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Telemetry 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

CARDIAC Rating Stars (Click) 1 2 3 4  
Acute Coronary Syndrome 
 
Congestive Heart Failure 
 
Post Open Heart (12-24 hours) 
 
Carotid Endarterectomy 
 
Post Vascular Surgery 
 
Heart Transplant 
 
Pacemaker - Temporary/Permanent 
 
Pacemaker - Epicardial 
 
Sheath Removal 
 
Heart Sounds 
 
PULMONARY Rating Stars (Click) 1 2 3 4  
Pneumonia 
 
Respiratory Distress 
 
COPD 
 
Breath Sounds 
 
Post Thoracic Surgery 
 
Chest Tube Placement & Management 
 
Trach Management 
 
Modes of Ventilation (AC/PC/SIMV/CPAP) 
 
Intubation/Extubation 
 
External CPAP/BiPAP 
 
Interpretation of Arterial Blood Gases 
 
NEUROLOGIC & PSYCHIATRIC Rating Stars (Click) 1 2 3 4  
Stroke Scale Assessment 
 
CVA 
 
Brain Injury 
 
Post Craniotomy 
 
Spinal Cord Injury 
 
Seizure Disorders 
 
ETOH/Drug Withdrawal 
 
GASTROINTESTINAL Rating Stars (Click) 1 2 3 4  
GI Bleeding 
 
GI Surgery 
 
Liver Failure 
 
Pancreatitis 
 
Liver Transplant 
 
Pancreas Transplant 
 
RENAL/GENITOURINARY Rating Stars (Click) 1 2 3 4  
Renal Failure 
 
Renal Surgery 
 
Renal Transplant 
 
Arteriovenous Fistula/Shunt 
 
Nephrostomy Tubes 
 
Peritoneal Dialysis 
 
ENDOCRINE METABOLIC Rating Stars (Click) 1 2 3 4  
Diabetes - Hypo/Hyperglycemic Crisis 
 
Pituitary Disorders 
 
IV Insulin Protocols 
 
Indwelling Insulin Pumps 
 
MEDICATIONS Rating Stars (Click) 1 2 3 4  
Anti-Arrhythmics 
 
Anticoagulants (IV, oral, & injection) 
 
Anti-Hypertensives 
 
Anti-Psychotics 
 
Anti-Seizure Medications 
 
Benzodiazepines 
 
Procedural Sedation 
 
Diuretics 
 
Emergency Medications 
 
Inhaled Medications 
 
Insulin 
 
Titrate Vasoactive Drips 
 
Manage Vasoactive Drips - No Titration 
 
Narcotics/Opioid Analgesics (IV, oral, & injection) 
 
Nitrates (Oral & Topical) 
 
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 Draws 
 
Central Line/Implanted Line Care 
 
Arterial Line Management 
 
TPN & Lipids 
 
Blood Product Administration 
 
Administration of Chemotherapy 
 
CARDIAC MONITORING & EMERG. RESPONSE Rating Stars (Click) 1 2 3 4  
Dysrhythmia Interpretation 
 
Dysrhythmia Management 
 
Obtain 12 Lead EKG 
 
Interpret 12 Lead EKG 
 
Cardioversion 
 
Defibrillation 
 
Malignant Hyperthermia 
 
PROFESSIONAL KNOWLEDGE AND SKILLS Rating Stars (Click) 1 2 3 4  
National Patient Safety Goals/Core Measures 
 
Fall Risk Assessment/Prevention 
 
Pressure Ulcer Risk Assessment/Prevention 
 
Restraints/Use of Least Restrictive Device 
 
Patient/Family Teaching 
 
Age Specific/Population-Based Care 
 
Isolation Precautions 
 
Infection Prevention 
 
Pain Assessment & Management 
 
Charge Experience 
 
Interpretation and Communication of Lab Values 
 
Specialty Beds 
 
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