Pediatric Intensive Care Unit


This checklist was electronically signed on (Today’s date)
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

PICU

Pediatric CVICU

Pediatric Step Down

Pediatric PACU

CARDIOVASCULAR

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

ECMO

PULMONARY

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

Brain Injury

Craniotomy

Spinal Cord Injury

Seizure Disorders

ICP Monitoring

VP Shunt

Meningitis

Neuromuscular Disease

Post Vertebral Surgery

Traction - General

Traction - Halo

GASTROINTESTINAL

Acute Surgical Abdomen

GI Bleeding

Pancreatitis

Hepatic Failure

Ostomy Management

Management of Gastric Tubes

Breast Milk Handling/Storage

RENAL/GENITOURINARY

Nephrotic Syndrome

Renal Transplant

Renal Replacement Therapy

Peritoneal Dialysis

ENDOCRINE/METABOLIC

Diabetes - Hypo/Hyperglycemic Crisis

Diabetic Ketoacidosis

IV Insulin Pumps

Indwelling Insulin Pumps

TRAUMA/OTHER

Blunt/Penetrating Trauma

Burns

Craniofacial Reconstruction

Near Drowning

Poison Ingestion/Overdose

Bites-Animal/Snake/Human

Suicide Precautions

Wound Management/VAC

Specialty Beds

ONCOLOGY

Bone Marrow Transplant

Immunosuppressive Disorder

Hemophilia Crisis

Sickle Cell Crisis

MEDICATIONS

Pediatric Dosage Calculations

Anti-Arrhythmics

Anticoagulants (IV, Oral and 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 and Injection)

Non-Opioid Analgesics (IV, Oral and Injection)

Reversal Agents

Steroids (IV, Oral, Inhaled)

Automated Medication Dispensing (i.e. Pyxis, Omnicell)

IV THERAPY

Starting Ivs

Central Line Blood Draw

Central Line/Implanted Line Care

TPN/Lipids

Blood Product Administration

Administration of Chemotherapy

CARDIAC MONITORING AND EMERG. RESPONSE

Dysrhythmia Interpretation

Dysrhythmia Management

Management of Cardiac Arrest

Shock Management

Malignant Hyperthermia

Multisystem Organ Failure

PROFESSIONAL KNOWLEDGE AND SKILLS

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 And Management

Charge Experience

Interpretation and Communication of Lab Values

Age Specific Competencies

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

Epic

Cerner

Eclipsys(RSV)

McKesson

Meditech

Other Computerized System

Computerized Physician Order Entry

Bar Coding for Medication Administration

EMR Conversion

CERTIFICATIONS

BLS

PALS

ACLS

PEARS

ENPC

CEN

TNCC

Other: Specify