Ventilator Competency Assessment Form
Evaluate clinician proficiency in ventilator setup, operation, monitoring, alarms, troubleshooting, infection control, and patient safety.
Ventilator Setup: Ability to assemble and prepare ventilator for use
*
Needs Improvement
1
2
3
4
Excellent
5
1 is Needs Improvement, 5 is Excellent
Ventilator Operation: Select appropriate modes and settings for patient condition
*
Needs Improvement
1
2
3
4
Excellent
5
1 is Needs Improvement, 5 is Excellent
Ventilator Monitoring: Ability to interpret ventilator readings and patient data
*
Needs Improvement
1
2
3
4
Excellent
5
1 is Needs Improvement, 5 is Excellent
Alarm Management: Responds appropriately to ventilator alarms
*
Needs Improvement
1
2
3
4
Excellent
5
1 is Needs Improvement, 5 is Excellent
Troubleshooting: Identifies and resolves common ventilator issues
*
Needs Improvement
1
2
3
4
Excellent
5
1 is Needs Improvement, 5 is Excellent
Infection Control: Adheres to infection prevention protocols during ventilator use
*
Needs Improvement
1
2
3
4
Excellent
5
1 is Needs Improvement, 5 is Excellent
Patient Safety: Ensures patient safety throughout ventilator management
*
Needs Improvement
1
2
3
4
Excellent
5
1 is Needs Improvement, 5 is Excellent
Select the most common causes of ventilator alarms (choose all that apply):
*
Patient disconnection
Airway obstruction
Circuit leak
Power failure
Other
Indicate which actions are appropriate if a high-pressure alarm occurs (select all that apply):
*
Check for patient coughing
Assess for airway obstruction
Suction airway if indicated
Ignore the alarm
Other
Rate your overall confidence in managing ventilated patients safely
*
Not Confident
1
2
3
4
Very Confident
5
1 is Not Confident, 5 is Very Confident
Submit Assessment
Should be Empty: