Critical Care Skills Checklist

Fill Out and Submit your Skills Checklist
Skills Checklist
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:
1No Experience
2Need Training
3Able to perform with supervisione
4Able to perform independently
General Skills
Advanced directives
0
Patient/family teaching
0
Restrictive devices (restraints)
0
Lift/transfer devices
0
Specialty beds
0
End of life care/palliative care
0
Wound assessment & care
0
Automated Medication Dispensing System, Pyxis, Omnicell, or other
0
Bar coding for medication administration
0
Blood Glucose Monitor (BGM)
0
Cardioversion/defibrillation
0
Electronic ICU
0
National Patient Safety Goals
0
Accurate patient identification
0
Effective communication
0
Interpretation & communication of lab values
0
Medication administration
0
Medication reconciliation
0
Labeling (medications & specimens)
0
Anticoagulation therapy
0
Monitoring conscious sedation
0
Pain assessment & management
0
Infection control
0
Universal precautions
0
Isolation
0
Minimize risk for falls
0
Prevention of pressure ulcers
0
Use of rapid response teams
0
Awareness of HCAHPS
0
Cardiovascular
Assessment of heart sounds
0
Interpretation of arrhythmias
0
Performing 12 lead EKG’s
0
Interpretation of 12 lead EKG
0
Interpretation of hemodynamic monitoring
0
Assist with Insertion & Management of:
CVC (Central Venous Catheter)
0
Arterial line
0
Swanz Ganz catheter
0
Flow trac or Vigileo monitoring caths
0
Intra-Aortic Balloon Pump (IABP)
0
Ventricular Assist Device (LVAD, RVAD)
0
Maintenance & Management of:
Permanent pacemakers
0
Implantable Cardioverter Defibrillator (ICD)
0
External pacemakers
0
Epicardial pacemaker wires
0
Discontinuing venous/arterial sheaths
0
Femostop/vasoseal
0
Care of Patients with:
Acute myocardial infarction
0
Pre/post: cardiac catheterization
0
Congestive heart failure
0
Cardiomyopathy
0
Dysrhythmias/conduction disturbances
0
Aortic aneurysm
0
Thoracic/abdominal surgery
0
Endoluminal graft
0
Cardiogenic shock
0
Hypertensive crisis
0
Pericarditis/endocarditis
0
MAZE procedure
0
Post open heart (CABG/valve)
0
Cardiac contusion/trauma
0
Heart transplant
0
Cardiac tamponade
0
Medication Administration:
ACLS medications and protocols
0
Antidysrythmics
0
Antihypertensives
0
Vasoactive/vasopressor agents
0
Anesthetics (propofol/presedex)
0
Thrombolytics (retavase/activase)
0
Platelet inhibitors (ReoPro/Integrilin/Aggrastat)
0
Flolan for pulmonary hypertension
0
Pulmonary
Assessment of breath sounds
0
Airway Management, Care & Maintenance of:
Oral/NT/ET airway
0
Tracheostomy
0
Arterial blood gas analysis/interpretation
0
Obtaining ABG blood sample/arterial line
0
Pulse oximetry
0
Ventilator Management:
BiPAP (Bi-level Positive Airway Pressure)
0
Oscillation/high-frequency ventilation
0
Nitric
0
Interpretation of weaning parameters
0
Maintenance & management of pleural chest tubes
0
Care of Patient with:
Acute respiratory failure
0
Adult Respiratory Distress Syndrome (ARDS)
0
Sudden Inflammation Respiratory Syndrome (SIRS)
0
Inhalation injuries
0
Pneumonia
0
Pulmonary edema
0
Near drowning
0
Chronic Obstructive Pulmonary Disease (COPD)
0
Pre/post thoracic surgery
0
Pulmonary embolism
0
Pulmonary/chest trauma
0
Pulmonary hypertension
0
Status asthmaticus
0
Medication Administration:
Rapid sequence intubation drugs/protocols
0
Nebulizer treatments: Ventolin, Atrovent
0
Neurology
Intracranial/Cerebral Perfusion Pressure Monitoring (ICP/CPP) via:
Care of Patients with:
Medication Administration:
Trauma & Burns
Burns: Calculation of Total Body Surface Area (BSA):
Gastrointestinal
Care of Patients with:
Medication Administration:
Renal
Care of Patients with:
Endocrine
Intravenous Management
Tele-ICU (ICU-E)
Other
Age Specific Competencies
Please list any Additional Skills