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)

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)

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)

MM slash DD slash YYYY

Type Of Facility Experience

TYPE OF FACILITY EXPERIENCE

Types Of Icu Experience

ICU (General ICU)
MICU (Medical Intensive Care Unit)
SICU (Surgical Intensive Care Unit)
CCU (Cardiac Care Unit)
CVICU (Cardiovascular Intensive Care Unit)
TICU (Trauma Intensive Care Unit)
Neurosurgical ICU
Burn ICU

Age Of Patients Cared For

Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler/Preschool (13 months to 5 years)
School Age Child/adolescent (6 years to 18 years)
Young Adults/ Middle Adult (19 years to 64 years)
Older Adults/Elderly (65+ years)

General Skills

Care of Patient in Restraints
Automated Med Dispensing Systems
Electronic Documentation
IV Pumps
CRRT Equipment
Peripheral IV Insertion, Care and Maintenance
Access/Management of Implanted Ports
Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, etc.)
Cardiac Monitoring/Interpretation
PCA/Epidural pumps
Titration of drips
Administration of Blood/Blood Products
Knowledge of "Do Not Use Abbreviations"
Do you have charge/supervisor experience?
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores

Medication Administration

Moderate/Conscious Sedation
Sedation Reversal Agents
Antibiotics IM/IV
Antiemetics
Adenosine
Aminophylline(Theophylline)
Atropine
Anticoagulants
Anticonvulsants
Antihypertensives
Barbituate Induced Coma
Charcoal
Cardizem
Cordarone
Decadron
Dopamine
Diuretics
Epinephrine
Heparin Drip protocol
Inotropes (Digoxin,Dobutamine,Primacor)
Inocor
Insulin Infusions
Intrathecal Medication
Isuprel
Kayexelate
Lidocaine
Mannitol
Nitroglycerin
Nipride
Steroids
Thrombolytic Therapy
Vasopressin
Ventolin (Albuterol)

Cardiovascular

Care Of The Patient With:

Adult ECMO
Continuous Cardiac Monitoring
Femoral-Arterial Sheath/Removal
Intra Aortic Balloon Pump
Abdominal Aortic Aneurysm/Bypass
Acute MI
Angioplasty
Bacterial Endocarditis
Pericarditis
Carotid Endarterectomy
Fem-Pop Bypass
Cardiac Arrest
CHF
Fresh Open Heart Surgery
Open Heart Surgery ( more than 6 hrs. post-op)
Heart Transplant
Myocardial Contusion
Mediastinal Tube
Vascular Surgeries
Cardiac Tamponade
EP Study and Ablation
POST Pacemaker/AICD Insertion
Pre/Post Cardiac Cath
Post Artherectomy (DCA)
Hyperthermia Blanket
Hypothermia protocol (post arrest)

Shock:

Anaphylactic
Cardiogenic
Hypovolemic
Neurogenic
Septic

Pacemaker:

External
Permanent
Temporary
Transthoracic
Ventricular Assist Device (RVAD,LVAD, BIVAD)

Hemodynamic Monitoring:

Set up, use and Interpreation of Reading of CVP
Set up, use and Interpretation of Reading of PA/Swan-Ganz
Transducer Setup and Monitoring
Cardiac Output
Cardiac Index
Wedge Pressures
SVO2
Set up and use of Arterial Line

Pulmonary

Care Of The Patient With:

Ventilator/Weaning
CPAP/BIPAP
Asphyxiation (Near Drowning)
Oral Airway
Endotracheal Tube
Laryngeal Spasm
Tracheostomy
Lung Transplant
Epistaxis
Aspiration
ARDS
COPD
Lobectomy
Pneumonectomy
Pneumothorax/Tension Pneumothorax
Hemothorax
Pneumonia
Assist with Emergency Tracheostomy
Thoracentesis
Inhalation Injuries
Pulmonary Edema
Pulmonary Embolism
Status Asthmaticus
Tuberculosis
Chest Tube (pleurevac/Thoraclex)
Assist with Intubation
Assist with Extubation
Assist with Chest Tube Insertion
ABG Interpretation

Neurological

Intracranial Pressure Monitoring
Ventriculostomy Drain
Increased ICP
Closed Head Injuries
Heat Exhaustion
Multiple Sclerosis
Psychiatric Disorders
Aneurysm Precautions
Basal Skull Fracture
Coma
CVA
Encephalitis
Craniotomy
Delirium Tremors
Meningitis
Seizures
Status Epilepticus
Spinal Cord Injury
Halo Traction/Cervical Tongs
Intracranial Tumor Resection
Cranial Nerve Assessment
Reflex/Motor Deficits
Assist with Lumbar Puncture
Stryker Frame
Overdose

Orthopedics

Multiple Long Bone Fractures
Pelvic Fracture
Open Book Pelvic Fracture
Fracture/Dislocation
Traumatic Amputation
Osteoporosis
Pined Fractures
Total Joint Replacements
Brace/Splint Application
Fractured Ribs/Sternum
Traction Devices

Gastrointestinal

Gastric Lavage
Gastrostomy Tube
Jejunostomy Tube
Nasogastric Tube
Salem Sump
PEG Tube
Acute Cholecystitis
Bowel Obstruction
Cirrhosis
GI Bleed
Paralytic Ileus
GI Surgery
Pancreatitis
Liver Failure
Liver Transplant
Acute Abdominal Pain
Blunt Abdominal Trauma
Penetrating Abdominal Trauma
Ostomies
Esophageal Bleeding
Whipple

Renal/genitourinary

AV Fistula
Suprapubic Catheter
Hemodialysis
Peritoneal Dialysis
Nephrostomy Tube
Peritoneal Lavage
Acute Renal Failure
Renal Transplant
Renal Rejection Syndrome
Nephrectomy
TURP
Bladder Irrigation
CRRT (continuous Renal Replacement Therapy)

Endocrine/metabolic

Adrenal Disorders (Addison's Disease)
Diabetic Ketoacidosis
Diabetes Mellitus
Insulin Shock
Hypothyroidism
Hyperthyroidism (Graves Disease)
Pituitary Disorders
Thyroidectomy

Infectious Disease

Hepatitis
HIV
MRSA ( Methicillin Resistant Staphylococcus)
VRE ( Vancomycin Resistant Enterococci)
CRE ( Carbapenem Resistant Enterobacteriaceae)
C Difficile
Tuberculosis
Isolation Precautions/Procedures

Oncology

Chemotherapy
Bone Marrow Transplants
Leukemia
Lymphoma
Radiation Implants

Wound Management

Multiple Abdominal Wounds and Drains
Gunshot Wound
Stab Wound
Lacerations
Hazardous Material Exposure
Radiation Exposure
Stasis Ulcers
Surgical Wound Healing
Traumatic Wounds
Multi System Organ Failure
DIC
Organ/Tissue Donation

Burns:

First Degree
Second Degree
Third Degree
Rule of Nines
Fluid Resuscitation Burn Formula
Electrical Burns

Cardiac Monitors

Hewlett-Packard
Spacelab
Siemens
Marquette
Mennen
Lifecare
Nihon-Koder