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PACU Skills Checklist
WORK SETTING - My experience in the following settings:
Yrs.
Inpatient PACU
Yrs.
Outpatient/Ambulatory PACU
Yrs.
ICU
Yrs.
Pre/Post Op
Yrs.
Pain Management Department
Yrs.
PEDI-PACU
Yrs.
Please mark your level of experience
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
CARDIOVASCULAR
1
2
3
4
Open Heart Recovery
1
2
3
4
AAA Repair
1
2
3
4
Vascular Surgery
1
2
3
4
Pacemaker-Permanent & Temporary
1
2
3
4
Cardioversion
1
2
3
4
AICD Insertion
1
2
3
4
Cardiac Arrest
1
2
3
4
Cardiac Tamponade
1
2
3
4
CHF/Pulmonary Edema
1
2
3
4
Abnormal Heart Sounds/Murmurs
1
2
3
4
Pulses/Circulation Checks
1
2
3
4
PULMONARY
1
2
3
4
Ventilator Management
1
2
3
4
Fresh Tracheostomy
1
2
3
4
Thoracotomy/Lobectomy/Pneumonectomy
1
2
3
4
Pneumothorax/Hemothorax
1
2
3
4
Laryngospasm
1
2
3
4
Pulmonary Embolism
1
2
3
4
COPD
1
2
3
4
ABG Interpretation
1
2
3
4
NEUROLOGIC
1
2
3
4
Post Craniotomy
1
2
3
4
Anterior/Posterior Spinal Fusion
1
2
3
4
Carotid Endardarectomy
1
2
3
4
Spine Surgery
1
2
3
4
CVA
1
2
3
4
Stroke Scale
1
2
3
4
Glascow Coma Scale
1
2
3
4
Spinal Precautions
1
2
3
4
Hypothermia Protocol
1
2
3
4
Hypo/Hyperthermia Blanket
1
2
3
4
Sedation Scales/Levels
1
2
3
4
GASTROINTESTINAL
1
2
3
4
Pancreas/Liver Transplant
1
2
3
4
Colon Surgery
1
2
3
4
Colostomy/Ileostomy
1
2
3
4
ERCP
1
2
3
4
G Tube/J Tube Management
1
2
3
4
T Tube Management
1
2
3
4
RENAL/GENITOURINARY
1
2
3
4
Renal Surgery
1
2
3
4
TURP
1
2
3
4
Arteriovenous Fistula/Shunt
1
2
3
4
Nephrostomy Tubes
1
2
3
4
ENDOCRINE METABOLIC
1
2
3
4
Diabetes - Hypo/Hyperglycemic Crisis
1
2
3
4
IV Insulin Protocols
1
2
3
4
ORTHOPEDIC
1
2
3
4
Laminectomy
1
2
3
4
Total Joint Replacement
1
2
3
4
Amputation
1
2
3
4
Open Reduction/Internal Fixation
1
2
3
4
General Orthopedic Surgeries
1
2
3
4
CPM/Traction
1
2
3
4
Circulation Checks
1
2
3
4
WOUND MANAGEMENT
1
2
3
4
Surgical Drains
1
2
3
4
Wound Vac
1
2
3
4
Surgical Wound Assessment
1
2
3
4
Skin Assessment for Breakdown
1
2
3
4
Staging Decubitus Ulcers
1
2
3
4
MEDICATIONS
1
2
3
4
Procedural Sedation
1
2
3
4
Anesthesia Medications
1
2
3
4
Anti-Arrhythmics
1
2
3
4
Anticoagulants
1
2
3
4
Anti-Hypertensives
1
2
3
4
Anti-Seizure Medications
1
2
3
4
Benzodiazepines
1
2
3
4
Emergency Medications
1
2
3
4
Insulin
1
2
3
4
Narcotics/Opioid Analgesics
1
2
3
4
Nitrates
1
2
3
4
Non-Opioid Analgesics
1
2
3
4
Reversal Agents
1
2
3
4
Steroids
1
2
3
4
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
1
2
3
4
IV THERAPY
1
2
3
4
Starting IVs
1
2
3
4
Central Line Blood Draws
1
2
3
4
Central Line/Implanted Line Care
1
2
3
4
Blood Product Administration
1
2
3
4
CARDIAC MONITORING & EMERG. RESPONSE
1
2
3
4
Malignant Hyperthermia
1
2
3
4
Dysrhythmia Interpretation
1
2
3
4
Dysrhythmia Management
1
2
3
4
12 Lead EKG
1
2
3
4
PROFESSIONAL KNOWLEDGE AND SKILLS
1
2
3
4
National Patient Safety Goals/Core Measures
1
2
3
4
Fall Risk Assessment/Prevention
1
2
3
4
Pressure Ulcer Risk Assessment/Prevention
1
2
3
4
Age Specific/Population-Based Care
1
2
3
4
Pain Assessment & Management
1
2
3
4
Charge Experience
1
2
3
4
Interpretation and Communication of Lab Values
1
2
3
4
Specialty Beds
1
2
3
4
COMPUTERIZED CHARTING
1
2
3
4
Epic
1
2
3
4
Cerner
1
2
3
4
Eclipsys
1
2
3
4
McKesson
1
2
3
4
Meditech
1
2
3
4
Other Computerized System
1
2
3
4
Computerized Physician Order Entry
1
2
3
4
Bar Coding for Medication Administration
1
2
3
4
Yes
No
EMR Conversion
Yes
No
First Name
*
Last Name
*
Phone Number
*
Last 4 of Social Security Number
*
Email Address
*
Date Completed:
*
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*
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