indications and contraindications–
• P 8 Opioid side effects and reversal agent–
• P 9 Escalation routes in and out of hours–
• P 10 Safety equipment required with PCA/NCA–
• P 11 Managing and escalating PCA side effects–
• P 12 Rising analgesia needs as deterioration sign–
• CH-SED Sedation and neuromuscular blockade
• Sed1 Giving IV sedation and NMBA infusions and boluses–
• Sed2 Giving enteral sedation–
• Sed3 Finding sedation and NMBA dosing information–
• Sed4 Sedation scoring and documentation4
• Sed5 Assessing paralysis and sedation together4
• Sed6 Converting IV to enteral sedation1
• Sed7 Non-drug methods to keep child calm–
• Sed8 Assessing for sedation withdrawal6
• Sed9 Assessing for delirium10
• Sed10 Goals of sedation and NMBA2
• Sed11 Pharmacology of common sedatives and NMBAs7
• Sed12 Day-night routine and calming strategies3
• Sed13 Withdrawal risk, prevention and assessment9
• Sed14 Delirium risk, identification and management33
• Sed15 When sedation is indicated3
• Sed16 When NMBA use is indicated–
• Sed17 Sedation targets and correcting over or under sedation10
• Sed18 Monitoring NMBA effectiveness–
• Sed19 Managing sedation and NMBA side effects7
• Sed20 Extra care needs during neuromuscular blockade3
• CH-PR Procedural sedation
• PR1 Preparing patients for procedural sedation–
• PR2 Procedural sedation risk checklist–
• PR3 Giving enteral and IV procedural sedation2
• PR4 Vital sign monitoring during and after sedation–
• PR5 Emergency equipment availability–
• PR6 Indications for procedural sedation1
• PR7 Procedural sedation risks and contraindications2
• PR8 Managing under and over sedation–
• PR9 Responding to sedation emergencies–
• CH-SI Skin integrity and wound care
• SI 1 Mouth care–
• SI 2 Mouth care and oral suction when ventilated–
• SI 3 Eye care–
• SI 4 Eye care in sedated or unconscious patients–
• SI 5 Full wash and skin hygiene–
• SI 6 Pressure risk assessment and prevention2
• SI 7 Aseptic wound dressing changes–
• SI 8 Managing vacuum-assisted closure devices–
• SI 9 Assisting with IV line insertion1
• SI 10 Wound drain insertion assistance and removal–
• SI 11 Skin physiology and function–
• SI 12 Physical and psychological effects of skin damage–
• SI 13 Trust documentation for skin, wounds and handling–
• SI 14 Pressure ulcer staging–
• SI 15 Extravasation recognition and first actions1
• SI 16 Burns first management and physiology5
• SI 17 Wound healing physiology–
• SI 18 Dressing types and uses–
• SI 19 Referral to tissue viability–
• SI 20 Wound evaluation and infection recognition–
• SI 21 Implementing and evaluating wound care plans–
• SI 22 Following wound management plan and dressing choice–
• SI 23 Pressure redistributing equipment use and troubleshooting–
• SI 24 Response to extravasation injury1
• CH-IC Infection prevention and control
• IC1 Aseptic non-touch technique1
• IC2 Hand washing–
• IC3 Selecting, donning and doffing PPE3
• IC4 Safe specimen collection techniques1
• IC5 Assisting with lumbar puncture6
• IC6 Infection control principles and hand hygiene moments2
• IC7 Recognising and escalating signs of infection5
• IC8 Policy for alert organisms–
• IC9 Types of isolation and isolation guidance1
• IC10 ANTT principles and line management5
• IC11 Reporting and documenting infection signs–
• IC12 Patient-specific infection control precautions–
• IC13 Adherence to and promotion of infection control–
• CH-MH Manual handling, falls and VTE prevention
• MH1 Manual handling risk assessment–
• MH2 Bed rail risk assessment–
• MH3 Falls risk assessment–
• MH4 Moving patients with hoists and slings–
• MH5 Use of slide sheets–
• MH6 Compression stockings and pneumatic devices–
• MH7 Passive limb exercises–
• MH8 Applying splints and orthoses–
• MH9 Importance of manual handling procedures–
• MH10 Moving and handling equipment availability–
• MH11 Risks of immobility4
• MH12 VTE risk identification and prevention7
• MH13 Preventing limb stiffness and foot drop–
• MH14 Early mobility in critical illness19
• MH15 Responding to high-risk handling, falls and VTE patients–
• MH16 Appropriate use of handling equipment–
• MH17 Referral to MDT members–
• MH18 Care plans for handling, falls and VTE risk–
• CH-C Communication and teamwork
• C1 Respectful communication with colleagues–
• C2 Active listening–
• C3 Admission documentation–
• C4 Discharge documentation1
• C5 Daily care plans and evaluations–
• C6 Health advocacy services–
• C7 Effective and closed loop communication1
• C8 SBAR and escalation tools6
• C9 Communication styles and their impact–
• C10 Accessibility of information–
• C11 Cultural differences in communication–
• C12 Respecting diverse opinions–
• C13 Importance of clear documentation–
• C14 Managing challenging or aggressive situations–
• C15 Using documentation to inform care–
• C16 Professional documentation standards–
• C17 Followership communication in emergencies3
• CH-SC Safety checks
• SC1 Start of shift bedside safety checks–
• SC2 Hourly safety checks–
• SC3 Responding to alarms–
• SC4 Supervision cover when leaving bed space–
• SC5 Communicating changes in patient status1
• SC6 Crash trolley and defibrillator checks–
• SC7 Location of other emergency equipment–
• SC8 Supported admission of a level 3 patient–
• SC9 Supported patient discharge–
• CH-VA Underpinning concepts of ventilation
• VA1 Observations for mode of ventilation–
• VA2 Physiology of normal breathing1
• VA3 Functional residual capacity–
• VA4 Positive pressure ventilation versus normal physiology3
• VA5 Methods of delivering positive pressure2
• VA6 PEEP3
• VA7 Peak inspiratory pressure–
• VA8 Pressure support breaths1
• VA9 CPAP as a ventilation mode2
• VA10 Pressure controlled ventilation1
• VA11 Volume controlled ventilation1
• VA12 Inspiratory time and I:E ratio–
• VA13 Tidal and minute volume calculation1
• VA14 Setting ventilator alarm limits1
• VA15 Normal capnography and changes1
• VA16 Applying ventilation concepts to local patients2
• VA17 Responding to common ventilator alarms–
• CH-VB Care of the ventilated patient
• VB1 Ventilator and bed space set-up1
• VB2 Preparing for intubation9
• VB3 Endotracheal tube taping and position documentation3
• VB4 Assessing endotracheal tube position1
• VB5 Endotracheal tube cuff pressure checks1
• VB6 Anaesthetic circuit selection and set-up–
• VB7 Supervised hand bagging–
• VB8 Equipment for endotracheal suction1
• VB9 Suction pressures and supervised suctioning4
• VB10 Inline suction1
• VB11 Open suction2
• VB12 Tube patency and obstruction response2
• VB13 Recognising tube dislodgement2
• VB14 Preparing for extubation4
• VB15 Intubation indications and risks8
• VB16 Intubation grades1
• VB17 Risks of ventilation5
• VB18 Minimising positive pressure ventilation risks10
• VB19 Intubation drugs1
• VB20 Tube position on chest X-ray–
• VB21 Safe cuff pressure maintenance1
• VB22 Indications and safety of tube suction12
• VB23 Inline versus open suction4
• VB24 Ventilator associated pneumonia prevention2
• VB25 Extubation readiness criteria7
• VB26 Ventilator alarm troubleshooting1
• VB27 Monitoring instability during intubation2
• VB28 Escalating out-of-range volumes and pressures–
• VB29 Adjusting ventilation from blood gases1
• VB30 Contributing to extubation decisions–
• VB31 Safety during bagging and suctioning4
• VB32 Recognising need for senior help–
• CH-BG Basic blood gas interpretation
• BG1 Capillary blood gas sampling–
• BG2 Arterial line blood gas sampling–
• BG3 Appropriate frequency of blood gas analysis–
• BG4 Normal values by sample source–
• BG5 Indications and principles of blood gas analysis–
• BG6 Respiratory acidosis causes–
• BG7 Respiratory alkalosis causes1
• BG8 Metabolic acidosis causes5
• BG9 Metabolic alkalosis causes–
• BG10 Mixed acid-base disorders1
• BG11 Applying gas interpretation to clinical conditions–
• BG12 Choosing blood gas sampling intervals–
• BG13 Blood gases informing treatment plans–
• CH-B Bronchiolitis
• B1 Positioning infants with bronchiolitis–
• B2 Advocating minimal handling–
• B3 Pathophysiology of bronchiolitis8
• B4 Bronchiolitis effects on gas exchange1
• B5 Oxygen delivery and humidification1
• B6 Evidence-based suctioning in bronchiolitis2
• B7 Physiotherapy referral reasons3
• B8 Hydration assessment and fluid management5
• B9 NICE and local bronchiolitis guidance5
• B10 Recognising and escalating respiratory deterioration3
• B11 Applying bronchiolitis guidance8
• CH-NHF Nasal high flow therapy
• NHF1 Choosing nasal cannula and tubing–
• NHF2 Infant high flow set-up and troubleshooting3
• NHF3 Child and adolescent high flow set-up and troubleshooting–
• NHF4 Adjusting high flow settings to prescription–
• NHF5 Monitoring and recording during high flow1
• NHF6 When to use and avoid nasal high flow6
• NHF7 Physiological effects of nasal high flow3
• NHF8 Weaning and stopping high flow, minimum flow1
• NHF9 Applying high flow skills in clinical practice–
• NHF10 Optimising effective use of high flow–
• CH-NIV Non-invasive ventilation
• NIV1 Checking interface position and leak1
• NIV2 Two-person NIV application in acute care–
• NIV3 Applying NIV for stable long-term patients1
• NIV4 Checking mask components function–
• NIV5 Assembling the NIV circuit–
• NIV6 Circuit change frequency and documentation–
• NIV7 Adding oxygen to the NIV circuit–
• NIV8 Connecting humidifier to NIV circuit–
• NIV9 In-circuit nebuliser set-up–
• NIV10 Checking device alarm limits–
• NIV11 Pressure area care during NIV5
• NIV12 Indications for non-invasive ventilation5
• NIV13 Acute NIV indications, contraindications and precautions4
• NIV14 Safety risks of NIV: aspiration and distension–
• NIV15 Need for humidification in NIV–
• NIV16 Understanding and responding to NIV alarms–
• NIV17 Role of the exhalation leak–
• NIV18 Role of the anti-asphyxia valve–
• NIV19 Vented versus non-vented masks–
• NIV20 Preventing and managing pressure injuries11
• NIV21 Choosing the right NIV interface4
• NIV22 Troubleshooting NIV delivery and escalating3
• CH-T Tracheostomy care
• T1 Bedside and portable tracheostomy equipment–
• T2 Tracheostomy suctioning and secretion assessment5
• T3 Choosing and evaluating tracheostomy humidification–
• T4 Nebulisers via tracheostomy, ventilated or not–
• T5 Cuff deflation and inflation1
• T6 Inner tube changing and cleaning1
• T7 Aspirating the subglottic suction port–
• T8 Tape change and stoma care1
• T9 Tracheostomy tube change preparation and conduct4
• T10 Managing a blocked tracheostomy5
• T11 Managing a dislodged tracheostomy6
• T12 Reasons for tracheostomy and upper airway patency5
• T13 Communication barriers with a tracheostomy–
• T14 Speech and language therapy and swallow assessment1
• T15 Emergency tracheostomy box contents–
• T16 Tracheostomy tube types and selection2
• T17 Suction rationale, catheter size and depth4
• T18 Purpose and types of tracheostomy humidification–
• T19 Tubes with subglottic suction ports–
• T20 Complications of a new tracheostomy1
• T21 Cuffed tracheostomy use and pre-deflation suction–
• T22 Inner tube rationale and changes–
• T23 Fenestrated tubes and care implications–
• T24 Tape change frequency and secure fixation–
• T25 Stoma cleaning, infection and granulomas–
• T26 Routine tube change rationale and contingencies2
• T27 Cleaning tracheostomy tubes–
• T28 Tracheostomy red flag signs–
• T29 Emergency tracheostomy algorithm1
• T30 Reasons for emergency tube change3
• T31 Emergencies with double lumen tracheostomies–
• T32 Monitoring the child with a tracheostomy2
• T33 Timely escalation of tracheostomy concerns–
• T34 MDT liaison and referrals–
• T35 Tracheostomy bedhead signage–
• CH-LTV Long-term ventilation
• LTV1 Circuit test, changes and bacterial filter–
• LTV2 Circuit change frequency for NIV and tracheostomy–
• LTV3 Inlet filter identification and changing–
• LTV4 Checking ventilator battery time–
• LTV5 Humidification connection and correct fluid–
• LTV6 Dry circuit set-up and changeover–
• LTV7 Equipment for leaving the clinical area–
• LTV8 Following an LTV weaning plan–
• LTV9 Indications for long-term ventilation–
• LTV10 Ventilator inlets, fans and safe positioning–
• LTV11 Ventilator filter changes and reuse–
• LTV12 Typical internal battery duration–
• LTV13 Risks of starting dry circuit time–
• LTV14 Cleaning and checking NIV masks–
• LTV15 Off-unit risks and escort staffing–
• LTV16 Assessing a patient during LTV weaning–
• LTV17 Escalating LTV concerns–
• LTV18 MDT liaison and referral in LTV–
• LTV19 Partnership with parents and carers3
• CH-EOL End of life and palliative care
• EOL1 Following palliative care plans collaboratively3
• EOL2 Following end of life care plans collaboratively4
• EOL3 Supporting families with end of life choices1
• EOL4 Memory making–
• EOL5 Assisting with last offices–
• EOL6 Taking hand and foot prints–
• EOL7 Preparing a body to go home–
• EOL8 Use and access of body bags–
• EOL9 Documentation after a patient death–
• EOL10 Information resources for bereaved families–
• EOL11 Roles of visiting palliative professionals2
• EOL12 Own role and limits in care planning–
• EOL13 Mortuary transfer and coroner involvement–
• EOL14 Best interests, autonomy, treatment limitation and DNAR9
• EOL15 Sensitive communication about end of life7
• EOL16 Supporting families around death and bereavement5
• EOL17 Early organ donation referral5
• EOL18 Recognising and accessing personal support–
• CH-NE Neonatal care option
• NE1 Incubator temperature and humidity set-up–
• NE2 Developmental positioning of neonates–
• NE3 Jaundice management and phototherapy care–
• NE4 Newborn screening technique–
• NE5 Neonatal developmental care principles–
• NE6 Neonatal thermoregulation1
• NE7 Cold stress and hypoglycaemia prevention–
• NE8 Neonatal skin care and breakdown prevention2
• NE9 Neonatal oxygen targets and risks1
• NE10 Preventing IVH and retinopathy of prematurity–
• NE11 Common neonatal surgical conditions–
• NE12 Neonatal feeding regimes–
• CH-A Asthma option
• A1 Basic respiratory observations in asthma–
• A2 Chest auscultation: wheeze and silent chest–
• A3 Using a spacer–
• A4 Giving nebulisers1
• A5 Grading asthma attack severity1
• A6 Drugs for acute severe asthma11
• A7 Side effects of asthma drugs5
• A8 Monitoring treatment response1
• A9 Finding national and local asthma guidance1
• A9b Recognising and communicating change in asthma–
• A-12 Promoting lifestyle changes for asthma control–
• CH-CP Cardiac pacing option
• CP1 Nursing care and security of pacing wires–
• CP2 Assisted pacing wire removal and post-removal observations–
• CP3 Identifying underlying rhythm and its implications1
• CP4 Tamponade risk after pacing wire removal–
• CP5 Common postoperative pacing modes–
• CP6 Common pacing problems such as sensing and capture faults–
• CP7 Clinical assessment of the paced patient–
• CP8 Basic nursing care of a paced child–
• CP9 Actions when pacing is lost–
• CH-CV Cardiac surgery care option
• CV1 Structured assessment after cardiac surgery1
• CV2 Grading drain losses by patient weight–
• CV3 Fluid balance management after cardiac surgery–
• CV4 Measuring pre- and post-ductal saturations–
• CV5 Drawing normal cardiac anatomy–
• CV6 Normal blood flow through the heart3
• CV7 Target saturations for specific cardiac defects–
• CV8 Oxygen use in duct-dependent lesions1
• CV19 Selecting and interpreting pre- and post-ductal saturations1
• CV10 Hypoxia as a cause of cardiac arrest–
• CV11 Starting enteral feeds after cardiac surgery5
• CV12 Responding to cardiovascular changes and escalating1
• CV13 Responding to changing drain losses–
• CV14 Recognising postoperative cardiac emergencies5
• CH-ECG 12-lead ECG option
• ECG1 Explaining the ECG to child and family–
• ECG2 Privacy and dignity during ECG–
• ECG3 Equipment needed for a 12-lead ECG–
• ECG4 Infection control during ECG–
• ECG5 Patient identification on the ECG machine–
• ECG6 Patient positioning for ECG–
• ECG7 Chest and limb electrode placement–
• ECG8 Obtaining a good quality ECG trace–
• ECG9 Indications for a 12-lead ECG–
• ECG10 Effect of positioning on ECG results–
• ECG11 Producing a diagnostically useful ECG–
• ECG12 Timely reporting and documentation of ECG–
• CH-NH Hydrocephalus option
• NH1 Head circumference measurement and centile plotting–
• NH2 Perioperative care for shunt insertion or revision–
• NH3 Perioperative care for external ventricular drain–
• NH4 Perioperative care for endoscopic third ventriculostomy–
• NH5 Care with intracranial pressure monitoring–
• NH7 Nursing care in raised intracranial pressure3
• NH9 Assisting with intrathecal drug administration–
• NH10 Definition of hydrocephalus–
• NH11 Causes and treatments of hydrocephalus–
• NH12 Ventricular shunt function–
• NH13 Complications of shunt insertion–
• NH16 Endoscopic third ventriculostomy: use, risks and aftercare–
• NH17 External ventricular drain: rationale, risks and aftercare–
• NH-18 Raised intracranial pressure causes and reduction strategies7
• NH25 Safe care and escalation in hydrocephalus–
• NH26 Supporting family understanding of hydrocephalus–
• CH-NT Neuro tumours option
• NT1 Care after infratentorial tumour resection–
• NT2 Care after supratentorial tumour resection–
• NT3 Care after pituitary tumour resection–
• NT4 Care after spinal tumour resection–
• NT5 Aetiology of CNS tumours–
• NT6 Nursing principles and risks: infratentorial resection–
• NT7 Nursing principles and risks: supratentorial resection–
• NT8 Nursing principles and risks: pituitary resection–
• NT9 Nursing principles and risks: spinal tumour resection–
• NT10 Team liaison and monitoring for post-surgical deterioration–
• CH-D Diabetes and DKA option
• D1 Treating low glucose in a conscious patient–
• D2 Treating hypoglycaemia in an unconscious patient–
• D3 Managing hyperglycaemia with ketones2
• D4 Monitoring after hyperglycaemia2
• D5 Basic pathophysiology of diabetes–
• D6 Safe insulin storage–
• D7 Symptoms of hypoglycaemia–
• D8 Causes of hypoglycaemia–
• D9 Symptoms of hyperglycaemia–
• D10 Causes of hyperglycaemia–
• D11 Ketones and their bodily effects–
• D12 Importance of clearing ketones1
• D13 Ketone testing in DKA–
• D14 Pathophysiology and risks of DKA8
• D15 Gradual glucose reduction and fluid management in DKA16
• D16 Collaborative adherence to DKA management plans5
• CH-AR Advanced renal option
• AR1 Multi-day fluid balance assessment2
• AR2 Drugs for urine output and blood pressure–
• AR3 Assessing pulmonary and peripheral oedema–
• AR4 Suprapubic catheter care–
• AR5 Paediatric renal conditions–
• AR6 Mechanisms and categories of acute kidney injury9
• AR7 Pharmacology of drugs to increase urine output1
• AR8 Renal mechanisms of oedema–
• AR9 Linking blood results to renal function8
• AR10 Conditions needing specialist renal instructions–
• AR12 Care before renal transplant–
• AR13 Care after renal transplant–
• AR14 Recognising and escalating renal deterioration2
• CH-L Liver option
• L1 Signs of liver disease in stool, urine, skin–
• L2 Interpreting liver function tests–
• L3 Abdominal girth measurement in liver patients–
• L4 Neurological and encephalopathy monitoring–
• L5 Post-transplant wound and drain assessment–
• L6 Caring for a liver transplant recipient–
• L7 Liver anatomy and physiology–
• L8 Liver functions linked to clinical signs–
• L9 Classifications of liver disease–
• L10 Metabolic liver disease–
• L11 Autoimmune liver disease and treatment–
• L12 Liver malignancies–
• L13 Managing acute liver failure with neuroprotection4
• L14 Liver transplant assessment and coordinator roles–
• L15 Types of liver transplant–
• L16 Assessing coagulopathy and its risks2
• L17 Physiology of jaundice–
• L18 Ascites and the role of albumin–
• L19 Portal hypertension–
• L20 Hepatic encephalopathy2
• L21 Nutritional assessment in liver disease–
• L22 Liver disease and fluid status–
• L23 Immunosuppressant effects and importance–
• L24 Octreotide use in liver patients–
• L25 Relating blood results to clinical status–
• L26 Urgent changes in acute liver failure1
• L27 Critical care of the liver transplant patient–
• CH-O Orthopaedic option
• O1 Neurovascular observations–
• O2 Pain assessment and relief in orthopaedics–
• O3 Moving, handling and mobility aids–
• O7 Pin site care–
• O8 Fitting and checking traction–
• O9 Applying a sling–
• O10 Assessing cast fit–
• O13 Anatomy relevant to orthopaedic injury–
• O14 Bone growth and healing–
• O15 Common orthopaedic conditions and injuries–
• O17 Fracture types–
• O18 Components of neurovascular assessment–
• O19 Compartment syndrome pathophysiology and treatment–
• O23 Skin grafts and donor sites–
• O24 Detecting change and infection in orthopaedic patients–
• CH-ADV Advanced interventions option
• ADV-HFOV High frequency oscillatory ventilation
• Adv1 Safety checks and observations on HFOV–
• Adv2 Supported nursing care of a child on HFOV–
• Adv3 Principles of HFOV–
• Adv4 Indications and contraindications of HFOV–
• Adv5 Recognising own limits with HFOV–
• ADV-NO Inhaled nitric oxide
• Adv6 Safety checks and observations with nitric oxide–
• Adv7 Switching circuits during nitric oxide therapy–
• Adv8 Principles of nitric oxide therapy–
• Adv9 Indications and contraindications of nitric oxide–
• Adv10 Recognising own limits with nitric oxide–
• ADV-CRRT Continuous renal replacement therapy
• Adv11 Hourly checks and documentation on CRRT1
• Adv12 CRRT alarms and responses–
• Adv13 Indications and contraindications of CRRT6
• Adv14 Recognising own limits with CRRT–

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