PACU 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

  CARDIOVASCULAR         Rating Stars (Click) 1 2 3 4
  Open Heart Recovery  
  AAA Repair  
  Vascular Surgery  
  Pacemaker-Permanent & Temporary  
  Cardioversion  
  AICD Insertion  
  Cardiac Arrest  
  Cardiac Tamponade  
  CHF/Pulmonary Edema  
  Abnormal Heart Sounds/Murmurs  
  Pulses/Circulation Checks  
  PULMONARY         Rating Stars (Click) 1 2 3 4
  Ventilator Management  
  Fresh Tracheostomy  
  Thoracotomy/Lobectomy/Pneumonectomy  
  Pneumothorax/Hemothorax  
  Laryngospasm  
  Pulmonary Embolism  
  COPD  
  ABG Interpretation  
  NEUROLOGIC         Rating Stars (Click) 1 2 3 4
  Post Craniotomy  
  Anterior/Posterior Spinal Fusion  
  Carotid Endardarectomy  
  Spine Surgery  
  CVA  
  Stroke Scale  
  Glascow Coma Scale  
  Spinal Precautions  
  Hypothermia Protocol  
  Hypo/Hyperthermia Blanket  
  Sedation Scales/Levels  
  GASTROINTESTINAL         Rating Stars (Click) 1 2 3 4
  Pancreas/Liver Transplant  
  Colon Surgery  
  Colostomy/Ileostomy  
  ERCP  
  G Tube/J Tube Management  
  T Tube Management  
  RENAL/GENITOURINARY         Rating Stars (Click) 1 2 3 4
  Renal Surgery  
  TURP  
  Arteriovenous Fistula/Shunt  
  Nephrostomy Tubes  
  ENDOCRINE METABOLIC         Rating Stars (Click) 1 2 3 4
  Diabetes - Hypo/Hyperglycemic Crisis  
  IV Insulin Protocols  
  ORTHOPEDIC         Rating Stars (Click) 1 2 3 4
  Laminectomy  
  Total Joint Replacement  
  Amputation  
  Open Reduction/Internal Fixation  
  General Orthopedic Surgeries  
  CPM/Traction  
  Circulation Checks  
  WOUND MANAGEMENT         Rating Stars (Click) 1 2 3 4
  Surgical Drains  
  Wound Vac  
  Surgical Wound Assessment  
  Skin Assessment for Breakdown  
  Staging Decubitus Ulcers  
  MEDICATIONS         Rating Stars (Click) 1 2 3 4
  Procedural Sedation  
  Anesthesia Medications  
  Anti-Arrhythmics  
  Anticoagulants  
  Anti-Hypertensives  
  Anti-Seizure Medications  
  Benzodiazepines  
  Emergency Medications  
  Insulin  
  Narcotics/Opioid Analgesics  
  Nitrates  
  Non-Opioid Analgesics  
  Reversal Agents  
  Steroids  
  Automated Medication Dispensing (i.e. Pyxis  
  Omnicell)  
  IV THERAPY         Rating Stars (Click) 1 2 3 4
  Starting Ivs  
  Central Line Blood Draws  
  Central Line/Implanted Line Care  
  Blood Product Administration  
  CARDIAC MONITORING & EMERG. RESPONSE         Rating Stars (Click) 1 2 3 4
  Malignant Hyperthermia  
  Dysrhythmia Interpretation  
  Dysrhythmia Management  
  12 Lead EKG  
  PROFESSIONAL KNOWLEDGE AND SKILLS         Rating Stars (Click) 1 2 3 4
  National Patient Safety Goals/Core Measures  
  Fall Risk Assessment/Prevention  
  Pressure Ulcer Risk Assessment/Prevention  
  Age Specific/Population-Based Care  
  Pain Assessment & Management  
  Charge Experience  
  Interpretation and Communication of Lab Values  
  Specialty Beds  
  EMR         Rating Stars (Click) 1 2 3 4
  Epic  
  Cerner  
  Eclipsys  
  McKesson  
  Meditech  
  Other Computerized System  
  Computerized Physician Order Entry  
  Bar Coding for Medication Administration  
  PULMONARY  
  Age Specific Competencies         Rating Stars (Click) 1 2 3 4
  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)