NICU 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
PATIENT TYPES
Neonates < 28 Weeks
0
Neonates 29 - 34 Weeks
0
Neonates > 34 Weeks
0
WORK SETTINGS
Level II NICU
0
Level III NICU
0
Level IV NICU
0
CARDIOVASCULAR
Cardiac Surgery - Pre-op
0
Cardiac Surgery - Immediate Post-op
0
Congenital Heart Disease/Defects
0
CHF/Pulmonary Edema
0
Hemodynamic Instability
0
PULMONARY
Bronchopulmonary Dysplasia
0
Diaphragmatic Hernia
0
Fresh Tracheostomy
0
Meconium Aspiration
0
Persistent Pulmonary Hypertension
0
Pneumonia
0
Respiratory Distress Syndrome/Failure
0
Interpretation of ABGs
0
Assist with Intubation/Extubation
0
Endotracheal Suctioning
0
Chest Tube Placement and Management
0
Modes of Ventilation (AC/PC/SIMV/CPAP/BiPAP)
0
High Frequency Ventilation
0
Inhaled NO
0
ECMO
0
NEUROLOGIC
Ballard/Dubowitz
0
Reflexes Based on Gestational Age
0
Hydrocephalus
0
Intraventricular Hemorrhage
0
Meningocele/Myelomeningocele
0
Neonatal Abstinence Score/Syndrome
0
Seizures
0
GASTROINTESTINAL
Colostomy/Ileostomy
0
Gastroschisis/Omphalocele
0
GI Bleeding
0
Necrotizing Enterocolitis
0
Post Abdominal Procedure
0
FEEDINGS
Breast Milk Handling/Storage
0
Breast Pump
0
Gavage Feedings
0
NG/OG/NJ Tube Placement and Management
0
RENAL/ENDOCRINE/GENETIC
Circumcision Care
0
Genetic Disorders
0
Hypo/Hyperglycemia
0
Infant of Diabetic Mother
0
Malformations of the GU Tract/Kidney
0
Phototherapy
0
Renal Failure
0
INFECTIOUS DISEASES
Neonatal Sepsis
0
Septic Work Up
0
Assist with Lumbar Puncture
0
MEDICATIONS
Calculation of Neonatal Dosages
0
Antibiotics/Antivirals
0
Anticonvulsants
0
Immunizations
0
Digoxin
0
IV Vasopressors
0
Prostaglandin
0
Bronchodilators
0
Steroids
0
Caffeine
0
Surfactant
0
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
0
IV THERAPY
Administration of Blood/Blood Products
0
Central Line Catheter/Dressings
0
Management of UAC/UVC Lines
0
Radial Arterial Lines
0
Start IVs
0
CARDIAC MONITORING & EMERG. RESPONSE
Attend High Risk Deliveries
0
Preparation for Transport
0
Transport Neonate
0
Rhythm Interpretation
0
Dysrhythmia Management
0
PROFESSIONAL KNOWLEDGE AND SKILLS
National Patient Safety Goals/Core Measures
0
Bereavement/Postmortem Care
0
Neonatal Skin Care
0
Pressure Ulcer Risk Assessment/Prevention
0
Restraints/Use of Least Restrictive Device
0
Patient/Family Teaching
0
Age Specific/Population-Based Care
0
Isolation Precautions
0
Infection Prevention
0
Pain Assessment & Management
0
Charge Experience
0
Interpretation and Communication of Lab Values
0
EMR
Epic
0
Cerner
0
Eclipsys
0
McKesson
0
Meditech
0
Other Computerized System
0
Computerized Physician Order Entry
0
Bar Coding for Medication Administration
0
EMR Conversion
Certifications

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  • care@selectsourceintl.com
  • Phone: +1-952-546-3300
  • Fax: +1-952-546-3500
  • 13911 Ridgedale Drive, Suite 230
    Minnetonka, Minnesota 55305, United States

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