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PICU CheckList

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

WORK SETTINGS Rating Stars (Click) 1 2 3 4  
PICU 
 
Pediatric CVICU 
 
Pediatric Step Down 
 
Pediatric PACU 
 
CARDIOVASCULAR Rating Stars (Click) 1 2 3 4  
Congenital Heart Disease/Repair 
 
Post Cardiac Surgery (Directly from OR) 
 
Post Cardiac Surgery (NOT Directly from OR) 
 
Post Diagnostic/Interventional Cardiac Cath 
 
Heart Failure/Cardiogenic Shock 
 
Cardiac Transplant 
 
Hemodynamic Monitoring 
 
Arrhythmia Interpretation 
 
Pacemaker - Temporary/Permanent 
 
SVO2 Monitoring 
 
Intra-Aortic Balloon Pump 
 
Ventricular Assist Device 
 
ECMO 
 
PULMONARY Rating Stars (Click) 1 2 3 4  
Respiratory Distress Syndrome/Resp. Failure 
 
Reactive Airway Disease 
 
ENT Surgery 
 
Epiglottis 
 
Cystic Fibrosis 
 
Tuberculosis 
 
Intubation/Extubation 
 
Endotracheal Tube Management 
 
Tracheostomy Management 
 
Modes of Ventilation: AC/PC/SIMV/CPAP 
 
Modes of Ventilation: Jet/Oscillator 
 
Nitric Oxide 
 
Hemo/Pneumothorax 
 
NEUROLOGIC/ORTHOPEDIC Rating Stars (Click) 1 2 3 4  
Brain Injury 
 
Craniotomy 
 
Spinal Cord Injury 
 
Seizure Disorders 
 
ICP Monitoring 
 
VP Shunt 
 
Meningitis 
 
Neuromuscular Disease 
 
Post Vertebral Surgery 
 
Traction - General 
 
Traction - Halo 
 
GASTROINTESTINAL Rating Stars (Click) 1 2 3 4  
Acute Surgical Abdomen 
 
GI Bleeding 
 
Pancreatitis 
 
Hepatic Failure 
 
Ostomy Management 
 
Management of Gastric Tubes 
 
Breast Milk Handling/Storage 
 
RENAL/GENITOURINARY Rating Stars (Click) 1 2 3 4  
Nephrotic Syndrome 
 
Renal Transplant 
 
Renal Replacement Therapy 
 
Peritoneal Dialysis 
 
ENDOCRINE/METABOLIC Rating Stars (Click) 1 2 3 4  
Diabetes - Hypo/Hyperglycemic Crisis 
 
Diabetic Ketoacidosis 
 
IV Insulin Pumps 
 
Indwelling Insulin Pumps 
 
TRAUMA/OTHER Rating Stars (Click) 1 2 3 4  
Blunt/Penetrating Trauma 
 
Burns 
 
Craniofacial Reconstruction 
 
Near Drowning 
 
Poison Ingestion/Overdose 
 
Bites-Animal/Snake/Human 
 
Suicide Precautions 
 
Wound Management/VAC 
 
Specialty Beds 
 
ONCOLOGY Rating Stars (Click) 1 2 3 4  
Bone Marrow Transplant 
 
Immunosuppressive Disorder 
 
Hemophilia Crisis 
 
Sickle Cell Crisis 
 
MEDICATIONS Rating Stars (Click) 1 2 3 4  
Pediatric Dosage Calculations 
 
Anti-Arrhythmics 
 
Anticoagulants (IV, Oral & Injection) 
 
Anti-Hypertensives 
 
Anti-Seizure Medications 
 
Benzodiazepines 
 
Continuous IV Paralytics 
 
Continuous IV Sedation 
 
Procedural Sedation - Administration 
 
Diuretics 
 
Emergency Medication 
 
Inhaled Medications 
 
Insulin 
 
IV Vasopressors 
 
Narcotics/Opioid Analgesics (IV, Oral & Injection) 
 
Non-Opioid Analgesics (IV, Oral & Injection) 
 
Reversal Agents 
 
Steroids (IV, Oral, Inhaled) 
 
Automated Medication Dispensing (i.e. Pyxis, Omnicell) 
 
IV THERAPY Rating Stars (Click) 1 2 3 4  
Starting Ivs 
 
Central Line Blood Draw 
 
Central Line/Implanted Line Care 
 
TPN/Lipids 
 
Blood Product Administration 
 
Administration of Chemotherapy 
 
CARDIAC MONITORING & EMERG. RESPONSE Rating Stars (Click) 1 2 3 4  
Dysrhythmia Interpretation 
 
Dysrhythmia Management 
 
Management of Cardiac Arrest 
 
Shock Management 
 
Malignant Hyperthermia 
 
Multisystem Organ Failure 
 
PROFESSIONAL KNOWLEDGE AND SKILLS Rating Stars (Click) 1 2 3 4  
National Patient Safety Goals/Core Measures 
 
Recognize/Report Signs of Abuse 
 
EMTALA 
 
Fall Risk Assessment/Prevention 
 
Pressure Ulcer Risk Assessment/Prevention 
 
Restraints/Use of Least Restrictive Device 
 
Normal Growth and Development 
 
Age Specific/Population Based Care 
 
Patient Family Teaching 
 
Isolation Precautions 
 
Infection Prevention 
 
Reporting Communicable Diseases 
 
Pain Assessment & Management 
 
Charge Experience 
 
Interpretation and Communication of Lab Values 
 
Age Specific Competencies Rating Stars (Click) 1 2 3 4  
Infant (Birth - 1 year 
 
Preschooler (ages 2-5 years) 
 
Childhood (ages 6-12 years) 
 
Adolescents (ages 13-21 years) 
 
Young Adults (ages 22-39 years) 
 
Adults (ages 40-64 years) 
 
Older Adults (ages 65-79 years) 
 
Elderly (ages 80+ years) 
 
EMR Rating Stars (Click) 1 2 3 4  
Epic 
 
Cerner 
 
Eclipsys 
 
McKesson 
 
Meditech 
 
Other Computerized System 
 
Computerized Physician Order Entry 
 
Bar Coding for Medication Administration