Pediatric Intensive Skills Checklist

This profile is for use by Pediatric Intensive nurses with more than one year's experience in their discipline and specialty.

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Please indicate your level of experience
A. Theory, no practice C. One - two years experience
B. Intermittent experience D. Two plus years experience

A. CARDIOVASCULAR
  1. Assessment
    a. Auscultation (rate, rhythm, volume) A B C D
    b. Blood pressure/invasive (arterial line) A B C D
    c. Heart sounds/murmurs A B C D
    d. Perfusion A B C D
  2. Equipment & procedures
    a. Central venous pressure A B C D
    b. Non-invasive cardiac monitoring A B C D
    c. EKG interpretation A B C D
    d. Invasive hemodynamic monitoring
      (1) Pulmonary artery/capillary wedge A B C D
      (2) Right atrial/left atrial A B C D
  3. Care of the child with:
    a. Bacterial endocarditis A B C D
    b. Cardiac arrest A B C D
    c. Cardiac transplant A B C D
    d. Cardiogenic shock A B C D
    e. Cardiomyopathy A B C D
    f. Congenital heart disease/defects A B C D
    g. Hypovolemic shock A B C D
    h. Myocarditis A B C D
    i. Post cardiac surgery A B C D
    j. Post interventional cardiac cath A B C D
  4. Medication
    a. Dobutamine (Dobutrex) A B C D
    b. Dopamine (Intropin) A B C D
    c. Epinephrine (Adrenalin) A B C D
    d. Nipride (Nitroprusside) A B C D
    e. Nitroglycerine (Tridil) A B C D
    f. Sodium bicarbonate A B C D

B. PULMONARY
  1. Assessment
    a. Breath sounds A B C D
    b. Rate and work of breathing A B C D
  2. Interpretation of lab results
    a. Blood gases A B C D
    b. X-ray reports A B C D
  3. Equipment & procedures
    a. Airway management  
      (1) Assist with intubation A B C D
      (2) Bulb syringe A B C D
      (3) Endotracheal tube suctioning  
        (a) In-line suction A B C D
        (b) Open ET catheter suction A B C D
      (4) Extubation A B C D
      (5) Nasal airway/suctioning A B C D
      (6) Oral airway/suctioning A B C D
      (7) Tracheostomy/suctioning A B C D
    b. Apnea monitor A B C D
    c. Chest physiotherapy A B C D
    d. Chest tube (assist with)
      (1) Insertion A B C D
      (2) Removal A B C D
      (3) Set-up A B C D
    e. (ECMO (extracorporeal membrane oxygenation) A B C D
    f. End tidal CO2 A B C D
    g. Obtaining blood gases
      (1) Arterial A B C D
      (2) Heelstick A B C D
      (3) Peripheral A B C D
    h. Oximeter A B C D
    i. O2 therapy & medication delivery
      (1) Bag (anesthesia) & mask A B C D
      (2) Bag (self-inflating) & mask A B C D
      (3) Isolette A B C D
      (4) Nasal cannula A B C D
      (5) Nebulizer A B C D
      (6) Oxyhood A B C D
      (7) Tent A B C D
      (8) Trach collar A B C D
    j. Thoracentesis A B C D
    k. Ventilator care
      (1) CPAP/PEEP A B C D
      (2) High frequency jet ventilator A B C D
      (3) Home ventilator A B C D
      (4) IMV A B C D
      (5) Pressure ventilator A B C D
      (6) Volume ventilator A B C D
      (7) Weaning A B C D
  4. Care of the child with:
    a. Bronchiolitis (RSV) A B C D
    b. Chronic respiratory disease A B C D
    c. Epiglottitis A B C D
    d. Flail chest A B C D
    e. Foreign body aspiration A B C D
    f. Fresh tracheostomy A B C D
    g. Hemothorax A B C D
    h. LTB/croup A B C D
    i. Pneumonia A B C D
    j. Pneumothorax A B C D
    k. RDS A B C D
    l. Respiratory failure A B C D
    m. Severe respiratory distress A B C D
    n. Status asthmaticus A B C D
  5. Medications  
    a. Aminophylline (Theophylline) A B C D
    b. Prostaglandin A B C D

C. NEUROLOGICAL
  1. Assessment - Neurological status A B C D
  2. Equipment & procedures
    a. Intracranial pressure monitoring A B C D
  3. Care of the child with:
    a. Brain death/organ procurement A B C D
    b. Coma A B C D
    c. Encephalitis A B C D
    d. Externalized VP shunt/reservoirs A B C D
    e. Head trauma A B C D
    f. Meningitis A B C D
    g. Neuromuscular disease A B C D
    h. Post neurosurgery A B C D
    i. Spinal cord injury A B C D
    j. Status epilepticus A B C D
  4. Medication - Anticonvulsant medication A B C D

D. ORTHOPEDICS
  1. Equipment & procedures  
    a. Specialized orthopedic bed A B C D
  2. Care of the child with:
    a. Cervical traction A B C D
    b. Pinned fractures A B C D
    c. Post vertebral surgery A B C D

E. GASTROINTESTINAL
  1. Assessment  
    a. Abdominal A B C D
    b. Nutritional A B C D
  2. Equipment & procedures
    a. Abdominal decompression devices A B C D
    b. Feedings  
      (1) Assist with breast feeding A B C D
      (2) Bottle A B C D
      (3) Breast milk handling/storage A B C D
      (4) Gavage A B C D
    c. Placement of intestinal tubes
      (1) Gastrostomy/button A B C D
      (2) Jejunal A B C D
      (3) Nasogastric/orogastric A B C D
    d. Test for occult blood A B C D
  3. Care of the child with:
    a. Fresh ostomy A B C D
    b. Gastroenteritis/severe dehydration A B C D
    c. GE reflux A B C D
    d. GI bleeding A B C D
    e. Hepatic failure A B C D
    f. Hepatitis A B C D
    g. Necrotizing enterocolitis (NEC) A B C D
    h. Pancreatitis A B C D
    i. Post abdominal surgery A B C D
    j. Stress ulcer A B C D
    k. Surgical abdomen A B C D

F. RENAL/GENITOURINARY
  1. Assessment of fluid balance A B C D
  2. Interpretation of lab results
    a. Test urine and interpret  
      (1) Glucose A B C D
      (2) Labstix A B C D
      (3) Occult blood A B C D
      (4) pH A B C D
      (5) Specific gravity A B C D
  3. Equipment & procedures
    a. Collection of urine specimens
      (1) Assist with supra-pubic tap A B C D
      (2) Catheter A B C D
      (3) Diaper/bag A B C D
    b. Insertion & care of straight and Foley catheter
      (1) Female A B C D
      (2) Male A B C D
    c. Supra-pubic A B C D
  4. Care of the child with:
    a. Acute renal failure A B C D
    b. CAVH A B C D
    c. Diabetes insipidus (DI) A B C D
    d. Hemodialysis A B C D
    e. Hemolytic uremic syndrome (HUS) A B C D
    f. Nephritis A B C D
    g. Nephrotic syndrome A B C D
    h. Peritoneal dialysis A B C D
    i. Post renal trasplant A B C D
    j. Syndrome inappropriate ADH (SIADH) A B C D

G. ENDOCRINE/METABOLIC
  1. Assessment of electrolyte balance A B C D
  2. Equipment & procedures
    a. Blood glucose testing - type
  3. Care of the child with:
    a. Diabetic ketoacidosis A B C D
    b. Hyper/hypocalcemia A B C D
    c. Hyperbilirubinemia A B C D
    d. Thyroid dysfunction A B C D
  4. Medication - Insulin A B C D

H. WOUND MANAGEMENT
  1. Assessment  
    a. Skin for impending breakdown A B C D
    b. Stasis ulcers A B C D
    c. Surgical wound healing A B C D
  2. Equipment & procedures
    a. Air fluidized, low airloss beds A B C D
    b. Sterile dressing changes A B C D
    c. Wound care/irrigations A B C D
  3. Care of the child with:
    a. Burns  
      (1) First degree A B C D
      (2) Second degree A B C D
      (3) Third degree A B C D
    b. Pressure sores A B C D
    c. Staged decubitus ulcers A B C D
    d. Surgical wounds with drain(s) A B C D
    e. Traumatic wounds A B C D

I. ONCOLOGY
  1. Assessment  
    a. Nutritional status A B C D
    b. Pain control A B C D
  2. Interpretation of lab results
    a. Blood chemistry A B C D
    b. Blood counts A B C D
  3. Equipment & procedures
    a. Reverse isolation A B C D
  4. Care of the child with:
    a. Acute tumor lysis syndrome A B C D
    b. Bone marrow transplant A B C D
    c. Disseminated intravascular coagulation (DIC) A B C D
    d. Fresh oncologic surgery A B C D
    e. Inpatient chemotherapy A B C D
    f. Inpatient hospice A B C D
    g. Leukemia A B C D
    h. Malignant tumors A B C D
    i. Radiation implant A B C D
    j. Sickle cell anemia A B C D
  5. Medication
    a. Chemotherapy certification? Yes No

J. INFECTIOUS DISEASES
  1. Interpretation of lab results  
    a. CBC/differential A B C D
    b. Culture reports A B C D
  2. Equipment & procedures
    a. Assist with lumbar puncture A B C D
    b. Collect culture specimens A B C D
    c. Isolation techniques A B C D
  3. Care of the child with:
    a. Cytomegalo virus (CMV) A B C D
    b. HIV/AIDS A B C D
    c. Septic shock A B C D
    d. Tuberculosis A B C D

K. PHLEBOTOMY/IV THERAPY
  1. Interpretation of lab results A B C D
  2. Equipment & procedures
    a. Administration of blood/blood products  
      (1) Cryoprecipitate A B C D
      (2) Packed red blood cells A B C D
      (3) Plasma/albumin A B C D
      (4) Whole blood A B C D
    b. Delivery methods
      (1) Implantable venous port A B C D
      (2) Percutaneous arterial line A B C D
      (3) Percutaneous venous line A B C D
      (4) PICC (peripherally inserted central catheters) A B C D
    c. Drawing blood from central line A B C D
    d. Drawing venous blood A B C D
    e. Hyperalimentation/TPN
      (1) Central A B C D
      (2) Peripheral A B C D
    f. Intralipid A B C D
    g. Managing IV Therapy
      (1) Discontinuing A B C D
      (2) Dressing & tubing change A B C D
      (3) Site & patency assessment A B C D
    h. Starting IVs  
      (1) Angiocath A B C D
      (2) Butterfly A B C D
      (3) Heparin lock A B C D
  3. Care of the child with:
    a. Central line/catheter/dressing
      (1) Broviac A B C D
      (2) Groshong A B C D
      (3) Hickman A B C D
      (4) Portacath A B C D
      (5) Quinton A B C D
    b. Cutdown A B C D

L. PAIN MANAGEMENT
  1. Assessment of pain level/tolerance A B C D
  2. Care of the child with:  
    a. Epidural anesthesia/analgesia A B C D
    b. IV conscious sedation A B C D

M. MISCELLANEOUS
  1. Assessment  
    a. Knowledge of normal growth and development A B C D
    b. Recognize/report signs of child abuse/neglect A B C D
  2. Equipment & procedures
    a. Application of restraints A B C D
  3. Care of the child with:
    a. Anorexia/bulimia A B C D
    b. Blunt trauma A B C D
    c. Complex wound care A B C D
    d. Craniofacial reconstruction A B C D
    e. ENT surgery A B C D
    f. Gun shot/open chest A B C D
    g. Ingestions/overdose A B C D
    h. Kawasaki disease A B C D
    i. Multiple trauma A B C D
    j. Near drowning A B C D
    k. Penetrating trauma A B C D
    l. Suicidal ideation/attempt A B C D
  4. Medications
    a. Calculation of drugs delivered by continuous infusion A B C D
    b. Dosage calculations A B C D
    c. Knowledge of delivery methods  
      (1) Eye/ear installations A B C D
      (2) Intramuscular injections (IM) A B C D
      (3) Intravenous medications (IV) A B C D
      (4) Metered dose inhaler A B C D
      (5) Subcutaneous (SQ) injections A B C D
      (6) Z trach A B C D
    d. Knowledge of emergency drug action and reaction A B C D
    e. Pediatric drug actions & reactions A B C D

AGE SPECIFIC PRACTICE CRITERIA
Please check the boxes below for each age group for which you have expertise in providing age-appropriate nursing care.

A. Newborn/Neonate (birth - 30 days)
F. Adolescents (12 - 18 years)
B. Infant (30 days - 1 year)
C. Toddler (1 - 3 years)
D. Preschooler (3 - 5 years)
E. School age children (5 - 12 years)  


EXPERIENCE WITH AGE GROUPS: A B C D E F
Able to adapt care to incorporate normal growth and development.
Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level.
Can ensure a safe environment reflecting specific needs of various age groups.


My experience is primarily in: (Please indicate number of years.)
Pediatric Intensive Care year(s)
Pediatric Stepdown year(s)
General Pediatric year(s)

Certification: (mo/day/yr)
BCLS Exp. date:      
NRP Exp. date:      
PALS Exp. date:      
ACLS Exp. date:      
Other (type): Exp. date:
Computerized charting system:
Medication administration system:
 

The information I have given is true and accurate to the best of my knowledge. I hereby authorize Berean Healthcare Staffing to release this Pediatric Intensive Skills Checklist to Client facilities of Berean Healthcare Staffing in relation to consideration of my employment with those facilities.



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