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Infusion 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

Newborn/ Neonate (birth to 30 days)(Required)
Infant (1 month to 1 year)(Required)
Toddler (1 year to 3 years)(Required)
Preschooler (3 years to 5 years)(Required)
School Age Child (5 years to 12 years)(Required)
Adolescents (12 years to 18 years)(Required)
Young Adults (18 years to 39 years)(Required)
Middle Adults (39 years to 64 years)(Required)
Older Adults (64 years to 79 years)(Required)
Elderly Adults (over 79+ years)(Required)

GENERAL SKILLS

Care of Patient in Restraints(Required)
Automated Med Dispensing Systems(Required)
Electronic Documentation(Required)
Access/Management of Implanted Ports(Required)
Access/Management of Central Lines(Required)
Titration of Drips(Required)
Administration of Blood/Blood Products(Required)
Knowledge of Current IV Therapy Guidelines(Required)
Knowledge of Anatomy(Required)
Moderate Conscious Sedation(Required)
Sedation Reversal Agents(Required)

INSERTION OF

Peripheral IV – Adult(Required)
Peripheral IV – Child(Required)
Peripheral IV – Neonate(Required)
Vein Selection – Peripheral IVs(Required)
Interosseous Needles(Required)

MIDLINE/PICC LINES

Midline Catheter Insertion – Adult(Required)
Midline Catheter Insertion – Child(Required)
Indications for Midline/PICC Placement(Required)
Contraindications for Midline/PICC Placement(Required)
Vein Selection(Required)
Measuring Technique(Required)
Catheter and Introducer Device Selection(Required)
Correct Tip Placement(Required)
Insertion Technique – Basic (Vein)(Required)
Insertion Technique – Seldinger(Required)
Insertion Technique – Ultrasound(Required)
Assist with Insertion in Interventional Radiology(Required)
Insertion Site Preparation(Required)
Maintaining Sterile Field(Required)
Securing Insertion Site Post Placement(Required)
X-Ray Assessment for Tip Location(Required)
Repositioning After X-Ray(Required)

CARE AND MAINTENANCE

Peripheral IV(Required)
Scalp IV(Required)
Heparin/Saline Lock(Required)
Groshong PICC(Required)
Groshong CVL(Required)
Hickman/Broviac(Required)
Port-a-Cath(Required)
Vascath(Required)
Multilumen Catheters(Required)
Subclavian Line(Required)
IJ Line(Required)
Femoral Line(Required)
Power PICC(Required)
Power Port(Required)
Dressing Changes(Required)
Cap Changes(Required)
Flushing Lines (Frequency/Solution)(Required)

MEDICATION ADMINISTRATION

Chemotherapy(Required)
Heparin(Required)
Streptokinase(Required)
TPA (Alteplase)(Required)
Lidocaine(Required)
TPN/Lipids(Required)
Ativan(Required)
Valium(Required)
Versed(Required)
Fentanyl(Required)

EQUIPMENT

IV Pumps(Required)
Needleless Systems(Required)
Blood Warmer(Required)
PCA Pumps(Required)
Pressure Lines(Required)

TROUBLESHOOTING/ COMPLICATIONS

Repair PICC(Required)
Repair Midline(Required)
Air Embolism(Required)
Bleeding(Required)
Brachial Plexus Injury(Required)
Cardiac Arrhythmia(Required)
Cardiac Tamponade(Required)
Catheter Erosion(Required)
Catheter Embolism(Required)
Catheter Occlusion(Required)
Catheter-Related Sepsis(Required)
Endocarditis(Required)
Exit Site Infection(Required)
Exit Site Necrosis(Required)
Extravasation(Required)
Hematoma(Required)
Laceration of Vessels or Viscus(Required)
Myocardial Erosion(Required)
Perforation of Vessels or Viscus(Required)
Phlebitis(Required)
Catheter Tip Malposition or Retraction(Required)
Thromboembolism(Required)
Venous Thrombosis(Required)
Ventricular Thrombosis(Required)
Vessel Erosion(Required)
Declotting Peripheral Site(Required)
Complications from Sedation(Required)

DISCONTINUING IV THERAPY

Peripheral IVs(Required)
PICC/Midline(Required)
Central Lines(Required)

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