Skill Checklists
Neonatal ICU
Name
Email
LAST 4 OF SSN
This checklist was electronically signed on (Today’s date)
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
Neonates < 28 Weeks
Neonates 29 - 34 Weeks
Neonates > 34 Weeks
Level II NICU
Level III NICU
Level IV NICU
Cardiac Surgery - Pre-op
Cardiac Surgery - Immediate Post-op
Congenital Heart Disease/Defects
CHF/Pulmonary Edema
Hemodynamic Instability
Bronchopulmonary Dysplasia
Diaphragmatic Hernia
Fresh Tracheostomy
Meconium Aspiration
Persistent Pulmonary Hypertension
Pneumonia
Respiratory Distress Syndrome/Failure
Interpretation of ABGs
Assist with Intubation/Extubation
Endotracheal Suctioning
Chest Tube Placement and Management
Modes of Ventilation (AC/PC/SIMV/CPAP/BiPAP)
High Frequency Ventilation
Inhaled NO
ECMO
Ballard/Dubowitz
Reflexes Based on Gestational Age
Hydrocephalus
Intraventricular Hemorrhage
Meningocele/Myelomeningocele
Neonatal Abstinence Score/Syndrome
Seizures
Colostomy/Ileostomy
Gastroschisis/Omphalocele
GI Bleeding
Necrotizing Enterocolitis
Post Abdominal Procedure
Breast Milk Handling/Storage
Breast Pump
Gavage Feedings
NG/OG/NJ Tube Placement and Management
Circumcision Care
Genetic Disorders
Hypo/Hyperglycemia
Infant of Diabetic Mother
Malformations of the GU Tract/Kidney
Phototherapy
Renal Failure
Neonatal Sepsis
Septic Work Up
Assist with Lumbar Puncture
Calculation of Neonatal Dosages
Antibiotics/Antivirals
Anticonvulsants
Immunizations
Digoxin
IV Vasopressors
Prostaglandin
Bronchodilators
Steroids
Caffeine
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
Surfactant
Administration of Blood/Blood Products
Central Line Catheter/Dressings
Management of UAC/UVC Lines
Radial Arterial Lines
Start IVs
Attend High Risk Deliveries
Preparation for Transport
Transport Neonate
Rhythm Interpretation
Dysrhythmia Management
National Patient Safety Goals/Core Measures
Bereavement/Postmortem Care
Neonatal Skin Care
Pressure Ulcer Risk Assessment/Prevention
Restraints/Use of Least Restrictive Device
Patient/Family Teaching
Age Specific/Population-Based Care
Isolation Precautions
Infection Prevention
Pain Assessment & Management
Charge Experience
Interpretation and Communication of Lab Values
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
EMR Conversion
Computerized Physician Order Entry
Bar Coding for Medication Administration
BLS
5
CNRN
ACLS
CCRN
Other:
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.
