Critical Care Checklist


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.

Total Stars:

Obtained Stars:

Ranking: 0%

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

  General Skills         Rating Stars (Click) 1 2 3 4
  Advanced directives  
  Patient/family teaching  
  Restrictive devices (restraints)  
  Lift/transfer devices  
  Specialty beds  
  End of life care/palliative care  
  Wound assessment & care  
  Automated Medication Dispensing System  
  Pyxis  
  Omnicell  
  or other  
  Bar coding for medication administration  
  Blood Glucose Monitor (BGM)  
  Cardioversion/defibrillation  
  Electronic ICU  
  National Patient Safety Goals  
  Accurate patient identification  
  Effective communication  
  Interpretation & communication of lab values  
  Medication administration  
  Medication reconciliation  
  Labeling (medications & specimens)  
  Anticoagulation therapy  
  Monitoring conscious sedation  
  Pain assessment & management  
  Infection control  
  Universal precautions  
  Isolation  
  Minimize risk for falls  
  Prevention of pressure ulcers  
  Use of rapid response teams  
  Awareness of HCAHPS  
  Cardiovascular         Rating Stars (Click) 1 2 3 4
  Assessment of heart sounds  
  Interpretation of arrhythmias  
  Performing 12 lead EKG�s  
  Interpretation of 12 lead EKG  
  Interpretation of hemodynamic monitoring  
  CVC (Central Venous Catheter)  
  Arterial line  
  Swanz Ganz catheter  
  Flow trac or Vigileo monitoring caths  
  Intra-Aortic Balloon Pump (IABP)  
  Ventricular Assist Device (LVAD  
  RVAD)  
  Permanent pacemakers  
  Implantable Cardioverter Defibrillator (ICD)  
  External pacemakers  
  Epicardial pacemaker wires  
  Discontinuing venous/arterial sheaths  
  Femostop/vasoseal  
  Acute myocardial infarction  
  Pre/post: cardiac catheterization  
  Congestive heart failure  
  Cardiomyopathy  
  Dysrhythmias/conduction disturbances  
  Aortic aneurysm  
  Thoracic/abdominal surgery  
  Endoluminal graft  
  Cardiogenic shock  
  Hypertensive crisis  
  Pericarditis/endocarditis  
  MAZE procedure  
  Post open heart (CABG/valve)  
  Cardiac contusion/trauma  
  Heart transplant  
  Cardiac tamponade  
  ACLS medications and protocols  
  Antidysrythmics  
  Antihypertensives  
  Vasoactive/vasopressor agents  
  Anesthetics (propofol/presedex)  
  Thrombolytics (retavase/activase)  
  Platelet inhibitors (ReoPro/Integrilin/Aggrastat)  
  Flolan for pulmonary hypertension  
  Pulmonary         Rating Stars (Click) 1 2 3 4
  Assessment of breath sounds  
  Oral/NT/ET airway  
  Tracheostomy  
  Arterial blood gas analysis/interpretation  
  Obtaining ABG blood sample/arterial line  
  Pulse oximetry  
  BiPAP (Bi-level Positive Airway Pressure)  
  Oscillation/high-frequency ventilation  
  Nitric  
  Interpretation of weaning parameters  
  Maintenance & management of pleural chest tubes  
  Acute respiratory failure  
  Adult Respiratory Distress Syndrome (ARDS)  
  Sudden Inflammation Respiratory Syndrome (SIRS)  
  Inhalation injuries  
  Pneumonia  
  Pulmonary edema  
  Near drowning  
  Chronic Obstructive Pulmonary Disease (COPD)  
  Pre/post thoracic surgery  
  Pulmonary embolism  
  Pulmonary/chest trauma  
  Pulmonary hypertension  
  Status asthmaticus  
  Rapid sequence intubation drugs/protocols  
  Nebulizer treatments: Ventolin  
  Atrovent  
  Neurology         Rating Stars (Click) 1 2 3 4
  Cranial nerve assessment  
  Glasgow coma scale  
  NIH stroke scale  
  NIH stroke certification  
  Seizure precautions  
  Skeletal traction  
  Cervical spine precautions/logroll positioning  
  Halo vest/halo traction  
  Monitoring of neuromuscular blocking agents/paralytics  
  Assist with lumbar puncture  
  Ventriculostomy  
  Subarachnoid screw/bolt  
  Lumbar drains  
  Cerebral aneurysm  
  Subarachnoid hemorrhage  
  Status epilepticus  
  TBI (Traumatic Brain Injury)  
  Spinal cord injury  
  CerebroVascular Accident (CVA)  
  Pre/post cranial surgery  
  Meningitis  
  Myasthenia gravis  
  Clipping and/or coilings of aneurysms  
  Pituitary Tumor  
  Steroids: Decadron  
  Solu-Medrol  
  Anticonvulsants: Dilantin  
  phenobarbital  
  Paralytic Agents: Norcuron  
  Pavalon  
  Nimbex  
  Tracrium  
  vecuronium  
  Mannitol  
  Antipsychotics: Haldol  
  Trauma & Burns         Rating Stars (Click) 1 2 3 4
  Mass casualty  
  Electrocution  
  Amputation  
  Gangrene  
  Multiple fractures  
  Thermoregulation: hypothermia/hyperthermia  
  Berdow Formula/ �Rule of Nines�  
  Lund and Browder chart  
  Fluid resuscitation  
  Care & management of burns  
  Gastrointestinal         Rating Stars (Click) 1 2 3 4
  Small bore feeding tube insertion (Dobhoff or Keofeed)  
  Nasogastric tube insertion  
  Post pyloric feeding tube insertion  
  Gastric lavage  
  Use of activated charcoal  
  Maintenance of gastric/jejunostomy tube  
  Stoma care  
  Maintenance & management of enteral tube feedings  
  Assisting/monitoring bedside procedures: endo/chest tubes/bronchs/trach insertion/PEG tubes  
  Abdominal trauma  
  Acute gastrointestinal hemorrhage  
  Esophageal varices  
  Balloon tamponade devices (i.e. Blakemore tube)  
  Peritonitis  
  Acute pancreatitis  
  Bowel obstruction  
  Liver/pancreas transplant  
  Antiemetics: Reglan  
  Zofran  
  H2 receptor antagonists  
  Renal         Rating Stars (Click) 1 2 3 4
  Foley catheter insertion  
  Suprapubic tube  
  Nephrostomy tube  
  Peritoneal dialysis  
  Continuous Arteriovenous Hemofiltration (CAVHD  
  CVVHD  
  SCUF  
  CRRT)  
  Hemodialysis of the critically ill patient  
  Acute renal failure  
  Chronic renal failure  
  AV fistulas  
  shunts & dialysis catheters  
  Nephrectomy  
  Renal transplant  
  Renal/urinary tract trauma  
  Endocrine         Rating Stars (Click) 1 2 3 4
  Diabetic Ketoacidosis (DKA)  
  Hyperosmolar Hyperglycemic Nonketotic Coma (HHNK)  
  Diabetes Insipidus (DI)  
  Syndrome of Inappropriate Antidiuretic Hormone (SIADH)  
  Administration & monitoring of insulin infusion  
  Use of Endo tool  
  Intravenous Management         Rating Stars (Click) 1 2 3 4
  Starting peripheral IV�s  
  Care of patient with Peripherally-Inserted Central Catheter (PICC)  
  Administration/monitoring of Total Parenteral Nutrition (TPN)  
  Administration of blood/blood products  
  Administration of narcotics/sedatives: (fentanyl  
  Valium  
  Ativan  
  Versed  
  morphine)  
  Bispectral monitoring  
  Tele-ICU (ICU-E)         Rating Stars (Click) 1 2 3 4
  Mentoring  
  Communication  
  Video assessment  
  Utilize tele-ICU system  
  Multi-tasking  
  Troubleshoot equipment  
  Giving directions over AV system  
  Interpretation of data  
  Critical thinking  
  Diplomacy  
  Other         Rating Stars (Click) 1 2 3 4
  Drug or chemical overdose (TCA  
  ethanol  
  ASA)  
  Poisoning (CO  
  cyanide)  
  Substance abuse (ETOH  
  stimulants  
  narcotics)  
  Human Immunodeficiency Virus (HIV)  
  Multisystem Organ Dysfunction Syndrome (MODS)  
  Anaphylaxis  
  Disseminated Intravascular Coagulation (DIC)  
  Septic shock  
  Cancer  
  Administration of chemotherapy  
  Monitoring of chemotherapy (does not initiate)  
  Hyperbaric oxygenation  
  Organ/tissue donation procedures  
  Suicide precautions  
  Age Specific Competencies         Rating Stars (Click) 1 2 3 4
  Adolescent (ages 13-21 years)  
  Young adult (ages 22-39 years)  
  Adult (ages 40-64 years)  
  Older adult (ages 65-79 years)  
  Elderly (ages 80+ years)