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Telemetry Checklist

WORK SETTING 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 *
Interventional Unit
Progressive Care Unit
Stepdown
Telemetry
Inpatient Acute Care Facility
Trauma Center
Academic/Teaching Facility
Outpatient Care Facility
Long term care/Skilled Nursing
Clinic/Ambulatory
Home Health Setting
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 *
Advanced directives
Awareness of HCAHPS
Patient/family teaching
Restrictive devices (restraints)
Lift/transfer devices
Specialty beds
End of life care/palliative care
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Bar coding for medication administration
National Patient Safety Goals
Accurate patient identification
Effective communication
Interpretation & communication of lab values
Medication administration
Labeling
Anticoagulation therapy
Medication reconciliation
Monitoring conscious sedation
Pain assessment & management
Use of PCA (IV, intrathecal, epidural)
Infection control
Universal precautions
Isolation
Minimize risk for falls
Prevention of pressure ulcers
Wound care
Wound vac
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 *
Obtains 12 lead EKG
Interpretation of rhythm strips
Treatment of dysrhythmias
Rapid Response Teams
Cardiac Arrest/ CPR
Oxygen therapy and delivery
Pulse oximetry
Use of Doppler/pulse checks
Automatic/manual Blood Pressure checks
IV THERAPY:

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 and maintaining peripheral Iv’s
Blood Draw: venous
Multi Lumen Central line care and dressing changes
Blood Draw Central line
Arterial Line care
IV Push
Care & Management of Port a catheter
Care & Management of PICC/ Groshong/Hickman
TPN and Lipids
Administration of blood/blood products
Administration of Chemotherapy
Monitoring Chemotherapy (does not initiate)
IV drip calculations
IV fluids
Management of IV Infusion Pumps (Alaris, Baxter)
Management of elastomeric infusion
Management of intrathecal pumps
Manage PCA pump
CARDIAC 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 *
Auscultation of Irregular of Heart Sounds
Angina
Aneurysm
Arrhythmias
Abdominal Aortic Aneurysm
Acute MI
Carotid Endarterectomy
Cardiogenic Shock
Cardiac Tamponade
Congestive heart Failure
Cardiomyopathy
Coagulation
Cardiac teaching
EP study/ablation
Endocarditis
External and Temporary Pacemakers
Femoral Popliteal Bypass
Femoral Artery Sheath Removal
Hypertension
Hypovolemic Shock
Assist w/ cardioversion
Management of Permanent Pacemakers/AICD
Multi System Organ Failure
Pulse oximetry
Pericarditis
Peripheral Edema
Pulse/Circulation checks
Pre/Post Cardiac Cath
Pre/Post PTCA/Stents
Care of patient with Valve replacements
TEE
Ventricular Assist Device (LVAD, RVAD)
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 *
Preparation and administration of emergency (ACLS) medications
Inotropic: (digoxin, dopamine, epinephrine)
Antiarrhythmics
Beta Blockers
Fibrinolytics
Antianginals (isordil/nitrates)
Antihypertensives
Antilipemic: statins
Anticoagulation medications
Diuretics
Antihistamines
Bronchodilators
Expectorants and anti-tussins
inhalers
Steroids
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 *
Assessment of abnormal breath sounds
Airway management/suctioning (ETT, Oral, trach)
ABG’s recognition and treatment of abnormal values
Acute Pneumonia
ARDS
Aspiration
Asthma
Chest Tube care and management
Establish and protect Airway
COPD
Incentive spirometer
Inhalation injury
Lobectomy
Thoracentesis
Lung transplant
Near drowning
Oxygen administration
Ambu bag
Nasal Canula
Nebulizer treatments
Non-rebreather
Trach collar
Venti mask
TB
Tracheostomy
Bronchoscopy
NEUROLOGY 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 *
Level of Consciousness
Comprehensive neuro assessment
Glasgow Coma Scale
CVA/ TIA
Intercranial Hemorrhage & hematoma
Reflex motor deficits
Visual communication deficit
CNS infection
Meningitis
Encephalitis
Alzheimer’s Disease
Delirium Tremens
Overdose
Neuromuscular disease
Multiple Sclerosis
Metastatic Tumor
Tumor resection
Pre/Post Neuro Surgery
Laminectomy
Assist Lumbar Puncture
Halo Traction/ Cervical Tongs
Increased ICP
Seizure Disorder
Spinal Cord Injury
Traumatic Brain Injury
Ventriculostomy
MEDICATION ADMINISTRATION USE & 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 *
Anticonvulsants (Dilantin/ Phenobarbital)
Antidepressants
Antiparkinson’s (Cogentin/Levodopa/Sinemet)
Corticosteroids
Antiemetics
Antispasmodics
Anticholinergics
Laxatives
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 *
Assessment of Bowel Sounds
Nutritional Status
Interpretation of labs and electrolyte imbalance
Bowel Obstruction
EGD
Insertion and management of NG tube
Bowel Prep/Colonoscopy
ERPC
Nausea/vomiting
Constipation/impaction
diarrhea
Insertion and management of small-bore feeding tubes (Dubhoff, Keofeed)
Management and care of PEG tub/feed
Management and care of gastrostomy tube/feed
Management and care of jejunostomy tube/feed
Gravity/bolus feedings
Kangaroo pump
Management and care of ostomy
Abdominal wounds
Pre/Post abdominal surgery
Paralytic Ileus
Management of post-surgical drains
Gastric Bypass
Peritonitis
GI bleed (upper/lower)
Hepatitis
Inflammatory Bowel Disease
Liver Failure
Liver Cancer
Paracentesis
Pancreatic Cancer
Pancreatitis
GENITOURINARY/RENAL 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 *
Insertion and maintenance of urethral catheter
Care of Nephrostomy tube
Care of Suprapubic catheter
Fluid and Electrolyte disturbance
GU irrigation
Kidney Failure (acute/Chronic)
Measurement of Intake and Output Monitoring
Urine Retention
CARE OF PATIENT 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 *
Pyelonephritis/UTI
BPH
TURP
Prostate Cancer
Nephrectomy
Ileoconduit
Renal Surgery
Hemodialysis
Peritoneal Dialysis
Shunts/Fistulas
Obstructions
Renal Trauma
Testicular Torsion
GYNECOLOGICAL 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 GYN exam/pap
Pre/Post Gyn Surgeries
Gynecological malignancies
Abnormal uterine bleeding
Ectopic Pregnancy
Pelvic Inflammatory Disease
Pregnancy Induced Hypertension
Hemorrhage
ORTHOPEDIC 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 *
Assess Range of Motion
Assessment of color, warmth, movement, sensation
Amputation
Cast Care
Fractures
Splints
Traction
Trauma
Strains/Sprain
immobilization
METABOLIC/ENDOCRINE 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 *
Diabetes
Diabetic Ketoacidosis
Blood Glucose Monitoring
Insulin Shock
Hyperosmolar Hyperglycemia
Cushing’s Syndrome
Thyroid Disease
SKIN/INTEGUMENTARY:

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 *
Skin assessment
Skin Breakdown monitoring
Staged Pressure Ulcers
Stasis Ulcers
Sterile dressing changes
Wound Vac maintenance and dressing changes
DOSE CALCULATION/TITRATION 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 *
Nitrates (IV Nitroglycerine)
Anti-arrhythmic agents (Amiodarone/Cardizem/Lidocaine)
IV Vasoactive agents (Dopamine, Dobutrex, Levophed)
Platelet inhibitors
Fibrinolytics/ IIB IIA inhibitors
Insulin Pump
CRITICAL CARE SETTINGS:

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 *
Interventional Unit
Progressive Care Unit
Stepdown
Telemetry
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 *
Newborn/neonate (birth-30 days)
Infant (31 days- 1 year)
Toddler (ages 2-3 yrs)
Preschool (ages 4-5 yrs)
School Age (ages 6-12 yrs)
Adolescent (ages 13-21 yrs)
Young Adult (ages 22-39)
Adult (ages 40-64)
Older Adult (ages 65+)