IV Therapy 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

Iv Therapy Experience With The Following Ages:

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
Access/Management of Implanted Ports
Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, etc.)
Titration of drips
Administration of Blood/Blood Products
Leading Code Teams
Use of Computerized Patient ID Systems
Knowledge of Current IV Therapy Guidelines (INS, ISMP, CDC, State, Etc.)
Knowledge of Anatomy
Moderate Conscious Sedation
Sedation Reversal Agents
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

Insertion Of:

Peripheral IV-Adult
Peripheral IV-Child
Peripheral IV-Neonate
Vein Selection - Peripheral IV's
Interosseous Needles

Midline's/picc Lines:

Midline Catheter Insertion - Adult
Midline Catheter Insertion - Child
Indications for Midline/PICC Placement
Contraindications for Midline/PICC Placement
Vein Selection
Measuring Techniques
Catheter and Introducer Device Selection
Correct Tip Placement
Insertion Technique - Basic (Vein)
Insertion Technique - Seldinger
Insertion Technique - Ultrasound
Assist with Insertion in Interventional Radiology
Insertion Site Preparation
Maintaining Sterile Field
Securing Insertion Site Post Placement
X-ray Assessment for Tip Location
Repositioning After X-ray

Care And Maintenance:

Peripheral IV
Scalp IV
Heparin/Saline Lock
Groshong PICC
Groshong CVL
Hickman/Broviac
Port-a-Cath
Vascath
Multilumen Catheters
Subclavian Line
IJ Line
Femoral Line
Power PICC
Power PORT
Dressing Changes
Cap Changes
Flushing Lines (Frequency/Solutions)

Medication Administration

Chemotherapy
Heparin
Streptokinase
TPA (Alteplase)
Lidocaine
TPN/Lipids
Ativan (Lorazepam)
Valium (Diazepam)
Versed (Midazolam)
Fentanyl

Equipment:

IV Pumps (check all that apply)
Needleless Systems
Blood Warmer
PCA Pumps
Pressure Lines

Troubleshooting/ Complications:

Repair PICC
Repair Midline
Air Embolism
Bleeding
Brachial Plexus Injury
Cardiac Arrhythmia
Cardiac Tamponade
Catheter Erosion
Catheter Embolism
Catheter Occlusion
Catheter-Related Sepsis
Endocarditis
Exit Site Infection
Exit Site Necrosis
Extravasation
Hematoma
Laceration of Vessels or Viscus
Myocardial Erosion
Perforation of Vessels or Viscus
Phlebitis
Catheter Tip Malposition or Retraction
Thromboembolism
Venous Thrombosis
Ventricular Thrombosis
Vessel Erosion
Declotting Peripheral Site
Complications from Sedation

Discontinuing Iv Therapy

Peripheral IV's
PICC/Midline
Central Lines