ICU Skills Checklist

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I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Instructions:This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

Cardiac

Defibrillation/Cardioversion:

★★★★

Assisting with Insertion of Central Lines:

★★★★

Pacemakers-External:

★★★★

Permanent or Temporary Pacemaker:

★★★★

Cardiac Arrest/CPR:

★★★★

A-Line (Transducer setup-D/C):

★★★★

Swan Ganz (Transducer setup-D/C):

★★★★

Support Devices

Balloon Pump (IABP):

★★★★

SvO2 Monitoring:

★★★★

Automatic Internal Cardioverter Defib:

★★★★

Care of Patient with

Aneurysm:

★★★★

Acute MI/Unstable Angina:

★★★★

Cardiogenic/Hypovolemic Shock:

★★★★

Pre/Post Cardiac Surgery:

★★★★

Heart Transplant:

★★★★

PTCA:

★★★★

COPD:

★★★★

ARDS:

★★★★

Pulmonary Embolism:

★★★★

Pulmonary Edema:

★★★★

Pneumonia:

★★★★

Inhalation Injuries:

★★★★

CVA:

★★★★

Seizure Disorder:

★★★★

Overdose:

★★★★

Neuro Injury/Trauma:

★★★★

Pre/Post Neuro Surgery:

★★★★

Cranial Hemorrhage:

★★★★

Aphasia:

★★★★

Multiple Sclerosis:

★★★★

GI & Renal

Pancreatitis:

★★★★

GI Bleed:

★★★★

Esophageal Bleeding:

★★★★

Bowel Obstruction:

★★★★

Liver Transplant:

★★★★

Paralytic Ileus:

★★★★

TURP:

★★★★

Shunts and Fistulas:

★★★★

Nephrectomy:

★★★★

Renal Transplant:

★★★★

Renal Trauma:

★★★★

Use and Administration of the following

Atropine:

★★★★

Bretylol:

★★★★

Bumex:

★★★★

Digoxin:

★★★★

Dopamine:

★★★★

Dobutrex:

★★★★

Inderal:

★★★★

Inocor:

★★★★

Isuprel:

★★★★

Lidocaine:

★★★★

Neosynephrine/Nipride:

★★★★

NTG:

★★★★

Pronestyl:

★★★★

Titrate Morphine:

★★★★

Verapamil:

★★★★

Thrombolitic Agents:

★★★★

Prep/Titration of Emergency Drugs:

★★★★

Aminophylline:

★★★★

Corticosteroids:

★★★★

Bronkosol:

★★★★

Ventolin:

★★★★

Alupent:

★★★★

Decadron:

★★★★

Dilantin:

★★★★

Magnesium Sulfate:

★★★★

Phenobarbital:

★★★★

Steroids:

★★★★

Valium:

★★★★

Versed:

★★★★

Respiratory

Lung Transplant:

★★★★

Establishing an Airway:

★★★★

Pulse Oximetry:

★★★★

Interpretation of ABG:

★★★★

Drawing ABG Blood Sample from A-Line:

★★★★

Incentive Spirometer:

★★★★

Neurology

Assessment of Neuro Signs:

★★★★

Use of Glascow Coma Scale:

★★★★

Seizure Precautions:

★★★★

Assist with Lumbar Puncture:

★★★★

ICP Monitoring:

★★★★

Crutchfield Tongs:

★★★★

Halo Traction:

★★★★

Stryker Frame:

★★★★

Assessment of Sensory-Motor Function:

★★★★

Cervical Traction:

★★★★

Cranial Nerve Assessment:

★★★★

LOC Assessment:

★★★★

Pre/Post Neuro Surgical Care:

★★★★

Visual Acuity Measurement:

★★★★

Vascular

Peripheral Pulses:

★★★★

Fluid Overload:

★★★★

Starting IV's:

★★★★

Subcutaneous Central Line:

★★★★

Hickman/Broviac/Groshong Catheters:

★★★★

Maintenance of Heparin Lock:

★★★★

TPN/Hyperalimentation:

★★★★

Air Occlusive Dressing:

★★★★

Dialysis Support

Infusion Pump:

★★★★

Peritoneal Dialysis:

★★★★

Hemodialysis:

★★★★

Heparin Drip – Precautions and Maintenance:

★★★★

Gastrointestinal

NG Tube Insertion:

★★★★

Gastronomy Tube:

★★★★

Jejunostomy Tube:

★★★★

Enterostomal Care:

★★★★

Genito Urinary/Renal

Foley Catheter Insertion:

★★★★

GU Irrigations:

★★★★

Nephrostomy Tube:

★★★★

Suprapubic Tube:

★★★★

Electrolyte Imbalance/Replacement:

★★★★

Other

Oncology:

★★★★

Chemotherapy:

★★★★

Isolation Techniques:

★★★★

Hyperbaric Oxygenation:

★★★★

Fingerstick Blood Glucose monitoring:

★★★★

Equipment

Bear I:

★★★★

Bear II:

★★★★

Bear V:

★★★★

Bennett 7200:

★★★★

CPAP:

★★★★

Emerson:

★★★★

EMV:

★★★★

MA-I:

★★★★

MA-II:

★★★★

Monihan:

★★★★

Ohio 560:

★★★★

PEEP:

★★★★

Pressure Pre-Set:

★★★★

Servo 900b:

★★★★

Servo 900c:

★★★★

Servo 900e:

★★★★

Siemens:

★★★★

Hewlett-Packard:

★★★★

Spacelab:

★★★★

Marquette:

★★★★

Mennen:

★★★★

Lifecare:

★★★★

Nihon-Koder:

★★★★

Age Specific Competencies

Infant (Birth - 1 year):

★★★★

Preschooler (ages 2-5 years):

★★★★

Childhood (ages 6-12 years):

★★★★

Adolescents (ages 13-21 years):

★★★★

Young Adults (ages 22-39 years):

★★★★

Adults (ages 40-64 years):

★★★★

Older Adults (ages 65-79 years):

★★★★

Elderly (ages 80+ years):

★★★★