Critical Care 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

General Skills Rating Stars (Click) 1 2 3 4  
Advanced directives 
Patient/family teaching 
Restrictive devices (restraints) 
Lift/transfer devices 
Specialty beds 
End of life care/palliative care 
Wound assessment & care 
Automated Medication Dispensing System, Pyxis, Omnicell, or other 
Bar coding for medication administration 
Blood Glucose Monitor (BGM) 
Electronic ICU 
National Patient Safety Goals 
Accurate patient identification 
Effective communication 
Interpretation & communication of lab values 
Medication administration 
Medication reconciliation 
Labeling (medications & specimens) 
Anticoagulation therapy 
Monitoring conscious sedation 
Pain assessment & management 
Infection control 
Universal precautions 
Minimize risk for falls 
Prevention of pressure ulcers 
Use of rapid response teams 
Awareness of HCAHPS 
Cardiovascular Rating Stars (Click) 1 2 3 4  
Assessment of heart sounds 
Interpretation of arrhythmias 
Performing 12 lead EKG’s 
Interpretation of 12 lead EKG 
Interpretation of hemodynamic monitoring 
CVC (Central Venous Catheter) 
Arterial line 
Swanz Ganz catheter 
Flow trac or Vigileo monitoring caths 
Intra-Aortic Balloon Pump (IABP) 
Ventricular Assist Device (LVAD, RVAD) 
Permanent pacemakers 
Implantable Cardioverter Defibrillator (ICD) 
External pacemakers 
Epicardial pacemaker wires 
Discontinuing venous/arterial sheaths 
Acute myocardial infarction 
Pre/post: cardiac catheterization 
Congestive heart failure 
Dysrhythmias/conduction disturbances 
Aortic aneurysm 
Thoracic/abdominal surgery 
Endoluminal graft 
Cardiogenic shock 
Hypertensive crisis 
MAZE procedure 
Post open heart (CABG/valve) 
Cardiac contusion/trauma 
Heart transplant 
Cardiac tamponade 
ACLS medications and protocols 
Vasoactive/vasopressor agents 
Anesthetics (propofol/presedex) 
Thrombolytics (retavase/activase) 
Platelet inhibitors (ReoPro/Integrilin/Aggrastat) 
Flolan for pulmonary hypertension 
Pulmonary Rating Stars (Click) 1 2 3 4  
Assessment of breath sounds 
Oral/NT/ET airway 
Arterial blood gas analysis/interpretation 
Obtaining ABG blood sample/arterial line 
Pulse oximetry 
BiPAP (Bi-level Positive Airway Pressure) 
Oscillation/high-frequency ventilation 
Interpretation of weaning parameters 
Maintenance & management of pleural chest tubes 
Acute respiratory failure 
Adult Respiratory Distress Syndrome (ARDS) 
Sudden Inflammation Respiratory Syndrome (SIRS) 
Inhalation injuries 
Pulmonary edema 
Near drowning 
Chronic Obstructive Pulmonary Disease (COPD) 
Pre/post thoracic surgery 
Pulmonary embolism 
Pulmonary/chest trauma 
Pulmonary hypertension 
Status asthmaticus 
Rapid sequence intubation drugs/protocols 
Nebulizer treatments: Ventolin, Atrovent 
Neurology Rating Stars (Click) 1 2 3 4  
Cranial nerve assessment 
Glasgow coma scale 
NIH stroke scale 
NIH stroke certification 
Seizure precautions 
Skeletal traction 
Cervical spine precautions/logroll positioning 
Halo vest/halo traction 
Monitoring of neuromuscular blocking agents/paralytics 
Assist with lumbar puncture 
Subarachnoid screw/bolt 
Lumbar drains 
Cerebral aneurysm 
Subarachnoid hemorrhage 
Status epilepticus 
TBI (Traumatic Brain Injury) 
Spinal cord injury 
CerebroVascular Accident (CVA) 
Pre/post cranial surgery 
Myasthenia gravis 
Clipping and/or coilings of aneurysms 
Pituitary Tumor 
Steroids: Decadron, Solu-Medrol 
Anticonvulsants: Dilantin, phenobarbital 
Paralytic Agents: Norcuron, Pavalon, Nimbex, Tracrium, vecuronium 
Antipsychotics: Haldol 
Trauma & Burns Rating Stars (Click) 1 2 3 4  
Mass casualty 
Multiple fractures 
Thermoregulation: hypothermia/hyperthermia 
Berdow Formula/ “Rule of Nines” 
Lund and Browder chart 
Fluid resuscitation 
Care & management of burns 
Gastrointestinal Rating Stars (Click) 1 2 3 4  
Small bore feeding tube insertion (Dobhoff or Keofeed) 
Nasogastric tube insertion 
Post pyloric feeding tube insertion 
Gastric lavage 
Use of activated charcoal 
Maintenance of gastric/jejunostomy tube 
Stoma care 
Maintenance & management of enteral tube feedings 
Assisting/monitoring bedside procedures: endo/chest tubes/bronchs/trach insertion/PEG tubes 
Abdominal trauma 
Acute gastrointestinal hemorrhage 
Esophageal varices 
Balloon tamponade devices (i.e. Blakemore tube) 
Acute pancreatitis 
Bowel obstruction 
Liver/pancreas transplant 
Antiemetics: Reglan, Zofran 
H2 receptor antagonists 
Renal Rating Stars (Click) 1 2 3 4  
Foley catheter insertion 
Suprapubic tube 
Nephrostomy tube 
Peritoneal dialysis 
Continuous Arteriovenous Hemofiltration (CAVHD, CVVHD, SCUF, CRRT) 
Hemodialysis of the critically ill patient 
Acute renal failure 
Chronic renal failure 
AV fistulas, shunts & dialysis catheters 
Renal transplant 
Renal/urinary tract trauma 
Endocrine Rating Stars (Click) 1 2 3 4  
Diabetic Ketoacidosis (DKA) 
Hyperosmolar Hyperglycemic Nonketotic Coma (HHNK) 
Diabetes Insipidus (DI) 
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) 
Administration & monitoring of insulin infusion 
Use of Endo tool 
Intravenous Management Rating Stars (Click) 1 2 3 4  
Starting peripheral IV’s 
Care of patient with Peripherally-Inserted Central Catheter (PICC) 
Administration/monitoring of Total Parenteral Nutrition (TPN) 
Administration of blood/blood products 
Administration of narcotics/sedatives: (fentanyl, Valium, Ativan, Versed, morphine) 
Bispectral monitoring 
Tele-ICU (ICU-E) Rating Stars (Click) 1 2 3 4  
Video assessment 
Utilize tele-ICU system 
Troubleshoot equipment 
Giving directions over AV system 
Interpretation of data 
Critical thinking 
Other Rating Stars (Click) 1 2 3 4  
Drug or chemical overdose (TCA, ethanol, ASA) 
Poisoning (CO, cyanide) 
Substance abuse (ETOH, stimulants, narcotics) 
Human Immunodeficiency Virus (HIV) 
Multisystem Organ Dysfunction Syndrome (MODS) 
Disseminated Intravascular Coagulation (DIC) 
Septic shock 
Administration of chemotherapy 
Monitoring of chemotherapy (does not initiate) 
Hyperbaric oxygenation 
Organ/tissue donation procedures 
Suicide precautions 
Age Specific Competencies Rating Stars (Click) 1 2 3 4  
Adolescent (ages 13-21 years) 
Young adult (ages 22-39 years) 
Adult (ages 40-64 years) 
Older adult (ages 65-79 years) 
Elderly (ages 80+ years)