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PICU 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
PICU
1
2
3
4
Pediatric CVICU
1
2
3
4
Pediatric Step Down
1
2
3
4
Pediatric PACU
1
2
3
4
CARDIOVASCULAR
1
2
3
4
Congenital Heart Disease/Repair
1
2
3
4
Post Cardiac Surgery (Directly from OR)
1
2
3
4
Post Cardiac Surgery (NOT Directly from OR)
1
2
3
4
Post Diagnostic/Interventional Cardiac Cath
1
2
3
4
Heart Failure/Cardiogenic Shock
1
2
3
4
Cardiac Transplant
1
2
3
4
Hemodynamic Monitoring
1
2
3
4
Arrhythmia Interpretation
1
2
3
4
Pacemaker - Temporary/Permanent
1
2
3
4
SVO2 Monitoring
1
2
3
4
Intra-Aortic Balloon Pump
1
2
3
4
Ventricular Assist Device
1
2
3
4
ECMO
1
2
3
4
PULMONARY
1
2
3
4
Respiratory Distress Syndrome/Resp. Failure
1
2
3
4
Reactive Airway Disease
1
2
3
4
ENT Surgery
1
2
3
4
Epiglottis
1
2
3
4
Cystic Fibrosis
1
2
3
4
Tuberculosis
1
2
3
4
Intubation/Extubation
1
2
3
4
Endotracheal Tube Management
1
2
3
4
Tracheostomy Management
1
2
3
4
Modes of Ventilation: AC/PC/SIMV/CPAP
1
2
3
4
Modes of Ventilation: Jet/Oscillator
1
2
3
4
Nitric Oxide
1
2
3
4
Hemo/Pneumothorax
1
2
3
4
NEUROLOGIC/ORTHOPEDIC
1
2
3
4
Brain Injury
1
2
3
4
Craniotomy
1
2
3
4
Spinal Cord Injury
1
2
3
4
Seizure Disorders
1
2
3
4
ICP Monitoring
1
2
3
4
VP Shunt
1
2
3
4
Meningitis
1
2
3
4
Neuromuscular Disease
1
2
3
4
Post Vertebral Surgery
1
2
3
4
Traction - General
1
2
3
4
Traction - Halo
1
2
3
4
GASTROINTESTINAL
1
2
3
4
Acute Surgical Abdomen
1
2
3
4
GI Bleeding
1
2
3
4
Pancreatitis
1
2
3
4
Hepatic Failure
1
2
3
4
Ostomy Management
1
2
3
4
Management of Gastric Tubes
1
2
3
4
Breast Milk Handling/Storage
1
2
3
4
RENAL/GENITOURINARY
1
2
3
4
Nephrotic Syndrome
1
2
3
4
Renal Transplant
1
2
3
4
Renal Replacement Therapy
1
2
3
4
Peritoneal Dialysis
1
2
3
4
ENDOCRINE/METABOLIC
1
2
3
4
Diabetes - Hypo/Hyperglycemic Crisis
1
2
3
4
Diabetic Ketoacidosis
1
2
3
4
IV Insulin Pumps
1
2
3
4
Indwelling Insulin Pumps
1
2
3
4
TRAUMA/OTHER
1
2
3
4
Blunt/Penetrating Trauma
1
2
3
4
Burns
1
2
3
4
Craniofacial Reconstruction
1
2
3
4
Near Drowning
1
2
3
4
Poison Ingestion/Overdose
1
2
3
4
Bites-Animal/Snake/Human
1
2
3
4
Suicide Precautions
1
2
3
4
Wound Management/VAC
1
2
3
4
Specialty Beds
1
2
3
4
ONCOLOGY
1
2
3
4
Bone Marrow Transplant
1
2
3
4
Immunosuppressive Disorder
1
2
3
4
Hemophilia Crisis
1
2
3
4
Sickle Cell Crisis
1
2
3
4
MEDICATIONS
1
2
3
4
Pediatric Dosage Calculations
1
2
3
4
Anti-Arrhythmics
1
2
3
4
Anticoagulants (IV, Oral & Injection)
1
2
3
4
Anti-Hypertensives
1
2
3
4
Anti-Seizure Medications
1
2
3
4
Benzodiazepines
1
2
3
4
Continuous IV Paralytics
1
2
3
4
Continuous IV Sedation
1
2
3
4
Procedural Sedation - Administration
1
2
3
4
Diuretics
1
2
3
4
Emergency Medication
1
2
3
4
Inhaled Medications
1
2
3
4
Insulin
1
2
3
4
IV Vasopressors
1
2
3
4
Narcotics/Opioid Analgesics (IV, Oral & Injection)
1
2
3
4
Non-Opioid Analgesics (IV, Oral & Injection)
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
Dysrhythmia Interpretation
1
2
3
4
Dysrhythmia Management
1
2
3
4
Management of Cardiac Arrest
1
2
3
4
Shock Management
1
2
3
4
Malignant Hyperthermia
1
2
3
4
Multisystem Organ Failure
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
EMTALA
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