Pediatric Intensive Care Nursing Knowledge & Skills Checklist
Content
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
NAME: ID #: DATE: This Skills Checklist is for use by nurses with more than one year experience in their discipline and specialty. Please be accurate with your assessment. DESCRIPTION 1 2 3 4 NEUROLOGICAL: 1. Assessment: a. Intracranial pressure monitoring b. Neurological status 2. Equipment & Procedures: a. Brain death/organ procurement b. Externalized VP Shunt/reservoirs c. Coma d. Encephalitis e. Head Trauma f. Meningitis g. Neuromuscular disease h. Post Neurosurgery i. Spinal Cord Injury j. Status Epilepticus 3. Medication a. Anticonvulsant medication b. Mannitol c. Pavulon PULMONARY 1. Assessment: a. Breath sounds b. Rate and work of breathing 2. Equipment & procedures: a. Airway management (1) Assist with intubation (2) bulb syringe (3) Endotracheal tube
suctioning
b. Apnea monitor c. Chest Tube (assist with) DIRECTIONS: Please indicate your level of experience by placing a check (√) in the box. Experience level: 1 NO EXPERIENCE 2 MINIMAL EXPERIENCE-requires
supervision/assistance
3 4
MODERATELY EXPERIENCED-requires initial review, then performs independently VERY EXPERIENCED- proficient
(4) (5) (6) (7)
Extubation Nasal airway/suctioning Oral airway/suctioning Tracheostomy/suctioning
DESCRIPTION 1 2 3 4 (1) Insertion (2) Removal (3) Set-up d. Obtaining blood gases: (1) Arterial (2) Heelstick (3) Peripheral (4) Pulse oximeter e. O2 therapy & medication delivery: (1) Bag and mask (2) Isolette (3) Nasal cannula (4) Nebulizer (5) Oxyhood (6) Tent (7) Trach collar f. Thoracentesis i. Ventilator care: (1) CPAP/PEEP (2) IMV (3) High frequency jet ventilation (4) Pressure ventilator (5) Weaning 3. Care of the patient with: a. Bronchiolitis (RSV) b. Severe respiratory distress c. Chronic respiratory disease d. Epiglottitis e. Foreign Body aspiration f. Fresh tracheostomy
1 | Page
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
g. Hemothorax h. Croup i. Pneumonia j. Pneumothorax Name: DESCRIPTION 1 2 3 4 k. RDS l. Respiratory failure m. Status asthmaticus 5. Medications: a. Aminophylline (Theophylline) b. Prostaglandin CARDIOVASCULAR 1. Assessment: a. Auscultation (rate, rhythm, volume) b. Blood pressure/invasive (arterial line) d. Heart sounds/murmurs 2. Equipment & procedures: a. EKG interpretation b. Non-invasive cardiac monitoring c. Invasive hemodynamic monitoring (1) Pulmonary artery/capillary wedge (2) Cardiac output/index d. Central venous pressure 3. Care of the child with: a. Cardiac arrest b. Congenital heart disease/defects c. Cardiomyopathy d. Hypovolemic shock e. Myocarditis f. Post cardiac surgery 4. Medications: a. Dobutamine b. Digoxin c. Dopamine d. Epinephrine e. Heparin f. Lidocaine g. Nitroglycerine h. Nipride 2 | Page i. Potassium Chloride e. Sodium bicarbonate ORTHOPEDICS 1. Equipment & Procedures a. Specialized orthopedic bed 2. Care of child with: a. Cervical traction b. Pinned fractures ID #: DESCRIPTION 1 2 3 4 c. Post vertebral surgery GASTROINTESTINAL 1.Assessment: a. Abdominal b. Nutritional 2. Equipment & procedures: a. Abdominal decompression devices b. Feedings: (1) Assist with breast feeding (2) Bottle c. Placement of Intestinal tubes: (1) Gastrostomy/button (2) Jejunal (3) Nasogastric/Orogastric e. Test of occult blood 3. Care of the child with: a. Fresh Ostomy b. Gastroenteritis/severe dehydration c. GI Reflux d. GI Bleeding e. Hepatic failure f. Hepatitis g. Post Abdominal surgery h. Surgical abdomen RENAL/GENITOURINARY 1. Assessment of fluid balance 2. Equipment & Procedures: a. Collection of urine specimens: (1) Assist with supra-pubic tap (2) Catheter (3) Diaper/bag b. Insertion & care of straight Foley catheter: (1) Female
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
(2) Male c. Supra-pubic 3. Care of the child with: a. Acute renal failure b. Hemodialysis c. Nephritis d. Nephrotic syndrome e. Peritoneal dialysis f. Post renal transplant Name: DESCRIPTION 1 2 3 4 g. Syndrome inappropriate ADH (SIADH) ENDOCRINE/METABOLIC 1. Assessment of electrolyte balance 2. Equipment & procedures: a. Blood glucose testing type: 3. Care of the child with: a. Diabetic ketoacidosis b. Hyper/hypocalcemia c. Hyperbilirubinemia d. Thyroid dysfunction 4. Medication – Insulin drip INFECTIOUS DISEASES 1. Equipment & procedures a. Assist with lumbar puncture B. Isolation techniques 2. Care of the neonate with: a. Cytomegalovirus (CMV) b. HIV/AIDS c. Septic Shock d. Tuberculosis 3. Interpretation of lab results PHLEBOTOMY/IV THERAPY 1. Equipment & procedures: a. Administration of blood/blood products (1) Packed red blood cells (2) Plasma/albumin (3) Platelets b. Delivery systems: (1) Implantable venous port (2) Percutaneous arterial line (3) Percutaneous venous line (4) PICC (peripherally inserted central
catheters)
c. Drawing blood from central line d. Drawing venous blood e. Hyperalimentation/TPN: (1) Central (2) Peripheral f. Intralipid g. Managing IV Therapy: (1) Discontinuing (2) Dressing & tubing change (3) Site & patency assessment ID #: DESCRIPTION h. Starting IVs 2. Care of the child with: a. Central line/catheter/dressing: (1) Hickman (2) Portacath (3) PICC b. Cutdown c. Percutaneous venous line d. Peripheral line/dressing e. PICC (peripherally inserted central
catheter)
1 2 3 4
f. Umbilical artery line g. Umbilical venous line PAIN MANAGEMENT 1. Assessment of pain level/tolerance 2. Care of the child with: a. Epidural anesthesia/analgesia b. IV Conscious sedation WOUND MANAGEMENT 1. Assessment: a. Skin for impending breakdown b. Stasis ulcers c. Surgical wound healing 2. Equipment & procedures a. Air fluidized, low air loss beds b. Sterile dressing changes c. Wound care/irrigations 3. Care of the child with: a. Burns: (1) First degree (2) Second degree (3) Third degree
3 | Page
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
b. Pressure sores c. Stage Decubitus ulcers d. Surgical wounds with drain(s) e. Traumatic wounds ONCOLOGY 1. Assessment: a. Nutritional status b. Pain control 2. Interpretation of lab results: a. Blood chemistry b. Blood counts Name: DESCRIPTION 3. Equipment & procedures a. Reverse isolation 4. Care of the child with:
b. Disseminated intravascular coagulation (DIC)
reaction
k. Suicidal ideation/attempt 4. Medications: a. Dosage calculations b. Drip calculations c. Knowledge of emergency drug action and
d. Pediatric drug actions & reactions 5. Miscellaneous: a. Interpretation of lab values: (1) Blood Chemistry (2) Blood hematology (3) Blood gases 1 2 3 4 ID #: COMPUTERIZED CHARTING 1. Cerner 2. Eclipsys 3. Epic 4. McKesson 5. Meditech 6. Other: Other: Other: Yes
b. Inpatient chemotherapy c. Inpatient hospice d. Leukemia e. Malignant tumors f. Radiation implant g. Sickle cell anemia 5. Medication: a. Chemotherapy certification? No MISCELLANEOUS 1. Assessment: a. Knowledge of normal growth and
development b. Recognize/report signs of child abuse/neglect
2. Equipment & procedures: a. Application of restraints 3. Care of the child with: a. Anorexia/bulimia b. Blunt trauma c. Complex wound care d. Craniofacial reconstruction e. ENT surgery f. Gunshot/open chest g. Ingestions/overdose h. Multiple trauma i. Near drowning j. Penetrating trauma 4 | Page
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
Name: Please check the boxes below for each age group for which you have expertise in providing age-appropriate nursing care. A. Newborn/Neonatal (birth – 30 days) B. Infant (30 days – 1 year) C. Toddler (1 – 3 years) D. Preschool (3 – 5 years) E. School Age Children (5 – 12 years) F. Adolescent (12 – 18 years) G. Young Adults (18 – 39 years) H. Middles Adults (40 – 64 years) I. Older Adults (64 + years) EXPERIENCE WITH AGE GROUPS: 1. Able to assess age appropriate behavior, motor skills and physiological norms. A B C D E F G H I
MY EXPERIENCE IS PRIMARILY IN: NEUROLOGY PULMONARY SURGICAL MEDICAL CARDIAC CARE TELEMETRY years years years years years years
I HAVE CURRENT CERTIFICATIONS FOR: TYPE DATE (MM/DD/YY) ARRHYTHMIA CRITICAL CARE ACLS BCLS TNCC NRP PALS NALS BTLS CCRN Other Other COURSE
2. Able to adapt care according to normal growth and development. A B C D E F G H I
3. Able to communicate and instruct patient according to their age, maturity and comprehension ability. A B C D E F G H I
The information I have provided in this knowledge and skills checklist it true and accurate to the best of my knowledge. Signature
(Written/Electronic)
Date
ID #: This skills checklist has been reviewed and approved by Nicole Bloxham, RN. Signature
(Written/Electronic)
4. Able to provide a safe environment according to the specific needs of various age groups. A B C D E F G H I
Date
ID #: 5 | Page
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
Please return to: Northwest Nurse Company, PA ATTN: Records Dept. Fax: (866) 352-4338 Staffing
Email: [email protected]
6 | Page
NAME: ID #: DATE: This Skills Checklist is for use by nurses with more than one year experience in their discipline and specialty. Please be accurate with your assessment. DESCRIPTION 1 2 3 4 NEUROLOGICAL: 1. Assessment: a. Intracranial pressure monitoring b. Neurological status 2. Equipment & Procedures: a. Brain death/organ procurement b. Externalized VP Shunt/reservoirs c. Coma d. Encephalitis e. Head Trauma f. Meningitis g. Neuromuscular disease h. Post Neurosurgery i. Spinal Cord Injury j. Status Epilepticus 3. Medication a. Anticonvulsant medication b. Mannitol c. Pavulon PULMONARY 1. Assessment: a. Breath sounds b. Rate and work of breathing 2. Equipment & procedures: a. Airway management (1) Assist with intubation (2) bulb syringe (3) Endotracheal tube
suctioning
b. Apnea monitor c. Chest Tube (assist with) DIRECTIONS: Please indicate your level of experience by placing a check (√) in the box. Experience level: 1 NO EXPERIENCE 2 MINIMAL EXPERIENCE-requires
supervision/assistance
3 4
MODERATELY EXPERIENCED-requires initial review, then performs independently VERY EXPERIENCED- proficient
(4) (5) (6) (7)
Extubation Nasal airway/suctioning Oral airway/suctioning Tracheostomy/suctioning
DESCRIPTION 1 2 3 4 (1) Insertion (2) Removal (3) Set-up d. Obtaining blood gases: (1) Arterial (2) Heelstick (3) Peripheral (4) Pulse oximeter e. O2 therapy & medication delivery: (1) Bag and mask (2) Isolette (3) Nasal cannula (4) Nebulizer (5) Oxyhood (6) Tent (7) Trach collar f. Thoracentesis i. Ventilator care: (1) CPAP/PEEP (2) IMV (3) High frequency jet ventilation (4) Pressure ventilator (5) Weaning 3. Care of the patient with: a. Bronchiolitis (RSV) b. Severe respiratory distress c. Chronic respiratory disease d. Epiglottitis e. Foreign Body aspiration f. Fresh tracheostomy
1 | Page
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
g. Hemothorax h. Croup i. Pneumonia j. Pneumothorax Name: DESCRIPTION 1 2 3 4 k. RDS l. Respiratory failure m. Status asthmaticus 5. Medications: a. Aminophylline (Theophylline) b. Prostaglandin CARDIOVASCULAR 1. Assessment: a. Auscultation (rate, rhythm, volume) b. Blood pressure/invasive (arterial line) d. Heart sounds/murmurs 2. Equipment & procedures: a. EKG interpretation b. Non-invasive cardiac monitoring c. Invasive hemodynamic monitoring (1) Pulmonary artery/capillary wedge (2) Cardiac output/index d. Central venous pressure 3. Care of the child with: a. Cardiac arrest b. Congenital heart disease/defects c. Cardiomyopathy d. Hypovolemic shock e. Myocarditis f. Post cardiac surgery 4. Medications: a. Dobutamine b. Digoxin c. Dopamine d. Epinephrine e. Heparin f. Lidocaine g. Nitroglycerine h. Nipride 2 | Page i. Potassium Chloride e. Sodium bicarbonate ORTHOPEDICS 1. Equipment & Procedures a. Specialized orthopedic bed 2. Care of child with: a. Cervical traction b. Pinned fractures ID #: DESCRIPTION 1 2 3 4 c. Post vertebral surgery GASTROINTESTINAL 1.Assessment: a. Abdominal b. Nutritional 2. Equipment & procedures: a. Abdominal decompression devices b. Feedings: (1) Assist with breast feeding (2) Bottle c. Placement of Intestinal tubes: (1) Gastrostomy/button (2) Jejunal (3) Nasogastric/Orogastric e. Test of occult blood 3. Care of the child with: a. Fresh Ostomy b. Gastroenteritis/severe dehydration c. GI Reflux d. GI Bleeding e. Hepatic failure f. Hepatitis g. Post Abdominal surgery h. Surgical abdomen RENAL/GENITOURINARY 1. Assessment of fluid balance 2. Equipment & Procedures: a. Collection of urine specimens: (1) Assist with supra-pubic tap (2) Catheter (3) Diaper/bag b. Insertion & care of straight Foley catheter: (1) Female
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
(2) Male c. Supra-pubic 3. Care of the child with: a. Acute renal failure b. Hemodialysis c. Nephritis d. Nephrotic syndrome e. Peritoneal dialysis f. Post renal transplant Name: DESCRIPTION 1 2 3 4 g. Syndrome inappropriate ADH (SIADH) ENDOCRINE/METABOLIC 1. Assessment of electrolyte balance 2. Equipment & procedures: a. Blood glucose testing type: 3. Care of the child with: a. Diabetic ketoacidosis b. Hyper/hypocalcemia c. Hyperbilirubinemia d. Thyroid dysfunction 4. Medication – Insulin drip INFECTIOUS DISEASES 1. Equipment & procedures a. Assist with lumbar puncture B. Isolation techniques 2. Care of the neonate with: a. Cytomegalovirus (CMV) b. HIV/AIDS c. Septic Shock d. Tuberculosis 3. Interpretation of lab results PHLEBOTOMY/IV THERAPY 1. Equipment & procedures: a. Administration of blood/blood products (1) Packed red blood cells (2) Plasma/albumin (3) Platelets b. Delivery systems: (1) Implantable venous port (2) Percutaneous arterial line (3) Percutaneous venous line (4) PICC (peripherally inserted central
catheters)
c. Drawing blood from central line d. Drawing venous blood e. Hyperalimentation/TPN: (1) Central (2) Peripheral f. Intralipid g. Managing IV Therapy: (1) Discontinuing (2) Dressing & tubing change (3) Site & patency assessment ID #: DESCRIPTION h. Starting IVs 2. Care of the child with: a. Central line/catheter/dressing: (1) Hickman (2) Portacath (3) PICC b. Cutdown c. Percutaneous venous line d. Peripheral line/dressing e. PICC (peripherally inserted central
catheter)
1 2 3 4
f. Umbilical artery line g. Umbilical venous line PAIN MANAGEMENT 1. Assessment of pain level/tolerance 2. Care of the child with: a. Epidural anesthesia/analgesia b. IV Conscious sedation WOUND MANAGEMENT 1. Assessment: a. Skin for impending breakdown b. Stasis ulcers c. Surgical wound healing 2. Equipment & procedures a. Air fluidized, low air loss beds b. Sterile dressing changes c. Wound care/irrigations 3. Care of the child with: a. Burns: (1) First degree (2) Second degree (3) Third degree
3 | Page
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
b. Pressure sores c. Stage Decubitus ulcers d. Surgical wounds with drain(s) e. Traumatic wounds ONCOLOGY 1. Assessment: a. Nutritional status b. Pain control 2. Interpretation of lab results: a. Blood chemistry b. Blood counts Name: DESCRIPTION 3. Equipment & procedures a. Reverse isolation 4. Care of the child with:
b. Disseminated intravascular coagulation (DIC)
reaction
k. Suicidal ideation/attempt 4. Medications: a. Dosage calculations b. Drip calculations c. Knowledge of emergency drug action and
d. Pediatric drug actions & reactions 5. Miscellaneous: a. Interpretation of lab values: (1) Blood Chemistry (2) Blood hematology (3) Blood gases 1 2 3 4 ID #: COMPUTERIZED CHARTING 1. Cerner 2. Eclipsys 3. Epic 4. McKesson 5. Meditech 6. Other: Other: Other: Yes
b. Inpatient chemotherapy c. Inpatient hospice d. Leukemia e. Malignant tumors f. Radiation implant g. Sickle cell anemia 5. Medication: a. Chemotherapy certification? No MISCELLANEOUS 1. Assessment: a. Knowledge of normal growth and
development b. Recognize/report signs of child abuse/neglect
2. Equipment & procedures: a. Application of restraints 3. Care of the child with: a. Anorexia/bulimia b. Blunt trauma c. Complex wound care d. Craniofacial reconstruction e. ENT surgery f. Gunshot/open chest g. Ingestions/overdose h. Multiple trauma i. Near drowning j. Penetrating trauma 4 | Page
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
Name: Please check the boxes below for each age group for which you have expertise in providing age-appropriate nursing care. A. Newborn/Neonatal (birth – 30 days) B. Infant (30 days – 1 year) C. Toddler (1 – 3 years) D. Preschool (3 – 5 years) E. School Age Children (5 – 12 years) F. Adolescent (12 – 18 years) G. Young Adults (18 – 39 years) H. Middles Adults (40 – 64 years) I. Older Adults (64 + years) EXPERIENCE WITH AGE GROUPS: 1. Able to assess age appropriate behavior, motor skills and physiological norms. A B C D E F G H I
MY EXPERIENCE IS PRIMARILY IN: NEUROLOGY PULMONARY SURGICAL MEDICAL CARDIAC CARE TELEMETRY years years years years years years
I HAVE CURRENT CERTIFICATIONS FOR: TYPE DATE (MM/DD/YY) ARRHYTHMIA CRITICAL CARE ACLS BCLS TNCC NRP PALS NALS BTLS CCRN Other Other COURSE
2. Able to adapt care according to normal growth and development. A B C D E F G H I
3. Able to communicate and instruct patient according to their age, maturity and comprehension ability. A B C D E F G H I
The information I have provided in this knowledge and skills checklist it true and accurate to the best of my knowledge. Signature
(Written/Electronic)
Date
ID #: This skills checklist has been reviewed and approved by Nicole Bloxham, RN. Signature
(Written/Electronic)
4. Able to provide a safe environment according to the specific needs of various age groups. A B C D E F G H I
Date
ID #: 5 | Page
PEDIATRIC INTENSIVE CARE NURSING KNOWLEDGE & SKILLS CHECKLIST
Please return to: Northwest Nurse Company, PA ATTN: Records Dept. Fax: (866) 352-4338 Staffing
Email: [email protected]
6 | Page
