Skills Checklist

NICU Checklist

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GENERAL SKILLS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Experience in level II nursing
Experience in level III nursing
Awareness of HCAHPS
Setting: Childrens hospital
Setting: University healthcare facility
Setting: High risk delivery center
Setting: Community hospital
Family teaching
Consents
Specialty beds: giraffe incubator
Specialty beds: radiant warmer bed
Restrictive devices (restraints)
Preparation for transport/transfer
Air transport (jet or helicopter)
Other transport experience: stable return transport
Other transport experience: procedural transport
End of life care/palliative care
Wound assessment & care
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Bar coding for medication administration
Blood Glucose Monitoring (BGM)
Insulin/dextrose administration
National Patient Safety Goals
Accurate patient identification
Effective communication
Interpretation & communication of lab values
Medication administration
Infant dosage calculations
Delivery methods: IM/IV/SQ
Medication reconciliation
Labeling (medications & specimens)
Anticoagulation therapy
Steroids (inhaled/IV/PO)
Monitoring conscious sedation
Pain assessment & management
Infection control
Universal precautions
Isolation
Minimize risk falls
Skin assessment
Prevention of pressure ulcers

IV THERAPY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Starting & maintaining IVs
Blood draw: heel stick/venous
Central venous insertion & management
Blood draw: central line
Maintain umbilical catheter (arterial/venous)
TPN administration
Administration of blood & blood products
Infusion pumps

CARDIOVASCULAR EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

CV assessment
Invasive hemodynamic monitoring

CARDIAC MONITORING & EMERGENCY CARE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

NRP protocols & medication
Use of S.T.A.B.L.E. program & protocols
Broslow system
EKG interpretation & treatment
Use of rapid response teams
Defibrillation/cardioversion

CARE OF INFANT WITH:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Congenital heart disease
CHF
Hemodynamic instability
Hypovolemic shock
Post cardiac surgery
Seizures
Meningitis
External VP shunt/reservoirs
ICP monitoring
Spinal disorders
Neurological development & positioning
Tracheoesophogeal fistula (TEF)
Cleft lip/palate
Necrotizing Entercolitios (NEC)
Gastroenteritis/omphaloocele
Inguinal hernia
Post abdominal surgery
Acute renal failure
Malformations of GU tract
Hydronephrosis
Neonatal sepsis
HIV positive mother
HBsAg positive mother

MEDICATION ADMINISTRATION:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Antidysrythmics
Antihypertensives
Cardiac glycoside (digoxin)
Platelet inhibitors (aggrastat/integrillin/reopro)
Vasoactive agents
Bronchodilators

PULMONARY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Respiratory Assessment
Obtain & interpret blood gases
Airway management (nasal/oral/ET)
Tracheostomy care & management
Oxygen therapy (NC/oxyhood)
Pulse oximeter
Ventilation & management
High Frequency Jet Vent (HFJV)
Partial liquid ventilation
Nitric oxide therapy
Surfactant therapy
ECMO
Assist with & manage chest tube

CARE OF CHILD WITH:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Apnea
Bronchopulmonary Dysplasia (BPD)
Diaphragmatic hernia
MAS (Meconium Aspiration Syndrome)
Pulmonary edema
Persistent Pulmonary Hypertension (PPHN)
Respiratory Distress Syndrome (RDS)
Pneumothorax

NEUROLOGICAL EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Neurological assessment
Drug withdrawal & abstinence scoring

MEDICATIONS:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Anticonvulsants

GASTROINTESTINAL EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

GI assessment (include palate & girth)
Nutritional assessment

FEEDINGS:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Assist with breast/bottle feeding
Breastmilk handling & storage
Gavage
Placement of OGT/NGT
Gastrostomy tubes
Colostomy/ileostomy care

RENAL/GU EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Urinary catheter insertion & management
Peritoneal dialysis
Assist with circumcision
Post circumcision care

INFECTIOUS DISEASES EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Assist with lumbar puncture

MEDICATION:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Immunizations
Anti-infectives
Respigam/synergis prophylaxis

ADMISSION/ASSESSMENT EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Attending high risk deliveries
APGAR scoring
Gestational age
Eye exam
Hearing screen
Thermoregulation
Care of infant under phototherapy
Experience in level II nursery
Experience in level III nursery

AGE-SPECIFIC COMPETENCIES EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Neonatal (< 23 weeks)
Neonatal (24-28 weeks)
Neonatal (29-32 weeks)
Neonatal (>33 weeks)