ICU RN | Ikajuq Care

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Electronic Documentation

Allscripts

eCLinicalWorks

McKesson

Soarian

Care360

EPIC

Meditech

N/A

Cerner

MACLAB

PACS

Intensive Care Unit RN Skills Checklist

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only

1 = Limited Experience / Rarely Done (<6 times/year)

2 = May Need Some Review / Occasionally Done (1 - 2 times/month)

3 = Experienced / Frequently Done (daily or weekly)

TYPE OF FACILITY EXPERIENCE

Acute Hospital Level 1

Acute Hospital Level 2

Acute Hospital Level 3

CAH (Critical Access Hospital)

Unknown or No Trauma Designation

Long-Term Acute Care (LTAC)

Rehab

Skilled Nursing Facility (SNF)

TYPES OF ICU EXPERIENCE

ICU (General ICU)

1

2

3

MICU (Medical Intensive Care Unit)

1

2

3

SICU (Surgical Intensive Care Unit)

1

2

3

CCU (Cardiac Care Unit)

1

2

3

CVICU (Cardiovascular Intensive Care Unit)

1

2

3

TICU (Trauma Intensive Care Unit)

1

2

3

Neurosurgical ICU

1

2

3

Burn ICU

1

2

3

AGE OF PATIENTS CARED FOR

Newborn/Neonate (birth to 30 days)

1

2

3

Infant (31 days to 12 months)

1

2

3

Toddler/Preschool (13 months to 5 years)

1

2

3

School Age Child/adolescent (6 years to 18 years)

1

2

3

Young Adults/Middle Adult (19 years to 64 years)

1

2

3

Older Adults/Elderly (65+ years)

1

2

3

Automated Med Dispensing Systems

Accudose

Metro

Omnicell

Promanager Rx

Pyxis

N/A

Other Automated Med Dispensing Systems:

GENERAL SKILLS

Care of Patient in Restraints

1

2

3

Peripheral IV Insertion, Care and Maintenance

1

2

3

Access/Management of Implanted Ports

1

2

3

Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, etc.)

1

2

3

Cardiac Monitoring/Interpretation

1

2

3

PCA/Epidural pumps

1

2

3

Titration of drips

1

2

3

Administration of Blood/Blood Products

1

2

3

Knowledge of "Do Not Use Abbreviations"

1

2

3

Do you have charge/supervisor experience?

Yes

No

Knowledge of current Joint Commission National Patient Safety Goals

1

2

3

Knowledge/familiarity with HCAHPS scores

1

2

3

MEDICATION ADMINISTRATION

Moderate/Conscious Sedation

1

2

3

Sedation Reversal Agents

1

2

3

Antibiotics IM/IV

1

2

3

Antiemetics

1

2

3

Adenosine

1

2

3

Aminophylline(Theophylline)

1

2

3

Atropine

1

2

3

Anticoagulants

1

2

3

Anticonvulsants

1

2

3

Barbituate Induced Coma

1

2

3

Charcoal

1

2

3

Cardizem

1

2

3

Cordarone

1

2

3

Dopamine

1

2

3

Diuretics

1

2

3

Epinephrine

1

2

3

Heparin Drip protocol

1

2

3

Inotropes (Digoxin,Dobutamine,Primacor)

1

2

3

Inocor

1

2

3

Insulin Infusions

1

2

3

Intrathecal Medication

1

2

3

Isuprel

1

2

3

Kayexelate

1

2

3

Lidocaine

1

2

3

Mannitol

1

2

3

Nitroglycerin

1

2

3

Nipride

1

2

3

Steroids

1

2

3

Thrombolytic Therapy

1

2

3

Vasopressin

1

2

3

Ventolin (Albuterol)

1

2

3

CARDIOVASCULAR

Care of the Patient With:

Adult ECMO

1

2

3

Continuous Cardiac Monitoring

1

2

3

Femoral-Arterial Sheath/Removal

1

2

3

Intra Aortic Balloon Pump

1

2

3

Abdominal Aortic Aneurysm/Bypass

1

2

3

Acute MI

1

2

3

Angioplasty

1

2

3

Bacterial Endocarditis

1

2

3

Pericarditis

1

2

3

Carotid Endarterectomy

1

2

3

Fem-Pop Bypass

1

2

3

Cardiac Arrest

1

2

3

CHF

1

2

3

Fresh Open Heart Surgery

1

2

3

Open Heart Surgery ( more than 6 hrs. post-op)

1

2

3

Heart Transplant

1

2

3

Myocardial Contusion

1

2

3

Mediastinal Tube

1

2

3

Vascular Surgeries

1

2

3

Cardiac Tamponade

1

2

3

EP Study and Ablation

1

2

3

POST Pacemaker/AICD Insertion

1

2

3

Pre/Post Cardiac Cath

1

2

3

Post Artherectomy (DCA)

1

2

3

Hyperthermia Blanket

1

2

3

Hypothermia protocol (post arrest)

1

2

3

Shock:

Anaphylactic

1

2

3

Cardiogenic

1

2

3

Hypovolemic

1

2

3

Neurogenic

1

2

3

Septic

1

2

3

Pacemaker:

External

1

2

3

Permanent

1

2

3

Temporary

1

2

3

Transthoracic

1

2

3

Ventricular Assist Device (RVAD,LVAD, BIVAD)

1

2

3

Hemodynamic Monitoring:

Set up, use and Interpreation of Reading of CVP

1

2

3

Set up, use and Interpretation of Reading of PA/Swan-Ganz

1

2

3

Transducer Setup and Monitoring

1

2

3

Cardiac Output

1

2

3

Cardiac Index

1

2

3

Wedge Pressures

1

2

3

SVO2

1

2

3

Set up and use of Arterial Line

1

2

3

PULMONARY

Care of the Patient With:

Ventilator/Weaning

Bear

Bennett 7200

CPAP

Emerson

EMV

Engstrom/Erica

MA-I

MA-II

Monihan

Ohio 560

Other

PEEP

Pressure Pre-set

Servo

Siemens

N/A

Other Ventilator/Weaning:

CPAP/BIPAP

1

2

3

Asphyxiation (Near Drowning)

1

2

3

Oral Airway

1

2

3

Endotracheal Tube

1

2

3

Laryngeal Spasm

1

2

3

Tracheostomy

1

2

3

Lung Transplant

1

2

3

Epistaxis

1

2

3

Aspiration

1

2

3

ARDS

1

2

3

COPD

1

2

3

Lobectomy

1

2

3

Pneumonectomy

1

2

3

Pneumothorax/Tension Pneumothorax

1

2

3

Hemothorax

1

2

3

Pneumonia

1

2

3

Assist with Emergency Tracheostomy

1

2

3

Thoracentesis

1

2

3

Inhalation Injuries

1

2

3

Pulmonary Edema

1

2

3

Pulmonary Embolism

1

2

3

Status Asthmaticus

1

2

3

Tuberculosis

1

2

3

Chest Tube (pleurevac/Thoraclex)

1

2

3

Assist with Intubation

1

2

3

Assist with Extubation

1

2

3

Assist with Chest Tube Insertion

1

2

3

ABG Interpretation

1

2

3

NEUROLOGICAL

Intracranial Pressure Monitoring

1

2

3

Ventriculostomy Drain

1

2

3

Increased ICP

1

2

3

Closed Head Injuries

1

2

3

Heat Exhaustion

1

2

3

Multiple Sclerosis

1

2

3

Psychiatric Disorders

1

2

3

Aneurysm Precautions

1

2

3

Basal Skull Fracture

1

2

3

Coma

1

2

3

CVA

1

2

3

Encephalitis

1

2

3

Craniotomy

1

2

3

Delirium Tremors

1

2

3

Meningitis

1

2

3

Seizures

1

2

3

Status Epilepticus

1

2

3

Spinal Cord Injury

1

2

3

Halo Traction/Cervical Tongs

1

2

3

Intracranial Tumor Resection

1

2

3

Cranial Nerve Assessment

1

2

3

Reflex/Motor Deficits

1

2

3

Assist with Lumbar Puncture

1

2

3

Stryker Frame

1

2

3

Overdose

1

2

3

ORTHOPEDICS

Multiple Long Bone Fractures

1

2

3

Pelvic Fracture

1

2

3

Open Book Pelvic Fracture

1

2

3

Fracture/Dislocation

1

2

3

Traumatic Amputation

1

2

3

Osteoporosis

1

2

3

Pined Fractures

1

2

3

Total Joint Replacements

1

2

3

Brace/Splint Application

1

2

3

Fractured Ribs/Sternum

1

2

3

Traction Devices

1

2

3

GASTROINTESTINAL

Gastric Lavage

1

2

3

Gastrostomy Tube

1

2

3

Nasogastric Tube

1

2

3

Salem Sump

1

2

3

PEG Tube

1

2

3

Acute Cholecystitis

1

2

3

Bowel Obstruction

1

2

3

Cirrhosis

1

2

3

GI Bleed

1

2

3

Paralytic Ileus

1

2

3

Salem Sump

1

2

3

PEG Tube

1

2

3

Acute Cholecystitis

1

2

3

Bowel Obstruction

1

2

3

Cirrhosis

1

2

3

GI Bleed

1

2

3

Paralytic Ileus

1

2

3

GI Surgery

1

2

3

Pancreatitis

1

2

3

Liver Failure

1

2

3

Liver Transplant

1

2

3

Acute Abdominal Pain

1

2

3

Penetrating Abdominal Trauma

1

2

3

Ostomies

1

2

3

Esophageal Bleeding

1

2

3

Whipple

1

2

3

RENAL/GENITOURINARY

AV Fistula

1

2

3

Suprapubic Catheter

1

2

3

Hemodialysis

1

2

3

Peritoneal Dialysis

1

2

3

Nephrostomy Tube

1

2

3

Peritoneal Lavage

1

2

3

Acute Renal Failure

1

2

3

Renal Transplant

1

2

3

Renal Rejection Syndrome

1

2

3

Nephrectomy

1

2

3

TURP

1

2

3

Bladder Irrigation

1

2

3

CRRT (continuous Renal Replacement Therapy)

1

2

3

ENDOCRINE/METABOLIC

Adrenal Disorders (Addison's Disease)

1

2

3

Diabetic Ketoacidosis

1

2

3

Diabetes Mellitus

1

2

3

Insulin Shock

1

2

3

Hypothyroidism

1

2

3

Hyperthyroidism (Graves Disease)

1

2

3

Pituitary Disorders

1

2

3

Thyroidectomy

1

2

3

INFECTIOUS DISEASE

Hepatitis

1

2

3

HIV

1

2

3

MRSA ( Methicillin Resistant Staphylococcus)

1

2

3

VRE ( Vancomycin Resistant Enterococci)

1

2

3

CRE ( Carbapenem Resistant Enterobacteriaceae)

1

2

3

C Difficile

1

2

3

Tuberculosis

1

2

3

Isolation Precautions/Procedures

1

2

3

ONCOLOGY

Chemotherapy

1

2

3

Bone Marrow Transplants

1

2

3

Leukemia

1

2

3

Lymphoma

1

2

3

Radiation Implants

1

2

3

WOUND MANAGEMENT

Multiple Abdominal Wounds and Drains

1

2

3

Gunshot Wound

1

2

3

Stab Wound

1

2

3

Lacerations

1

2

3

Hazardous Material Exposure

1

2

3

Radiation Exposure

1

2

3

Stasis Ulcers

1

2

3

Surgical Wound Healing

1

2

3

Traumatic Wounds

1

2

3

Multi System Organ Failure

1

2

3

DIC

1

2

3

Organ/Tissue Donation

1

2

3

Burns:

First Degree

1

2

3

Second Degree

1

2

3

Third Degree

1

2

3

Rule of Nines

1

2

3

Fluid Resuscitation Burn Formula

1

2

3

Electrical Burns

1

2

3

CARDIAC MONITORS

Hewlett-Packard

1

2

3

Spacelab

1

2

3

Siemens

1

2

3

Marquette

1

2

3

Mennen

1

2

3

Nihon-Koder

1

2

3

Other Cardiac Monitors Please List:

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