INTENSIVE CARE UNIT SKILLS CHECKLIST
Nurse: ____________________________________
CHECK PROFICIENCY
Date: _____________________________________
Multiple sclerosis
1
2
3
4
Post craniotomy
Key: 1 = No Experience
2 = Little Experience
3 = Moderate Experience
4 = Extensive Experienced
Spinal cord injury
Ventriculostomy
Neurological (continued)
4. Medication
CHECK PROFICIENCY
NEUROLOGICAL
1. Assessment
1
2 3
4
Barbiturate induced coma
Decadron (Dexamethasone)
Dilantin (Phenytoin)
Cranial nerves
Epidural administration
Glasgow coma scale
Phenobarbital
Level of consciousness
Pathological reflexes
Valium (Diazepam)
Reflex or communication deficits
ENDORINE/METABOLIC
1. Interpretation of lab results
Visual or communication deficits
2. Equipment & procedures
Blood glucose
Halo traction/cervical tongs
Thyroid studies
2. Equipment and Procedures
Blood glucose measuring device (type) ______________
Intercranial pressure monitoring
Blood glucose monitoring
Nerve stimulators
Rotating bed
Performing finger stick
3. Care of patient with:
Seizure precautions
Diabetes mellitus
Spinal precautions
Diabetic ketoacidosis
Stryker frame
Disorders of adrenal gland (Addison’s)
Use of hyper/hypothermia blanket
3. Care of patient with:
Disorders of the pituitary glad (DI)
Aneurysm precautions
Hyperthyroidism (Graves disease)
Basal skull fracture
Hypothyroidism
Closed head injury
Insulin shock
Coma
Thyroidectomy
4. Medication
Assist with lumber puncture
CVA
DT’s
Drug overdose
Externalized VP shunts
Insulin pump
CARDIOVASCULAR
1. Assessment
Increased ICP
Abnormal heart sounds/murmurs
Meningitis
Auscultation (rate, rhythm, volume)
Blood pressure/non-invasive
Encephalitis
Metatastic tumor/intercranial tumor resection
INTENSIVE CARE UNIT SKILLS CHECKLIST
CHECK PROFICIENCY
1
2 3
4
CHECK PROFICIENCY
Doppler
Permanent
Pulses/circulation checks
2. Interpretation of lab results
Temporary
Transthoracic (epicardial)
Cardiac enzymes & isoenzymes
Ventricular assist device (RVAD or LVAD)
Coagulation studies
3. Equipment & procedures
Assist with:
4. Care of patient with:
Arterial line insertion
Central line insertion
Open chest emergency
CARDIOVASCULAR (continued)
Abdominal aortic aneurysm repair
Acute MI
Cardiac arrest
Cardiac tamponade
Congestive heart failure (CHF)
EP study & ablation
PA catheter/Swan Ganz Insertion
Heart transplant
Pericardocentesis
Immediate post open-heart surgery
Transesophageal echocardiogram
Infective endocarditis
Automatic internal cardioverter defibrillator
Myocardial contusion
Cardioversion
Pericarditis
CAVH-D
Hemodynamic monitoring:
Post AICD insertion
Post arthrectomy (DCA)
Cardiac index
Cardiac output
CVP monitoring
Femoral artery sheath removal
MAP
PA/Swan-Ganz
Post commssurotomy, valve repair/replacement
Post intracoronary stent placement
Post Percutaneous ballone valvuloplasty
Post rotoblade
Pre/post angioplasty
PCW pressure
Pre/post cardiac cath
5. Medications
PVR
Amiodarone (Cordarone)
Radial a-line
Atropine
SVO2
Bicarbonate
SVR
Bretylium (Bretylol)
Intra aortic balloon pump
Monitoring:
12 lead EKD interpretation
Arrhythmia interpretation
Lead placement
Rhythm strip assessment
Set up and rerun 12 lead EKD
Pacemaker:
External
Digoxin (Lanoxin)
Diltiazem (Cardizem)
Dobutamine (Dobutrex)
Dopamine (Intropin)
Epinephrine (Adrenalin)
Esmolol (Brevibloc)
Inocor (Amrinone)
Lidocaine (Xylocaine)
Nipride (Nirtoprusside)
1
2
3
4
INTENSIVE CARE UNIT SKILLS CHECKLIST
CHECK PROFICIENCY
Procainamide (Pronestyl)
1
2 3
4
CHECK PROFICIENCY
Reteplase recombinant (Retavase)
Aspiration
Strepokinase
Laryngospasm
TPA (Alteplase)
Tension pneumothorax
Verapamil (Calan, Isoptin, Verelan)
PAIN MANAGEMENT
Use of Pleurevac or Thoraclex drainage
1. Assessment of pain level tolerance
2. Care of patient with:
Use of wather seal drainage
O2 therapy & medication delivery systems:
Ambu bag and mask
Epidural anesthesia/analgesia
ET Tube
IV conscious sedation
Face masks
Patient controlled analgesia
PULMONARY
Nasal cannula
1. Assessment
Trach collar
Adventitious breath sounds
Portable O2 tank
Ventilator management:
Rate and work of breathing
2. Interpretation of lab results
External CPAP
Arterial blood gases
1. Equipment & Procedures
IMV
Air leak troubleshooting:
Pressure Support
Medicinal chest tube removal
PULMONARY (continued)
Pleural chest tube removal
Airway management devices/suctioning:
High frequency jet ventilation
PEEP
Weaning modes & T-piece weaning
4. Care of patient with:
Acute pneumonia
ARDS
Endotracheal tube/suctioning
Chest Trauma
Extubation
COPD
Nasal airway/suctioning
Fresh Tracheostomy
Oximetry
Lobectomy
Sputum specimen collection
Lung transplant
Tracheostomy/suctioning
Pneumonectomy
Assist with:
Pulmonary edema/hypertension
Bronchoscope
Pulmonary embolism
Chest tube insertion
Status asthmaticus
Emergency Trachoestomy
Thoracotomy
Thoracentesis
Tuberculosis
2. Medications
Establishing an airway:
1
2
3
Identification/intervention for respiratory complications:
Assist with intubation
Alupent (Metaproterenol sulfate)
Oral airway insertion
Aminophylline (Theophylline)
4
INTENSIVE CARE UNIT SKILLS CHECKLIST
CHECK PROFICIENCY
1
2 3
4
CHECK PROFICIENCY
Bronkosol (Isoetharine hydrochloride)
Female
Corticisteriods
Male
Ventolin (Albuterol)
RENAL/GENITOURINARY
Supra-pubic
4. Care of patient with:
1. Assessment
Acute renal failure
Arterio venous fistula/shunt
CAVH Dialysis
Fluid balance
2. Interpretation of lab results
Hemodialysis
BUN & creatinine
Peritoneal dialysis
Electrolytes
3. Equipment & procedures
Renalrejection syndrome
Bladder irrigations
Urinary diversion (ileal conduit nephrostomy)
Insertion & care of straight & Foley catheter:
Urinary tract infection
Nephrectomy
TURP
3-way Foley
Total Number of Years in Intensive Care Unit: _____________________
Field
YEARS OF EXPERIENCE BY FIELD IN INTENSIVE CARE SPECIALTIES
Years
Medical
Neurology
Cardiothoracic
Cardiovascular
PACU
Burn
Neuro
Coronary Care
Age Group
YEARS OF EXPERIENCE BY AGE GROUP
Years
Newborns (birth – 30 days)
Infants (30 days – 1 year)
Toddler (1-3 years)
Preschooler (3-5 years)
School Children (5-12 years)
Adolescents (12-18 years)
Young Adults (18-39 years)
Middle aged adults (39-64 years)
Senior Adults (64+ years)
1
2
3
4
INTENSIVE CARE UNIT SKILLS CHECKLIST
The information I have provided is true and accurate to the best of my knowledge. I authorize Northwest Nurse Staffing to release this
Skills Checklist to client hospitals as needed in relation to my employment.
Print name:
Signature: _________________________________
Date: _____________________________________