PICU 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

  WORK SETTINGS         Rating Stars (Click) 1 2 3 4
  PICU  
  Pediatric CVICU  
  Pediatric Step Down  
  Pediatric PACU  
  CARDIOVASCULAR         Rating Stars (Click) 1 2 3 4
  Congenital Heart Disease/Repair  
  Post Cardiac Surgery (Directly from OR)  
  Post Cardiac Surgery (NOT Directly from OR)  
  Post Diagnostic/Interventional Cardiac Cath  
  Heart Failure/Cardiogenic Shock  
  Cardiac Transplant  
  Hemodynamic Monitoring  
  Arrhythmia Interpretation  
  Pacemaker - Temporary/Permanent  
  SVO2 Monitoring  
  Intra-Aortic Balloon Pump  
  Ventricular Assist Device  
  ECMO  
  PULMONARY         Rating Stars (Click) 1 2 3 4
  Respiratory Distress Syndrome/Resp. Failure  
  Reactive Airway Disease  
  ENT Surgery  
  Epiglottis  
  Cystic Fibrosis  
  Tuberculosis  
  Intubation/Extubation  
  Endotracheal Tube Management  
  Tracheostomy Management  
  Modes of Ventilation: AC/PC/SIMV/CPAP  
  Modes of Ventilation: Jet/Oscillator  
  Nitric Oxide  
  Hemo/Pneumothorax  
  NEUROLOGIC/ORTHOPEDIC         Rating Stars (Click) 1 2 3 4
  Brain Injury  
  Craniotomy  
  Spinal Cord Injury  
  Seizure Disorders  
  ICP Monitoring  
  VP Shunt  
  Meningitis  
  Neuromuscular Disease  
  Post Vertebral Surgery  
  Traction - General  
  Traction - Halo  
  GASTROINTESTINAL         Rating Stars (Click) 1 2 3 4
  Acute Surgical Abdomen  
  GI Bleeding  
  Pancreatitis  
  Hepatic Failure  
  Ostomy Management  
  Management of Gastric Tubes  
  Breast Milk Handling/Storage  
  RENAL/GENITOURINARY         Rating Stars (Click) 1 2 3 4
  Nephrotic Syndrome  
  Renal Transplant  
  Renal Replacement Therapy  
  Peritoneal Dialysis  
  ENDOCRINE/METABOLIC         Rating Stars (Click) 1 2 3 4
  Diabetes - Hypo/Hyperglycemic Crisis  
  Diabetic Ketoacidosis  
  IV Insulin Pumps  
  Indwelling Insulin Pumps  
  TRAUMA/OTHER         Rating Stars (Click) 1 2 3 4
  Blunt/Penetrating Trauma  
  Burns  
  Craniofacial Reconstruction  
  Near Drowning  
  Poison Ingestion/Overdose  
  Bites-Animal/Snake/Human  
  Suicide Precautions  
  Wound Management/VAC  
  Specialty Beds  
  ONCOLOGY         Rating Stars (Click) 1 2 3 4
  Bone Marrow Transplant  
  Immunosuppressive Disorder  
  Hemophilia Crisis  
  Sickle Cell Crisis  
  MEDICATIONS         Rating Stars (Click) 1 2 3 4
  Pediatric Dosage Calculations  
  Anti-Arrhythmics  
  Anticoagulants (IV  
  Oral & Injection)  
  Anti-Hypertensives  
  Anti-Seizure Medications  
  Benzodiazepines  
  Continuous IV Paralytics  
  Continuous IV Sedation  
  Procedural Sedation - Administration  
  Diuretics  
  Emergency Medication  
  Inhaled Medications  
  Insulin  
  IV Vasopressors  
  Narcotics/Opioid Analgesics (IV  
  Oral & Injection)  
  Non-Opioid Analgesics (IV  
  Oral & Injection)  
  Reversal Agents  
  Steroids (IV  
  Oral  
  Inhaled)  
  Automated Medication Dispensing (i.e. Pyxis  
  Omnicell)  
  IV THERAPY         Rating Stars (Click) 1 2 3 4
  Starting Ivs  
  Central Line Blood Draw  
  Central Line/Implanted Line Care  
  TPN/Lipids  
  Blood Product Administration  
  Administration of Chemotherapy  
  CARDIAC MONITORING & EMERG. RESPONSE         Rating Stars (Click) 1 2 3 4
  Dysrhythmia Interpretation  
  Dysrhythmia Management  
  Management of Cardiac Arrest  
  Shock Management  
  Malignant Hyperthermia  
  Multisystem Organ Failure  
  PROFESSIONAL KNOWLEDGE AND SKILLS         Rating Stars (Click) 1 2 3 4
  National Patient Safety Goals/Core Measures  
  Recognize/Report Signs of Abuse  
  EMTALA  
  Fall Risk Assessment/Prevention  
  Pressure Ulcer Risk Assessment/Prevention  
  Restraints/Use of Least Restrictive Device  
  Normal Growth and Development  
  Age Specific/Population Based Care  
  Patient Family Teaching  
  Isolation Precautions  
  Infection Prevention  
  Reporting Communicable Diseases  
  Pain Assessment & Management  
  Charge Experience  
  Interpretation and Communication of Lab Values  
  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)  
  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