Critical Care Nurse Skills Checklist

Name: __________1_______________________________

Date: ___________________________

In order to provide suitable assignments for you, this checklist is intended as a method of assessing your professionalproficiency. Please rate your skill level as accurately as possible by placing a check ( ) in the appropriate box.

1 =2 =3 =4 =

No experience; Theory/observed onlyIntermittent experience; < 5 times per year; Needs reviewModerate experience; > 5 times per year; May need minimal resourceCompetent; Performs on a daily or weekly basis; ProficientSkill Level1234CardiovascularAssessmentAbnormal heart sounds/murmursAuscultation (rate, rhythm)Blood pressure/non-invasiveDopplerPulses/circulation checksInterpretation of lab resultsCardiac enzymes & isoenzymesCoagulation studiesEquipment usage & procedureIntra aortic balloon pumpHemodynamic monitoringCardiac indexCardiac outputCVP monitoringFemoral artery sheath removalMAPPA/Swan-GanzPCW pressurePVRRadial a-lineSVO2SVRMonitoring12 lead EKG interpretationArrhythmia interpretationRhythm strip assessmentSet up and run 12 lead EKGPacemakerExternalPermenant/TemporaryTransthoracic (epicardial)

Skill Level1234Cardiovascular contAssisting with:Arterial line insertionCentral line insertionOpen chest emergencyPA catheter/Swan-Ganz insertionPericardiocentesisTransesophageal echocardiogramAutomatic internal cardioverter defibCardioversionCAVH-DCare of the patient with:Abdominal aortic aneurysm repairAcute MICardiac arrestCardiac tamponadeCongestive heart failure (CHF)EP study & ablationHeart transplantImmediate post open-heart surgeryInfective endocarditisMyocardial contusionPericarditisPost AICD insertionPost arthrectomy (DCA)Post commissurotomyValve repairValve replacementPost intercoronary stent placementPost percut. balloon valvuloplastyPost rotobladePre/post angioplastyPre/post cardiac catheter

Cardiovascular contMedicationsAmiodarone (Cardarone)AtropineBicarbonateBretylium (Bretylol)Digoxin (Lanoxin)Diltiazem (Cardizem)Dobutamine (Dobutrex)Dopamine (Intropin)Epinephrine (Adrenalin)Esmolol (Brevibloc)Inocor (Amrinone)Lidocaine (Xylocaine)Metoprolol (Lopressor)Nipride (Nitroprusside)Nitroglycerine (Tridil)Procainamide (Pronestyl)Reteplase recombinant (Retavase)StreptokinaseTPA (Alteplase)Verapamil (Calan, Isoptin, Verelan)PulmonaryAssessment: adventitious breath soundsAssessment: rate and work of breathingInterpretation of lab results - blood gasEquipment usage & procedureAir leak troubleshootingMediastinal chest tube removalPleural chest tube removalAirway management devicesEndotracheal tube/suctioningExtubationNasal airway/suctioningOximetrySputum specimen collectionTracheostomy/suctioningAssist with:BronchoscopyChest tube insertionEmergency tracheostomyThoracentesisO2 therapy & med delivery systemsAmbu bag and maskET tubeFace maskNasal cannulaPortable O2 tankTrach collar

Pulmonary contEquipment usage & procedureEstablishing an airwayAssist with intubationOral airway insertionIdentification for respiratory compl.AspirationLaryngospasmTension pneumothoraxUse of Pleurevac drainageUse of Thoraclex drainageUse of water seal drainageVentilator managementExternal CPAPHigh frequency jet ventilationIMVPEEPPressure supportWeaning modes & T-Piece weanCare of the patient with:Acute pneumoniaARDSChest traumaCOPDCor pulmonaleFresh tracheostomyLobectomyLung transplantNear drowningPneumonectomyPulmonary edema/hypertensionPulmonary embolismStatus asthmaticusThoracotomyTuberculosisMedicationsAlupent (metaproterenol)Aminophylline (Theophylline)Bronkosol (Isoetharine hydrochloride)CorticosteroidsVentolin (Albuterol)NeurologicalAssessment:Cranial nervesGlasgow coma scaleLevel of consciousnessPathologic reflexesReflex/motor deficitsVisual or communication deficits

Neurological contEquipment usage & procedureAssist with lumbar punctureHalo traction/cervical tongsIntracranial pressure monitoringNerve stimulatorsRotating bedSeizure precautionsSpinal precautionsStryker frameUse of hyper/hypothermia blanketCare of the patient with:Aneurysm precautionsBasal skull fractureClosed head injuryComaCVADTsEncephalitisExternalized VP shuntsIncreased ICPLaminectomyMeningitisMetastatic tumorIntracranial tumor resectionMultiple sclerosisPost craniotomySpinal cord injuryVentriculostomyMedicationsBarbiturate induced comaDecadron (Dexamethasone)Dilantin (Phenytoin)Epidural administrationPhenobarbitalValium (Diazepam)GastrointestinalAssessment of abdominal/bowel soundsAssessment of nutrional dataInterpretation of lab resultsSerum ammoniaSerum amylaseLFTsEquipment usage & procedureAdministration of tube feedingBalloon tamponadeFeeding pumpFlexible feeding tubeGravity feeding

Gastrointestinal contEquipment usage & procedureIced saline lavageManagement of gastrostomy tubeManagement of jejunostomy tubeManagement of T-tubeManagement of TPN and lipids adminManagement of PPNPlacement of nasogastric tubeSalem sump to suctionCare of the patient with:Blunt traumaBowel obstructionColostomyERCPEsophageal bleedingGI bleedingGI surgeryHepatitisIleostomyInflammatory bowel diseaseLiver failureLiver transplantPancreatitisParalytic ileusPenetrating traumaMedicationsAqualMephyton (Vitamin K)Inderal (Propranolol)KayexelateLactulose (Cephulac)Pitressin (Vasopressin)Renal / GenitourinaryAssessment of A-V fisulaAssessment of A-V shuntAssessment of fluid statusInterpretation of lab resultsBUNCreatinineSerum electrolytesEquipment usage & procedureBladder irrigationInsertion & care of:Straight catheterFoley catheter3-way FoleyFemaleMaleSupra-pubic

Renal / Genitourinary contCare of the patient with:Acute renal failureCAVH dialysisHemodialysisNephrectomyPeritoneal dialysisRenal rejection syndromeRenal transplantTURPUrinary diversionUrinary tract infectionEndocrine / MetabolicInterpretation of lab resultsBlood glucoseThyroid studiesEquipment usage & procedureBlood glucose measuring devicesBlood glucose monitoringPerforming finger stickCare of the patient with:Diabetes mellitusDiabetic ketoacidosisDisorders of adrenal glandDisorders of pituitary glandDrug overdoseHyperthyroidism (Grave's disease)HypothyroidismInsulin shockThyroidectomyMedication - Insulin pumpWound ManagementAssessment of:Skin for impending breakdownStasis ulcersSurgical wound healingEquipment usage & procedureAir fluidized, low air loss bedsSterile dressing changesWound care/irrigationsCare of the patient with:Burns/pressure soresStaged decubitus ulcersSurgical wounds with drains(s)Traumatic woundsThe preceding information I have checked is true and correct.

Signature:P.A. Form AKO006.3

Phlebotomy / IV TherapyEquipment usage & procedureAdministration of blood & productsCryoprecipitatePacked red blood cellsPlasma/albuminWhole bloodDrawing blood from central lineDrawing venous bloodStarting IVsAngiocathButterflyHeparin lockCare of the patient with:Central line/catheter/dressingBroviacGroshongHickmanPortacathQuintonPeripheral line/dressingPain ManagementAssessment of pain level/toleranceCare of the patient with:Epidural anesthesia/analgesiaIV conscious sedationPatient controlled analgesiaMiscellaneousCare of the patient with:Anaphylactic shockDICHypovolemic shockMulti-system organ failureOrgan/tissue donationSeptic shockAge Specific Practice CriteriaNewborn/Neonate (birth - 30 days)Infant (30 days - 1 year)Toddler (1 - 3 years)Preschooler (3 - 5 years)School age children ( 5 -12 years)Adolescents (12 - 18 years)Young adults (18 - 39 years)Middle adults (39 - 64 years)Older adults (64+ years)

Date:

Rev 11/02