Skills Checklist

This Skills Checklist is a self-evaluation to assess your recent experience in various clinical settings focusing on the past 2 years.

0 = No Experience
1 = Some Experience
2 = Intermittent Experience
3 = Experienced
4 = Very Experienced

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AGE OF PATIENTS CARED FOR

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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+)

GENERAL SKILLS

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Standard Precautions
Isolation Precautions
Patient Head to Toe Assessment
Infant/ Neonatal Cardiac/ Respiratory Arrest
Adult Respiratory/ Cardiac Arrest
Prep and Administration of Emergency Meds
Crash Carts
Defibrillators
Care of Patient in Restraints
Automated Med Dispensing Systems
Electronic Documentation
Care Planning & Discharge Planning

CARE OF PATIENTS WITH:

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Acute/ chronic bronchitis
ARDS (adult respiratory distress syndrome)
Aspiration Asthma
Status Asthmaticus
Bronchoscopy
Bronco-Pulmonary dysplasia
CHF (congestive heart failure)
COPD (chronic obstructive pulmonary disease)
Croup
Cystic fibrosis
Epiglottis
Guillain Barre`
Hemopneumothorax
Myasthenia Gravis
Pneumonia
Pulmonary edema
Pulmonary embolism
Smoke inhalation
TB (tuberculosis)
Tension pneumothorax
Thoracotomy
Tracheal-esophageal fistula
Tracheotomy
Failure to thrive
Fem-pop bypass
Laryngospasm
Meconium aspiration
Near drowning
Persistent pulmonary hypertension
Pulmonary interstitial emphysema
RSV (respiratory syncytial virus)
Transient tachypnea of newborn

MEDICATION ADMINISTRATION:

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Atrovent
Albuterol
Bicarbonate
Breo
Combivent
Incruse
Isuprel
Mucomyst
Pulmicort
Racemic epinephrine
Spiriva
Terbutaline sulfate
Theophylline
Xopenex

KNOWLEDGE OF EFFECTS OF:

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Alupent
Anectine
Atropine
Azmacort
Bronkosol
Corticosteroids
Cromolyn sodium
Decadron
Diazepam
Digoxin
Dopamine
Flovent
Heliox therapy
Inhaled steroids
Ketamine
Lasix
Lidocaine
Morphine
Nitric oxide
Pavulon
Propofol
Tobramycin
Versed

EQUIPMENT

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Achieva
Siemens
Bi-Pap
PB7200
Sechrist IV 100B
Servo V60
Assist control
CPAP
Flow-by
High frequency ventilator
IMV
Inverse ratio vent
Pressure support
Pressure vents
SIMV
Troubleshooting high and low alarms

Oxygen/ Air delivery systems

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Ambu bag
Croup tent
e-cylinders
Nasal cannula
Non-rebreather
T-piece
Trach collar
Venturi mask
ABG - List

MEDICATION DELIVERY: Nebulizer

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Hand held
Humidification (cool/ warm)
Ultrasonic nebulizer

MEDICATION DELIVERY: MDI (metered dose inhaler)

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Aero chamber
IPPB (intermittent positive pressure)

PROCEDURES:

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Postural drainage
Chest percussion therapy
Sputum collection/ sampling
ABG’s (arterial blood gas)
Allen test
Femoral
Arterial
Set up and calibrate arterial lines
Radial
Analyzing ABG’s
Interpreting ABG’s

AIRWAY MANAGEMENT & SUCTIONING:

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Tracheal
Endotracheal
Nasotracheal
Oral
In-line suctioning

Adult

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Checking cuff pressure
Extubation
Intubations

Manual ventilation

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Neo-natal
Pediatrics

DIAGNOSTIC:

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Pulmonary function testing
Assist with bronchoscopes

Assist with high risk deliveries

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Obtain umbilical blood gas
Obtain capillary blood gas
Assist with thoracentesis
Homodynamic monitoring

TEACHING:

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Incentive spirometer
Peak flow meter
Pursed lip breathing
Segmental breathing
Splinting

WORK SETTINGS:

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CCU/ ICU
Emergency department
Home care
Neonatal ICU
Pediatric
Pediatric ICU
Pulmonary rehabilitation
Transport

Position Category

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Total Years of Experience

First Name

Last Name

Social Security #

Date of Birth

Email

Phone

Attestation

I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified, particularly within the last 2 years. I hereby authorize Alliant Personnel Resources (The Company) to collect, store, and release any information that I have provided in this Skills Checklist and/or any other documentation and information they have collected or that I have submitted in any form to its parent company(s), its subsidiaries, or other subcontractors/its service providers as it deems necessary in its business operations as well as to individuals and companies in relation to consideration of employment as a Healthcare Professional with those companies and individuals. I acknowledge that The Company will take precaution and care to protect my personal information that is collected/stored/shared but cannot guarantee permanent data security and I release The Company from all related liability for damages or punitive liability.

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Skills Checklist - RRT/CRT