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Neonatal Intensive Care Unit RN Skills Checklist

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1 – 2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

AGE OF PATIENTS CARED FOR

Neonate <23 weeks(Required)
Neonate 23-28 weeks(Required)
Neonate 29-32 weeks(Required)
Neonate >32 weeks(Required)
Full Term Newborn(Required)

GENERAL SKILLS

Automated Med Dispensing Systems
Electronic Documentation
IV Pumps
Peripheral IV Insertion, Care and Maintenances(Required)
Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, etc.)(Required)
Cardiac Monitoring/Interpretation(Required)
Titration of drips(Required)
Administration of Blood/Blood Products(Required)
Knowledge of "Do Not Use Abbreviations"(Required)
Do you have charge/supervisor experience?(Required)
Knowledge of current Joint Commission National Patient Safety Goals(Required)
Knowledge/familiarity with HCAHPS scores(Required)
Crash Carts(Required)
Defibrillators(Required)
Apgar scoring(Required)
Eye exam (r/o retinopathy)(Required)
Cord care(Required)
Neonatal skin care(Required)
Positioning Devices(Required)

NEUROLOGICAL

Assessment of neurological status(Required)
Intracranial pressure monitoring(Required)

NEUROLOGICAL-Care of Neonate with:

Brain death/organ procurement(Required)
Internal/Externalized VP shunt/reservoirs(Required)
Intraventricular hemorrhage(Required)
Increased intracranial pressure(Required)
Meningitis(Required)
Seizures(Required)
Myelomeningocele(Required)
Spina Bifida(Required)
Peri-Ventricular Leukomalacia(Required)
Care for a Myleo (wound/cathing)(Required)
Hypoxic/Ischemic Encephalopathy (HIE) CFM/Cool Cap(Required)
Lumbar Puncture to r/o Meningitis(Required)

KNOWLEDGE AND USE OF

Anticonvulsants(Required)

CARDIOVASCULAR

Assessment/Auscultation (rate, rhythm, volume)(Required)
Blood pressure/invasive (arterial line)(Required)
Blood Pressure/non-invasive(Required)
Heart Sounds/Murmurs(Required)
Perfusion(Required)
Pulses(Required)
Defibrillation/Cardioversion(Required)
Invasive hemodynamic monitoring(Required)
Central venous pressure(Required)
Echocardiogram(Required)

CARDIOVASCULAR-Care of Neonate with:

Cardiac Arrest(Required)
Cardiac Transplant(Required)
Cardiomyopathy(Required)
Congenital Heart Disease/Defects(Required)
Hemodynamic instability(Required)
Cardiogenic/Hypovolemic Shock(Required)
Post cardiac Surgery(Required)
Post Cardiac Cath(Required)
Hyper/hypotension(Required)

KNOWLEDGE AND USE OF

Digoxin(Required)
Dobutamine(Required)
Dopamine(Required)
Epinephrine(Required)
Nipride(Required)
Vasopressin(Required)
Milrinone(Required)
Sodium Bicarbonate(Required)

RESPIRATORY

Assessment of Breath Sounds(Required)
Rate and work of breathing(Required)
Interpretation of ABGs(Required)
Airway Management(Required)
Assist with Intubation(Required)
Bulb Syringe(Required)
Laryngeal Mask Airway (LMA)(Required)
Endotracheal Tube Suctioning(Required)
ETT Sutured In - Post mandibular Distraction, Airway Anomalies(Required)
In-Line Suction(Required)
Open ET catheter suction(Required)
Extubation(Required)
Nasal/Oral airway/suctioning(Required)
Tracheostomy/suctioning(Required)
Emergency Tracheostomy at Bedside(Required)
Apnea Monitor(Required)
Respiratory Arrest/Insufficiency(Required)

Chest Tube Care and Maintenance

Assist with Chest Tube Insertion(Required)
Pneumo Kit for Tension Pneumo - Emergent(Required)
Assist with Chest Tube Removal(Required)
ECMO (Extracorporeal Membrane Oxygenation)(Required)

O2 Therapy Delivery Systems

Bag and Mask(Required)
Blow -by Oxygen(Required)
Nasal cannula(Required)
Nebulizer(Required)
Oxyhood/Tent(Required)
Trach collar(Required)

Obtaining Blood Samples

Arterial(Required)
Heelstick(Required)
Peripheral(Required)
Umbilical Line(Required)

Use of Ventilators

CPAP/PEEP(Required)
High frequency jet ventilator(Required)
Home ventilator(Required)
IMV(Required)
Nasal IMV(Required)
Oscillating(Required)
Pressure ventilator(Required)
Volume ventilator(Required)
CO2 Monitoring(Required)
Weaning(Required)

RESPIRATORY-Care of Neonate with:

Apnea/Bradycardia/Desaturations(Required)
Meconium aspiration(Required)
Cystic Adenomatoid malformation CAM)(Required)
Pulmonary Interstitial Emphysema (PIE)(Required)
Persistent pulmonary hypertension (PPHN)(Required)
Bronchopulmonary dysplasia (BPD)(Required)
Transient Tachypnea of the Newborn (TTN)(Required)
Diaphragmatic hernia(Required)
Fresh tracheostomy(Required)
Pneumothorax(Required)
Respiratory distress syndrome (RDS)(Required)
Respiratory failure(Required)

KNOWLEDGE AND USE OF

Caffeine(Required)
Prostaglandin(Required)
Bronchodilators(Required)
Steroids(Required)
Lasix(Required)
Aldactazide(Required)
Diamox(Required)
Istat(Required)
Thoracentesis(Required)
Artificial surfactant(Required)

GASTROINTESTINAL

Abdominal girth(Required)
Bowel sounds(Required)
Palate(Required)
Wound Vac(Required)
Extreme Gastrochisis(Required)
Ostomies(Required)
Suck/Swallow(Required)
Care of gastrostomy tube(Required)

Feedings

Assist with breast feeding(Required)
Bottle(Required)
Breast milk handling/storage(Required)
Gavage(Required)
Hospital grade electric breast pump(Required)

Placement of intestinal tubes

Jejunal/gastro(Required)
Nasogastric/or gastric(Required)
Transpyloric(Required)
Weighted NG/OG(Required)
Gastric Aspiration to Check Placement(Required)
Test for occult blood(Required)

GASTROINTESTINAL-Care of Neonate with:

Cleft lip/palate(Required)
GI bleed(Required)
Ostomy(Required)
Post abdominal surgery(Required)
Diaphragmatic Hernia(Required)
Pnemotosis(Required)
MSPF - Malrotation(Required)
Adhesions/Strictures(Required)
Inguinal hernia(Required)
Necrotizing enter colitis(Required)
Gastroschesis/omphalocele(Required)
Duodenal Atresia(Required)
Bowel Obstruction(Required)
Biliary Atresia(Required)
Hirschsprungs Disease(Required)
Reflux(Required)
Tracheoesophageal fistula (TEF)(Required)

RENAL/GU/METABOLIC/ENDOCRINE

Fluid & electrolyte balance(Required)
Calculating Output(Required)
Knowledge/Interpretation of Lab Results/Chemistry(Required)
Bilirubin(Required)
Test Urine and Interpret(Required)
Glucose(Required)
Labstix(Required)
Occult Blood(Required)
pH(Required)
Cholestatic Jaundice(Required)
Liver, Jaundice(Required)
Specific gravity(Required)

Collection of urine specimens

Assist with suprapubic tab(Required)
Catheter(Required)
Diaper/bag(Required)

RENAL/GU/METABOLIC/ENDOCRINE-Care of Neonate with:

Phototherapy for jaundice(Required)
Post circumcision care(Required)
Acute renal failure(Required)
Polycystic Kidneys(Required)
DIC (disseminated intravascular coagulation)(Required)
Disorders of internal/external organs(Required)
Ascites(Required)
Acute Tubular Necrosis(Required)
Drug addiction/withdrawal(Required)
Hyper/hypokalemia(Required)
Hyper/hyponatremia(Required)
Infant of Diabetic Mother- Monitor for Hyper/hypoglycemia(Required)
Malformations of the GU tract, kidney(Required)
Peritoneal dialysis(Required)

INFECTIOUS DISEASES

Assist with lumbar puncture(Required)
Collect culture specimens(Required)
Isolation techniques(Required)
Standard precautions(Required)
Knowledge of Lab Results(Required)
CBC/differential(Required)
Culture reports(Required)
Maternal lab results(Required)

INFECTIOUS DISEASE-Care of Neonate with:

Hepatitis surface antigen+ mother(Required)
HIV positive mother(Required)
Neonatal sepsis(Required)

KNOWLEDGE AND USE OF

Antibiotics(Required)
HBIG(Required)
HBV(Required)
HIB(Required)
RespiGam/synagis prophylaxis(Required)

MEDICATION SKILLS/KNOWLEDGE & USE

Calculation of dosage(Required)
Prep and Administration of Emergency Meds(Required)
Emergency drug action & reaction(Required)
Eye Prophylaxis - Vitamin K(Required)
Neonatal drug action & reactions(Required)

PAIN MANAGEMENT

Assessment of pain level using age appropriate scales(Required)
Care of Neonate with sedation(Required)
Use of Sedation Reversal Agents(Required)
Fentanyl(Required)
Versed(Required)
Morphine(Required)
Ativan(Required)
Pavulon(Required)

IV THERAPY/PHLEBOTOMY

Administration of blood/blood products(Required)
Cryoprecipitate(Required)
Packed red blood cells(Required)
Plasma/albumin(Required)
Whole blood(Required)
Drawing blood from central line(Required)
Drawing venous blood(Required)
Hyperalimentation/TPN/PPN(Required)
Intralipid(Required)

Delivery Systems

IV pump(Required)
Syringe pump(Required)

Managing IV Therapy

Insertion(Required)
IV Infiltrate reversal Drugs(Required)
Discontinuation(Required)
Dressing & tubing change(Required)
Rate Calculation(Required)
Site & patency assessment(Required)

IV THERAPY/PHLEBOTOMY-Care of the Neonate with:

Central Line/Catheter/Dressing(Required)
Broviac(Required)
Groshong(Required)
Hickman(Required)
Port-A-Cath(Required)
Quinton(Required)
Percutaneous arterial line(Required)
PICC (peripherally inserted central catheter)(Required)
Umbilical artery line(Required)
Umbilical venous line(Required)

GESTATIONAL AGE

Ballard(Required)
Dubowitz(Required)
Gestational Age Assessment(Required)
Maternal history(Required)
Screen for hearing loss(Required)
Congenital Heart Screen(Required)
Car Seat Study(Required)
Equipment & Procedures(Required)
Bereavement/postmortem care(Required)

CONSENTS

Immunization(Required)
Procedural(Required)
Treatment(Required)

FAMILY TEACHING/EDUCATION

Care Planning(Required)
Preparation for transport/transfer(Required)

Thermoregulation

Isolette with humidity(Required)
Radiant warmer(Required)
Temperature (axillary,rectal,skin)(Required)
Weaning to open crib/bassinet(Required)

Weights

Bed scale(Required)
Scale(Required)

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