Skills Checklist - NICU

15849 N. 71st Street . Suite 100 - Scottsdale, AZ 85254 Toll Free: (877) 280-2600 - Fax: (877) 280-5200

Please mark your level of experience
For the skills listed below please check if you are:
(E) Expert - serves as resource
(P) Proficient - performs daily or weekly
(L) Limited - less than 6 times a year
(N) No Experience - observed only

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appropriate boxes.

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purpose of placing me on a travel assignment.

Name Date Email

Age Specific
Practice Critera

Newborn (birth -30 Days)		Middle (36-64 years)
Adolescent (12-15years)		Preschooler (3-5 Years
Infant (1month-1year)		Elderly (64 + years )
Young Adults (18-35 years)		School Age Children (5-12) Years
Toddler (1-3 Years)
Level II Nursery (years)		Level III Nursery (years)

Cardiovascular

Assessment
	E	P	L	N
Auscultation (rate, rhythm, volume)
Blood pressure/invasive (arterial line)
Blood pressure /Non Invasive
Heart sounds /murmurs
Perfusion
Pulses

Equipment and Procedures
	E	P	L	N
EKG Interpretation
Defibrillation / cardio version
Invasive hemodynamic monitoring
Central venous pressure
Care of the Neonate with:
Cardiac Arrest
Cardiac transplant
Cardiomyopathy
Congenital heart disease / defects
Hemodynamic instability
Hypovelemic shock
Post-cardiac surgery
Post-interventional cardiac cath
Medications
Dobutimine
Dopamine
Epinephrine
Nupride
Sodium bicarbonate

Endocrine/Metabolic

Assessment
	E	P	L	N
Finnegan
Fluid and electrolyte balance

Interpretation of Lab results
	E	P	L	N
Billrubin
Test urine and interpret
Glucose
Labstix
Occult blood
pH
Specific gravity

Equipment and Procedures
	E	P	L	N
Collection of urine specimens
Assist with supra pubic tap
Catheter
Diaper/ Bag

Care of the Neonate with
	E	P	L	N
Acute renal failure
DIC (disseminated intravascular coagulation)
Disorders of internal/external organs
Drug addiction /withdrawal
Hypo/hyperkalemia
Hypo/hypernatremia
IDM (infant of diabetic mother)
Hyperglycemia
Hypoglycemia
Malformations of the GU tract,kidney
Peritoneal disease

Gastrointestinal

Assessment
	E	P	L	N
Abdominal girth
Bowel sounds
Palate Suck /swallow

Equipment and Procedures
	E	P	L	N
Care of gastronomy tube

Feedings
	E	P	L	N
Assist with breast feeding
Bottle
Breast milk handling /storage
Gavage
Hospital grade electric breast pump

Placement of intestinal tubesh
	E	P	L	N
Jejunal gastro
Nasogastric/orogastric
Test for occult blood

Care of the Neonate with
	E	P	L	N
Cleft palate
Colostomy / ileostomy
Gastroschisis/omophalocele
GI bleeding
Inguinal hernia
Necrotizing enterocolitis (NEC)
Post abdominal surgery
Reflux precautions
Tracheoesophageal fistula (TEF)

Miscellaneous

Assessment
	E	P	L	N
Apgar scoring
Eye exam (r/o retinopathy)

Gestational age
	E	P	L	N
Ballard
Dubowitz
Maternal history
Screen for hearing loss

Equipment and Procedures
	E	P	L	N
Bereavement/postmortem care
Weights
Bed scale
Scale

Consents
	E	P	L	N
Immunizations
Procedural
Treatment
Cord care
Neonatal skin care
Positioning device
Preparation for transport/transfer

Thermoregulation
	E	P	L	N
Isolette with humidity
Radiant warmer
Temperature (axillaries, rectal, skin)
Weaning to open crib/bassinet

Medications
	E	P	L	N
Calculation of dosage
Emergency drug action/reaction
Eye prophylaxis vitamin K
Neonatal drug action and reaction

Neurological

Assessment
	E	P	L	N
Intracranial pressure monitoring
Neurological status

Care of Neonate
	E	P	L	N
Brain death/organ procurement
Externalized VP shunt/reservoirs
Increased intracranial pressure
Meningitis
Seizures
Medication-Anticonvulsant medication

Pain Management

Assessment
	E	P	L	N
Assessment of pain level
Care of Neonate with sedation, Ex. Morphine

Pulmonary

Assessment
	E	P	L	N
Breath sounds
Rate and work of breathing

Interpretation of Lab Results
	E	P	L	N
Blood gasses
Interpretation of X-rays reports

Equipment and Procedures
	E	P	L	N
Airway Management
Assist with intubation
Bulb syringe
CPAP nasal prongs
Endotracheal tube stabilization

Endotracheal tube suctioning
	E	P	L	N
In-line suction
Open ET- catheter suction
Extubation
Intubation
Nasal airway/ suctioning
Oral airway/ suctioning
Tracheostomy /suctioning
Apnea monitor
Cardiac resuscitation
ECMO(extracorporeal membrane oxygenation)

Chest tube (assist with)
	E	P	L	N
Insertion
Removal
Set-up

02 Therapy delivery systems
	E	P	L	N
Bag (anesthesia) and mask
Bag (self-inflating) and mask
Nasal Cannula
Nebulizer
Oxyhood
Tent
Trach collar

Obtaining blood gasses
	E	P	L	N
Arterial
Heelstick
Peripheral
Umbilical line
Thoracentesis
Use of artificial surfactant

Ventilator Care
	E	P	L	N
CPAP/PEEP
High frequency jet ventilator
Home ventilator
IMV
Oscillating
Pressure ventilator
Volume ventilator
Weaning

Care of Neonate with
	E	P	L	N
Broncopulminary dysplasia (BPD)
Cardiogenic /hypovolemic shock
Diaphragmatic hernia
Fresh tracheostomy
Meconium aspiration
Persistent pulmonary hypertension (PPHN)
Pneumothorax
Respiratory failure
Medications
Aminophylline
Prostaglandin

Phlebotomy/IV therapy

Equipment and Procedures
Administration of blood/ blood products	E	P	L	N
Cryoprecipitate
Packed red blood cells
Plasma / albumin
Whole blood

Delivery Systems
	E	P	L	N
IV pump
Syringe pump
Drawing blood cells from central line
Drawing venous blood
Hyperalimentation/TPN
Intralipid

Managing IV therapy
	E	P	L	N
Discontinuing
Dressing and tube change
Rate Calculation
Site and patency assessment

Starting IVs
	E	P	L	N
Angiocath
Butterfly
Heparin lock

Care of Neonate with
	E	P	L	N
Central line /catheter /dressing
Broviac
Groshong
Hickman
Portocath
Quinton
Percutanious arterial line
Percutanious venous line
Peripheral line/dressing
PICC (peripherally inserted central catheter)
Umbilical artery line
Umbilical venous line

Performance
Evaluation

Certifications		Expiration Date
ACLS
BCLS
TNCC
CCRN
CEN

Computerized Charting System
Medication Administration System

Signature Date