PEDIATRIC SKILLS CHECKLIST

Nurse: ______

Date: ______

CHECK PROFICIENCY / 1 / 2 / 3 / 4 /

CARDIOVASCULAR

1. Assessment

Ausculation (Rate, rhythm, volume)
Blood pressure/non-invasive
Heart sounds/murmers
Perfusion

2. Interpretation of lab results

Arterial blood gases
Hemoglobin & Hematocrit

3. Equipment & procedures

Basic EKG interpretation
Non-invasive cardiac monitoring

4. Care of child with:

Bacterial endocarditis
Cardiac arrest
Cardiomyopathy
Congenital heart defects/disease
Congestive heart failure
Myocarditis
Pericarditis
Post cardiac cath
Post cardiac surgery
Rheumatic fever
Shock

5. Medication – Digoxin (Lanoxin)

/ / / /

PULMONARY

1. Assessment
Breath sounds
Rate and work of breathing

2. Equipment & procedures:

Airway management devices/suctioning:
Bulb syringe
Nasal airway/suctioning

PULMONARY (continued)

Oral airway/suctioning
Tracheostomy/suctioning
Apnea monitor
Chest physiotherapy
Chest tubes
End tidal CO2
Oximeter

Oxygen therapy delivery systems:

Face masks
Hood
Isolette
Nasal cannula
Tent
Trach collar
Water seal drainage system

3. Care of patient with:

Asthma
Bronchiolitis (RSV)
Bronchopulmonary dysplasia (BPD)
Cystic fibrosis
Epiglottitis
LTB/croup
Pertussis
Pneumonia
Tonsillitis
Tuberculosis

4. Medication

Alupent (Meraproteranol)
Aminophylline (Theophylline)
Isuprel (Isoproterenol)
Ventolin (Albuterol)

NEUROLOGICAL/ORTHOPEDICS

1. Assessment – level of consciousness

2. Equipment & procedures:

Application of splints
Assist with lumbar puncture
Cast
ICP monitoring
Pinned Fractures
Traction

NEUROLOGICAL/ORTHOPEDICS (continued)

3. Care of the child with:

Battered child syndrome
Closed head trauma
Clubfoot
Encephalitis
Febrile seizures
Meningitis
Multiple sclerosis
Multiple trauma
Near drowning
Neuromuscular disease
Ostegenic sarcoma
Osteomyelitis
Spinal cord injury

4. Medications

Clonopin (Clonazapam)
Corticosteriods
Dilantin (Phytoin)
Phenobarbital
Tegretol
Valium

GASTROINTESTINAL

1. Assessment

Abdominal
Nutritional

2. Interpretation of lab results

Serum electrolytes

3. Equipment & procedures

Feedings:
Bottle
Breast
Central hyperalimenation
Gavage
Peripheral hyperalimentation
Gastrostomy/button
I-tubes
Jejunal feeding
NG and sump tubes to suction
Penrose drains
Placement of naso/orogastric tube
Wound irrigation/dressing change
4. Care of patient with:
Anal fissure
Cleft lip/palate
Colostomy
Diaphragmatic hernia
Failure to thrive (FTT)
Gastroenteritis/dehydration
GE reflux
GI bleeding
Ileostomy
Intestinal parasites
Necrotizing enterocolitis (NEC)
Pyloric stenosis
Surgical abdomen
Ulcerative colitis

RENAL/GENITOURINARY

1. Assessment – fluid balance

2. Interpretation of lab results

BUN & creatinine
Urinalysis

3. Equipment & procedures

Assist with suprapubic tap
Catheter insertion:
Catheter care
Female
Indwelling
Male
Straight
Collection of urine specimen

4. Care of the child with:

Circumcision
Glomerulonephritis
Hemodialysis
Hemolytic uremic syndrome (HUS)
Hypospadias
Ileal conduit ureteral
Infantile polycystic disease
Kidney transplant
Nephrotic syndrome
Peritoneal dialysis
Renal Failure
Urinary tract infection

ENDOCRINE/METABOLIC

1. Interpretation of lab results:

Blood glucose
Thyroid studies

2. Equipment & procedures

Blood glucose testing: Type: ______
3. Care of the child with:
Adrenal disorders
Cushing’s syndrome
Juvenile diabetes
Pituitary disorders
Thyroid malfunction

4. Medications

Growth hormone
Insulin
Thyroid

HEMATOLOGY/ONCOLOGY

1. Assessment – nutritional status
2. Interpretation of lab results
Blood chemistry
Blood counts

3. Equipment & procedures

Reverse Isolation

4. Care of the child with:

Anemia
Bone marrow transplant
Depressed immune system
Disseminated intravascular coagulation (DIC)
Hemophilia
Hodgkin’s disease
Infectious mononucleosis
Leukemia
Malignant tumors
Sickle cell anemia
Spleen trauma/splenectomy
5. Medications
Prednisone
Chemotherapy certification? / Yes / No

MEDICATION ADMINISTRATION FOR CHILDREN

Calculation of pediatric doses
Eye/ear instillations
Knowledge of emergency drugs
Knowledge of routine pediatric drugs
Metered does inhaler

PHLEBOTOMY IV THERAPY

1. Equipment & procedures

Administration of blood/blood products:

Cryoprecipitate
Packed red blood cells
Whole blood
Drawing blood from central line
Drawing venous blood
Starting IV’s:
Angiocath
Butterfly
Heparin lock
2. Care of patient with:

Central line/catheter/dressing:

Broviac
Groshong
Hickman
Portacath
Quinton
Cutdown line/dressing
Peripheral line/dressing

INFECTIOUS DISEASES

1. Interpretation of lab results – blood count
2. Equipment and procedures
Fever management
Isolation

3. Care of the child with:

AIDS
Common childhood communicable diseases
Cytomegalo virus (CMV)
Hepatitis
Kawasaki’s disease
Lyme’s disease
WOUND MANAGEMENT
1. Assessment
Skin for impending breakdown
Stasis ulcers
Surgical would healing

2. Equipment and procedures

1st degree burns (throughout body)
WOUND MANAGEMENT (continued)
2nd degree burns
3rd degree burns
Pressure sores
Staged decubitus ulcers
Sterile dressing changes
Surgical wounds with drain(s)
Traumatic wound care
Use of air fluidized, low airloss beds
Wound care/irrigations

MISCELLANEOUS

1. Assessment

Normal growth and development
Normal laboratory values
Recognize sign of abuse or neglect
2. Medication – immunization schedule

3. Care of the child with:

Anorexia/bulimia
Craniofacial reconstruction
Depression
ENT surgery
Eye surgery
Ingestion of foreign body
Ingestion of poison or toxins
Plastic surgery
Suicidal threats/actions

PAIN MANAGEMENT

1. Assessment of pain level/tolerance

2. Care of the child with:

Epidural anesthesia/analgesia
IV conscious sedation
Patient controlled analgesia (PA pump)

PEDIATRIC SKILLS CHECKLIST

YEARS OF EXPERIENCE BY FIELD IN PEDIATRIC SPECIALTIES

Field / Years
Medical
Surgical
Telemetry
Orthopedics
Oncology
Neurology
Psychiatry
Rehabilitation
Other:

YEARS OF EXPERIENCE BY AGE GROUP

Age Group / Years
Newborns (birth – 30 days)
Infants (30 days – 1 year)
Toddler (1-3 years)
Preschooler (3-5 years)
School Children (5-12 years)
Adolescents (12-18 years)

Total Number of Year in Pediatric Skills: ______

The information I have provided is true and accurate to the best of my knowledge. I authorize Northwest Nurse Staffing to release this Skills Checklist to client hospitals as needed in relation to my employment.

Print name: Date: ______

Signature: ______