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Pediatric Skills Checklist
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
WORK SETTINGS
1
2
3
4
Pediatric MedSurg
1
2
3
4
Pediatric Step Down/Telemetry
1
2
3
4
Pediatric Oncology
1
2
3
4
Pediatric Ortho
1
2
3
4
Pediatric Neuro
1
2
3
4
CARDIOVASCULAR
1
2
3
4
Congenital Heart Disease/Repair
1
2
3
4
Pre Cardiac Surgery
1
2
3
4
Post Cardiac Surgery
1
2
3
4
Heart Sounds
1
2
3
4
PULMONARY
1
2
3
4
Reactive Airway Disease
1
2
3
4
RSV
1
2
3
4
Tuberculosis
1
2
3
4
Esophageal Atresia
1
2
3
4
Epiglottitis
1
2
3
4
Tonsillitis
1
2
3
4
Laryngotracheobronchitis (Croup)
1
2
3
4
ENT Surgery
1
2
3
4
Oxygen Delivery Systems
1
2
3
4
Tracheostomy Management
1
2
3
4
Oral Suctioning
1
2
3
4
Deep Suctioning
1
2
3
4
Management of Chest Tubes
1
2
3
4
Apnea Monitor
1
2
3
4
Home Ventilator Therapy
1
2
3
4
NEUROLOGIC/ORTHOPEDIC
1
2
3
4
Brain Injury
1
2
3
4
Spinal Cord Injury
1
2
3
4
Seizure Disorders
1
2
3
4
Meningitis
1
2
3
4
Neuromuscular Disease
1
2
3
4
Extremity Fracture/Cast
1
2
3
4
Post Vertebral Surgery
1
2
3
4
Traction - General
1
2
3
4
Traction - Halo
1
2
3
4
Pin Care
1
2
3
4
VP Shunts/Internal/External
1
2
3
4
GASTROINTESTINAL
1
2
3
4
Cleft Lip/Palate
1
2
3
4
Inflammatory Bowel Disease
1
2
3
4
Colostomy/Ileostomy
1
2
3
4
Surgical Drains
1
2
3
4
Failure to Thrive
1
2
3
4
Feeding Intolerance
1
2
3
4
Gastroenteritis/Dehydration
1
2
3
4
Bowel Obstruction
1
2
3
4
Short Gut Syndrome
1
2
3
4
Breastfeeding Support/Handling of Breast Milk
1
2
3
4
RENAL/GENITOURINARY
1
2
3
4
Circumcision
1
2
3
4
Testicular Torsion
1
2
3
4
Glomerulonephritis
1
2
3
4
Renal Failure
1
2
3
4
Renal Transplant
1
2
3
4
Urinary Retention
1
2
3
4
Bladder Scan
1
2
3
4
Insertion/Management of Bladder Catheters
1
2
3
4
Management of Suprapubic Catheters
1
2
3
4
ENDOCRINE/METABOLIC
1
2
3
4
Diabetes - Hypo/Hyperglycemia
1
2
3
4
Diabetic Ketoacidosis
1
2
3
4
IV Insulin Pumps
1
2
3
4
Indwelling Insulin Pumps
1
2
3
4
Hyperbilirubinemia
1
2
3
4
Bili Bed
1
2
3
4
ONCOLOGY
1
2
3
4
Chemotherapy Administration
1
2
3
4
Hodgkin's Disease
1
2
3
4
Hemophilia
1
2
3
4
Sickle Cell Anemia
1
2
3
4
Leukemia
1
2
3
4
Solid Tumors
1
2
3
4
Bone Marrow Transplant
1
2
3
4
INFECTIOUS DISEASE
1
2
3
4
Childhood Communicable Diseases
1
2
3
4
Hepatitis
1
2
3
4
HIV
1
2
3
4
Kawasaki Disease
1
2
3
4
MEDICATIONS
1
2
3
4
Pediatric Dosage Calculations
1
2
3
4
Anti-Hypertensives
1
2
3
4
Anticoagulants
1
2
3
4
Anti-Seizure Medications
1
2
3
4
Benzodiazepines
1
2
3
4
Digoxin
1
2
3
4
Diurectics
1
2
3
4
Emergency Medications
1
2
3
4
Inhaled Medications
1
2
3
4
Insulin
1
2
3
4
Narcotics/Opioid Analgesics (IV/Oral/Injection)
1
2
3
4
Non-Opioid Analgesics (IV/Oral/Injection)
1
2
3
4
Procedural Sedation - Recovery
1
2
3
4
Reversal Agents
1
2
3
4
Steroids (IV/Oral/Inhaled)
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 Draw
1
2
3
4
Central Line/Implanted Line Care
1
2
3
4
TPN/Lipids
1
2
3
4
Blood Product Administration
1
2
3
4
Administration of Chemotherapy
1
2
3
4
CARDIAC MONITORING & EMERG. RESPONSE
1
2
3
4
Pediatric Early Warning Score (PEWS)/Rapid Response Team
1
2
3
4
Dysrhythmia Interpretation
1
2
3
4
Dysrhythmia Management
1
2
3
4
PROFESSIONAL KNOWLEDGE AND SKILLS
1
2
3
4
National Patient Safety Goals/Core Measures
1
2
3
4
Recognize/Report Signs of Abuse
1
2
3
4
Fall Risk Assessment/Prevention
1
2
3
4
Pressure Ulcer Risk Assessment/Prevention
1
2
3
4
Restraints/Use of Least Restrictive Device
1
2
3
4
Normal Growth and Development
1
2
3
4
Age Specific/Population Based Care
1
2
3
4
Patient Family Teaching
1
2
3
4
Isolation Precautions
1
2
3
4
Infection Prevention
1
2
3
4
Reporting Communicable Diseases
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
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:
*
+
By checking the "Agree" box and clicking “Submit” below you certify and acknowledge the information provided on this checklist is accurate to the best of your knowledge and an accurate representation of your abilities.
*
Agree