Infusion RN 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

  AGE OF PATIENTS CARED FOR         Rating Stars (Click) 1 2 3 4
  Newborn/Neonate (birth to 30 days)  
  Infant (1 month to 1 year)  
  Toddler (1 year to 3 years)  
  Preschooler (3 years to 5 years)  
  School Age Child (5 years to 12 years)  
  Adolescents (12 years to 18 years)  
  Young Adults (18 years to 39 years)  
  Middle Adults (39 years to 64 years)  
  Older Adults (64 years to 79 years)  
  Elderly Adults (over 79+ years)  
  GENERAL SKILLS         Rating Stars (Click) 1 2 3 4
  Care of Patient in Restraints  
  Automated Med Dispensing Systems  
  Electronic Documentation  
  Access/Management of Implanted Ports  
  Access/Management of Central Lines  
  Titration of Drips  
  Administration of Blood/Blood Products  
  Knowledge of Current IV Therapy Guidelines  
  Knowledge of Anatomy  
  Moderate Conscious Sedation  
  Sedation Reversal Agents  
  INSERTION OF         Rating Stars (Click) 1 2 3 4
  Peripheral IV – Adult  
  Peripheral IV – Child  
  Peripheral IV – Neonate  
  Vein Selection – Peripheral IVs  
  Interosseous Needles  
  MIDLINE/PICC LINES         Rating Stars (Click) 1 2 3 4
  Midline Catheter Insertion – Adult  
  Midline Catheter Insertion – Child  
  Indications for Midline/PICC Placement  
  Contraindications for Midline/PICC Placement  
  Vein Selection  
  Measuring Technique  
  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  
  CARE AND MAINTENANCE         Rating Stars (Click) 1 2 3 4
  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  
  MEDICATION ADMINISTRATION         Rating Stars (Click) 1 2 3 4
  Chemotherapy  
  Heparin  
  Streptokinase  
  TPA (Alteplase)  
  Lidocaine  
  TPN/Lipids  
  Ativan  
  Valium  
  Versed  
  Fentanyl  
  EQUIPMENT         Rating Stars (Click) 1 2 3 4
  IV Pumps  
  Needleless Systems  
  Blood Warmer  
  PCA Pumps  
  Pressure Lines  
  TROUBLESHOOTING/ COMPLICATIONS         Rating Stars (Click) 1 2 3 4
  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  
  DISCONTINUING IV THERAPY         Rating Stars (Click) 1 2 3 4
  Peripheral IVs  
  PICC/Midline  
  Central Lines