Neuro PCU Skills Checklist

Neuro PCU Skills Checklist

First Name*

Last Name*

Years of Experience*

E-mail*

example@example.com

ANSWER KEY

PROFICIENCY

1=Not Applicable 2=No Experience 3=Some Experience

4=Experienced 5=Very Experienced

FREQUENCY

1=Never Performed 2=Assisted Only 3=Rarely Performed

4=Occasionally Performed 5=Regularly Performed

Provision of Care for*

Rows	Proficiency	Frequency
Cardiac Arrest
Carotid Endarterectomy
Cardiac Tamponade
CHF
MI
Myocardial Contusion
Pericardial Effusion
Pericarditis

Assist With*

Rows	Proficiency	Frequency
Thoracentesis
Emergency Intubation
Set-Up for Cardioversion
Cardioversion
Central Line Insertion
Chest Tube Insertion
Chest Tube Removal
Emergency Tracheostomy

Assessment*

Rows	Proficiency	Frequency
12-Lead EKG Interpretation
EKG Changes for MI
Rhythm Interpretation
S/S DVT
Normal Heart Tones (i.e.: S1, S2)
Abnormal Heart Tones (i.e.: Murmur, Gallop, Friction Rub)
Identification of PMI (Point Maximal Intensity)
Blood Pressure (Non-Invasive)
Pulses / Circulation Via Palpation
Pulses / Circulation Via Doppler
Insertion Site Invasive Lines

Procedures*

Rows	Proficiency	Frequency
Obtain MAP
Obtain CVP Measurement
Obtain Lab Specimens From Central Line
Proper Cardiac Monitor Lead Placement

Management of*

Rows	Proficiency	Frequency
Blood and Blood Product Administration
Blood Transfusion Reactions

Pacemaker*

Rows	Proficiency	Frequency
PPM
Transcutaneous

Management of Pacemaker*

Rows	Proficiency	Frequency
Recognition of Failure to Sense, Capture

Provision of Care for*

Rows	Proficiency	Frequency
Acute Pneumonia
ARDS Chest Trauma
COPD
Fresh Tracheostomy
Near Drowning
Pulmonary Edema
Pulmonary Hypertension
Pulmonary Embolism
Status Asthmaticus
Tuberculosis

Chest Tubes*

Rows	Proficiency	Frequency
Perform Chest Tube Set-Up
Monitor & Record Chest Tube Output
Identify Presence of Air Leak

Procedures*

Rows	Proficiency	Frequency
Perform NT (Nasotracheal) Suctioning
Perform Suctioning of Tracheostomy
Collection of Sputum Via NT Suction

Assessment*

Rows	Proficiency	Frequency
Auscultate Breath Sounds
Identify Adventitious Lung Sounds
Auscultate for Confirmation of ET Tube Placement
Application of CPAP
Application of Oximetry
Interpretation of Oximetry Values

Assessment*

Rows	Proficiency	Frequency
Bowel Sounds
Nutritional Status
Proper N/G Tube Placement

Provision of Care*

Rows	Proficiency	Frequency
Blunt Abdominal Trauma
Bowel Obstruction
Colostomy
Esophageal Bleed
GI Bleed
Hemicolectomy
Hepatitis
Ileostomy
Inflammatory Bowel Disease
Liver Failure
Pancreatitis
Paralytic Ileus
Penetrating Trauma
Small Bowel Resection

Procedures*

Rows	Proficiency	Frequency
Administration of Tube Feeding
Continuous Suction
Gravity Feeding
Iced Saline Lavage
Insertion and maintenance of N/G Tube
Insertion and Maintenance of Rectal Tube
PPN (Peripheral Parenteral Nutrition)
Removal of N/G Tube
TPN and Lipids Administration
Utilization of Feeding Pump

Provision of Care for*

Rows	Proficiency	Frequency
Addison's Disease
Diabetes Mellitus
Diabetic Ketoacidosis
Diabetes Insipidus
Hyperthyroidism
Hypothyroidism
Insulin Shock
Thyroidectomy
Cushing's Syndrome

Procedures*

Rows	Proficiency	Frequency
Fingerstick Blood Glucose
Implementation of Sliding Scale

Equipment*

Rows	Proficiency	Frequency
Blood Glucose Monitoring Devices
Use of Insulin Pen
Use of Lancet

Provision of Care for*

Rows	Proficiency	Frequency
Acute Renal Failure
Hemodialysis
Peritoneal Dialysis
TURP
Urinary Diversion (i.e.: Ileal, Conduit Nephrostomy)
Urinary Tract Infection

Procedures*

Rows	Proficiency	Frequency
Hemodialysis
Bladder Irrigation
Insertion of Female Foley Catheter

Assessment*

Rows	Proficiency	Frequency
A-V Fistula / Shunt
Fluid Status

Assessment*

Rows	Proficiency	Frequency
Perform a Comprehensive Multisystem Assessment

Provision of Care for*

Rows	Proficiency	Frequency
Exploratory Laparotomy
Hypovolemic Shock
Cardiogenic Shock
Septic Shock
Sickle Cell Anemia
Disseminated Intravascular Coagulation (DIC)
Organ / Tissue Donation
Anaphylactic Shock
Multi-System Organ Failure
Alcohol Overdose
Gunshot Wounds
AIDS
Implementation of Core Measures
Drug Overdose

Care of Patient With*

Rows	Proficiency	Frequency
Epidural Anesthesia / Analgesia
IV Conscious Sedation
Patient Controlled Analgesia
Broviac Catheter
Groshong
Hickman
Portacath
Quinton
Peripheral Line / Dressing
PICC Line

Pain Management*

Rows	Proficiency	Frequency
Assessment of Pain Level
Assessment of Therapeutic Response

Assess for*

Rows	Proficiency	Frequency
Skin Intact
Stasis Ulcers
Surgical Wound Healing

Provision of Care for*

Rows	Proficiency	Frequency
Pressure Sores
Staged Decubitus Ulcers
Surgical Wounds With Drains
Traumatic Wounds

Procedures*

Rows	Proficiency	Frequency
Sterile Dressing Changes
Wound Care / Irrigations

Equipment*

Rows	Proficiency	Frequency
Air Fluidized, Low Airloss Beds

Interpretation of*

Rows	Proficiency	Frequency
ABG's
BUN / Creatinine
Coagulation Studies
Electrolytes
Cardiac Enzymes
Blood Glucose
Thyroid Panel

Provision of Care*

Rows	Proficiency	Frequency
Perform Dosage Drip Calculations
Management of IV Medication Drips

Medications*

Rows	Proficiency	Frequency
Alupent (Metaproterenol)
Aminophylline (Theophylline)
Amiodarone (Cordarone)
Atropine
AquaMephyton (Vitamin K)
Apresoline
Barbiturate Induced Coma
Bretylium (Bretylol)
Corticosteroids
Decadron (Dexamethasone)
Digoxin (Lanoxin)
Dialantin (Phenytoin)
Diltiazem (Cardizem)
Dobutamine (Dobutrex)
Dopamine (Intropin)
Lasix (Furosemide)
Epinephrine (Adrenalin)
Esmolol (Brevibloc)
Heparin Drip
Inderal (Propranolol)
Inocor (Amrinone)
Kayexelate
Lactulose (Cephulac)
Lidocaine
Mannitol
Metoprolol (Lopressor)
Phenobarbital
Procainamide (Pronestyl)
Sodium Bicarbonate
Valium (Diazepam)
Verapamil (Calan, Isoptin, Verelan)
Ventolin (Albuterol)
Management of Epidural Administration

General*

Rows	Proficiency	Frequency
Provide Care for End-of-Life Decisions
Adhere to Legal Procedures Regarding Notification of Organ Donation Provider
Demonstrate Spiritual and Cultural Considerations for the Neuro Progressive Care Unit Patient
Provide for the Integration of Comfort Care and Death With Dignity
Demonstrate Effective Coping Skills in Caring for the Neuro Progressive Care Unit Patient

Assessment*

Rows	Proficiency	Frequency
Cranial Nerves
Glasgow Coma Scale
Pathologic Reflexes
Reflex / Motor Deficits
Visual / Communication Deficits

Provision of Care*

Rows	Proficiency	Frequency
CVA
TIA
Encephalopathy
Aneurysm Precautions
Basilar Skull Fracture
Closed Head Injury
Coma
Seizure Disorder
DT's
Encephalitis
Externalized VP Shunts
Increased ICP
Laminectomy
Meningitis
Metastatic Tumor / Intracranial Tumor Resection
Multiple Sclerosis
Post Craniotomy
Spinal Cord Injury
Neurogenic Shock
Autonomic Dysreflexia

Assist With*

Rows	Proficiency	Frequency
Application of Halo to Patient With C-Spine Injury
Assist in Placement and Changing of Head Dressings
Lumbar Puncture
Application of Nerve Stimulators
Application of TENS Unit
Spinal Precautions
Seizure Precautions

Equipment*

Rows	Proficiency	Frequency
Rotating Bed
Stryker Frame
Use of Hyper / Hypothermia Blanket

General*

Rows	Proficiency	Frequency
Management of Disease Process
Turn, Cough, and Deep Breathing Technique
Importance of Increasing Mobility Post-Op When Applicable

Age Specific Criteria*

Rows	Proficiency	Frequency
Newborn / Neonatal (up to 30 days)
Infant (30 days to 1 year)
Toddler (1 to 3 years)
Preschooler (3 to 5 years)
School Age (5 to 12 years)
Adolescents (12 to 18 years)
Young Adults (18 to 39 years)
Middle Adults (40 to 64 years)
Older Adults (65 & up)

The information provided is true and to the best of my knowledge. I hereby authorize Summit Medical Staffing to present my Skills Checklist to facilities for the purpose of employment. Please Type Your Name in This Box to Electronically Sign this Form.

First NameLast Name

Date*

MonthDayYear

Hour MinutesAM/PM Option

Form Reply Email Address

Salesforce Check

Cardiovascular

Pulmonary

Gastroenterology

Endocrine

Renal

Multisystem

Integumentary

Labs

Neuro Progressive Care Unit Pharmacology

Patient Advocacy

Neurology

Patient Education