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Skills Checklist - Tele, PCU, Stepdown RN

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

Standard Precautions(Required)
Isolation Precautions(Required)
Pediatric Respiratory/ Cardiac Arrest(Required)
Adult Respiratory/ Cardiac Arrest(Required)
Crash Carts(Required)
Defibrillators(Required)
Care of Patients in Restraints(Required)
Pain Management(Required)
Care Planning and Discharge Planning(Required)
Patient/ Family Education(Required)
Patient Head to Toe Assessment(Required)
Dressing Changes(Required)
Knowledge of Normal Serum Lab Values(Required)
Obtaining Cultures (Blood, Sputum, Swab, Urine)(Required)
Administration of Blood and Blood Products (Blood, Sputum, Swab, Urine)(Required)
PCA Pumps (Blood, Sputum, Swab, Urine)(Required)
Infusion Pumps (Blood, Sputum, Swab, Urine)(Required)
Calculate mcg/min and mcg/kg/min (Blood, Sputum, Swab, Urine)(Required)
Titrating Medications(Required)
Moderate/Conscious Sedation & Reversal Agents)(Required)
Automated Med Dispensing Systems
Electronic Documentation

IV THERAPY

Initiate Peripheral IV(Required)
Discontinue Peripheral IV(Required)
Central Line Blood Draw(Required)
Central Line Care & Maintenance(Required)
PICC Line Blood Draw(Required)
PICC Line Care & Maintenance(Required)

NEURO GENERAL SKILLS

Assessment of Neuro Signs(Required)
Glasgow Coma Scale(Required)
Seizure Precautions(Required)
Assist With Lumbar Puncture(Required)
Halo Traction(Required)

NEURO - Care of Patients with:

CVA(Required)
Seizure Activity(Required)
Overdose(Required)
Neuro/Head Injury/ Trauma(Required)
Pre/Post Neurosurgery(Required)
Cranial Hemorrhage(Required)
Multiple Sclerosis(Required)
Post-Op AV Shunt(Required)

NEURO GENERAL SKILLS

Assessment of Neuro Signs(Required)
Glasgow Coma Scale(Required)
Seizure Precautions(Required)
Assist With Lumbar Puncture(Required)
Halo Traction(Required)

MEDICATION KNOWLEDGE AND USE OF

Decadron(Required)
Dilantin(Required)
Magnesium Sulfate.(Required)
Phenobarbital(Required)
Steroids(Required)
Valium(Required)
Versed.(Required)

CARDIAC GENERAL SKILLS

Auscultation of Cardiac Sounds(Required)
Dopplers(Required)
Interpretation of 12 lead EKG(Required)
Interpretation of Arrhythmias(Required)
Defibrillation/cardioversion(Required)
Permanent Pacemaker(Required)
Temporary Pacemaker(Required)
AICD(Required)
Art-Line (transducer set-up, D/C)(Required)
Sheath Removal(Required)
Interpretation of Cardiac Enzymes(Required)

CARDIAC - CARE OF PATIENTS WITH

Angina(Required)
CHF(Required)
Post MI(Required)
Pre/Post Cardiac Cath(Required)
Pre/Post Cardiac Surgery(Required)
Open Sternal Wound (Debridement)(Required)
Heart Transplant(Required)

MEDICATION KNOWLEDGE AND USE OF:*

Atropine(Required)
Diuretics(Required)
Digoxin(Required)
Dopamine(Required)
Dobutrex(Required)
Heparin Drip (Precautions & Maintenance)(Required)
Inderal(Required)
Inocor(Required)
Isuprel(Required)
Lidocaine(Required)
Nipride(Required)
Nitroglycerin(Required)
Pronestyl(Required)
Morphine(Required)
Thrombolytic Agents(Required)
Magnesium Sulfate(Required)
Versed(Required)
Prep/Titration of Emergency Drugs(Required)

RESPIRATORY GENERAL SKILLS

Establishing an Airway(Required)
Ambuing Techniques(Required)
Administration of O2(Required)
Chest Tubes(Required)
Pulse Oximetry(Required)
Interpretation of ABG(Required)
Use of IPPB(Required)
Incentive Spirometer(Required)
Oral Suctioning(Required)
Nasotracheal Suctioning(Required)
ET Suctioning(Required)

RESPIRATORY CARE OF PATIENTS WITH

COPD(Required)
ARDS(Required)
Pulmonary embolism(Required)
Pulmonary Edema(Required)
Emphysema(Required)
Pre/ Post Thoracic Surgery(Required)
Pneumothorax(Required)
Pneumonia(Required)
Inhalation Injuries(Required)
Asthma(Required)
Lung Transplant(Required)

MEDICATION KNOWLEDGE AND USE OF

Aminophylline(Required)
Corticosteroids(Required)
Bronchodilators(Required)

GASTROINTESTINAL GENERAL SKILLS

NG Tube Insertion, Care and Maintenance(Required)
Gastrostomy Tube(Required)
Jejunostomy Tube(Required)
Enterostomal Care(Required)
Tube Feedings(Required)

GASTROINTESTINAL- CARE OF PATIENTS WITH

Pancreatitis(Required)
G.I. Bleed(Required)
Esophageal Bleeding(Required)
Bowel Obstruction(Required)
Whipple Procedure(Required)
Liver Transplant(Required)
Paralytic Ileus(Required)
E.R.C.P.(Required)

MEDICATION KNOWLEDGE AND USE OF:

Antiemetics(Required)
TPN/Hyperalimentation(Required)

MEDICATION KNOWLEDGE AND USE OF

Peritoneal Dialysis(Required)
Hemodialysis(Required)
Foley/Straight Catheter Insertion(Required)
GU Irrigations(Required)
Nephrostomy Tube(Required)
Suprapubic Tube(Required)
Electrolyte Imbalance/ Replacement(Required)

GENITOURINARY/ RENAL - CARE OF PATIENTS WITH:*

T.U.R.P.(Required)
Shunts and Fistulas(Required)
Nephrectomy(Required)
Renal Transplant(Required)
Renal Trauma(Required)
Chronic/Acute Renal Failure(Required)

GYNECOLOGY GENERAL SKILLS

GYN Exam Prep(Required)

GYNECOLOGY- CARE OF PATIENTS WITH:

Ectopic Pregnancy/Ruptured Ectopic Pregnancy(Required)
Hysterectomy(Required)
Repair of Cystocele/ Rectocele(Required)

ORTHOPEDIC GENERAL SKILLS

Assessment of C/M/S(Required)
K-Wises/Steinmann Pins(Required)
Removal of Hardware(Required)

ORTHOPEDIC- CARE OF PATIENT WITH:*

Total Joint Replacement(Required)
Spica Cast/Body Cast(Required)
Amputation(Required)
Traction(Required)
Ortho Trauma(Required)
Laminectomy(Required)

ENDOCRINE GENERAL SKILLS

Diabetic Teaching(Required)
Blood Glucose Monitoring(Required)

ENDOCRINE - Care of Patients With:

Hyper/Hypoglycemia(Required)

MEDICATION KNOWLEDGE AND USE OF.

Insulin (IV, SQ)(Required)
D50(Required)

PHLEBOTOMY/ IV THERAPY

Peripheral IV Insertion, Care and Maintenance(Required)
Assisting with Insertion of Central Lines(Required)
Care and Maintenance of Central Lines(Required)
Assisting with Insertion of PICC Lines(Required)
Care and Maintenance of PICC Lines(Required)
Assist with IC Cutdown(Required)
Phlebitis(Required)

OTHER

Heparin Drip (Precautions and Maintenance)(Required)
Care of Oncology Patient(Required)
Chemotherapy Administration(Required)
Care of Patient with Burns(Required)
Care of Patient with HIV/AIDS(Required)
Hyperbaric Oxygenation(Required)
Suicide Precautions(Required)
Post Mortem Cares(Required)

CARDIAC MONITORS

Hewlett- Packard(Required)
Spacelab(Required)
Siemens.(Required)
Marquette(Required)
Mennen(Required)
Lifecare(Required)
Nihon-Koder(Required)
Hyper/ hypoglycemia(Required)

VENTILATORS

Bear(Required)
Bennett 7200 Performing Fingersticks(Required)
CPAP(Required)
Emerson(Required)
Engstrom/ Erica(Required)
EMV(Required)
MA-I(Required)
MA-II(Required)
Monihan(Required)
Ohio 560 PEEP(Required)
Pressure Pre-Set(Required)
Servo(Required)
Siemens(Required)

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