Age of Patients Cared ForNewborn/Neonate (birth to 30 days)* 1 2 3 4 Infant (1 month to 1 year)* 1 2 3 4 Toddler (1 year to 3 years)* 1 2 3 4 Preschooler (3 years to 5 years)* 1 2 3 4 School Age Child (5 years to 12 years)* 1 2 3 4 Adolescents (12 years to 18 years)* 1 2 3 4 Young Adults (18 years to 39 years)* 1 2 3 4 Middle Adults (39 years to 64 years)* 1 2 3 4 Older Adults (64 years to 79 years)* 1 2 3 4 Elderly Adults (over 79+ years)* 1 2 3 4 Patient Observations and Recordings:Respiratory* 1 2 3 4 Cardiovascular* 1 2 3 4 Neurological* 1 2 3 4 Cardiovascular* 1 2 3 4 Glasgow Coma Scale* 1 2 3 4 Gastrointestinal* 1 2 3 4 Psychological* 1 2 3 4 Pressure Area Care* 1 2 3 4 Dietary Requirements* 1 2 3 4 Fluid Balance Charts* 1 2 3 4 EKG12 Lead* 1 2 3 4 Arrhythmias* 1 2 3 4 Lead Placement* 1 2 3 4 Interpretation* 1 2 3 4 Lab Results InterpretationBlood Gases* 1 2 3 4 Blood Chemistry* 1 2 3 4 Cardiac Enzymes* 1 2 3 4 CBC* 1 2 3 4 Coagulation studies* 1 2 3 4 Electrolytes* 1 2 3 4 Urine dipstick* 1 2 3 4 Hemodynamic monitoring, non-invasiveAuscultation* 1 2 3 4 Doppler* 1 2 3 4 Automatic BP cuff* 1 2 3 4 Palpation* 1 2 3 4 Hemodynamic Monitoring, InvasiveSwan-Ganz cath insertion assist* 1 2 3 4 Swan-Ganz cath care* 1 2 3 4 MAP* 1 2 3 4 CVP* 1 2 3 4 PAWP/Wedge/PA* 1 2 3 4 Cardiac Output* 1 2 3 4 Cardiac Index* 1 2 3 4 SVO2* 1 2 3 4 Arterial line insertion assist* 1 2 3 4 Arterial line care* 1 2 3 4 SVR/PVR Calculation* 1 2 3 4 Pulmonary Artery Pressures* 1 2 3 4 Central Venous Pressures* 1 2 3 4 Specimen CollectionBlood via femoral artery* 1 2 3 4 Blood via radial artery* 1 2 3 4 Blood via arterial line* 1 2 3 4 Blood via central line* 1 2 3 4 Blood via venous line* 1 2 3 4 Cultures* 1 2 3 4 Sputum* 1 2 3 4 Urine* 1 2 3 4 SuctioningET tube - closed* 1 2 3 4 ET Tube - open* 1 2 3 4 Nasal-pharyngeal* 1 2 3 4 Tracheostomy* 1 2 3 4 Oral/Yankauer* 1 2 3 4 EquipmentCardiac Monitor* 1 2 3 4 Centrifuge* 1 2 3 4 Defibrillator* 1 2 3 4 Glucometer* 1 2 3 4 Hypo/hyperthermia blankets* 1 2 3 4 Infusion pumps (specific brands)* 1 2 3 4 Apnea monitor* 1 2 3 4 Pulse Oximeter* 1 2 3 4 Vigileo* 1 2 3 4 ECMO Machine* 1 2 3 4 CRRT machine* 1 2 3 4 High frequency oscillatory ventilation* 1 2 3 4 Specialty Beds* 1 2 3 4 VentilatorCPAP* 1 2 3 4 High frequency jet* 1 2 3 4 Peep* 1 2 3 4 T-Piece* 1 2 3 4 Tidal Volume* 1 2 3 4 IMV* 1 2 3 4 NuerologyNeuro Assessment/Neuro Vitals* 1 2 3 4 ICP Monitoring* 1 2 3 4 Seizure precautions* 1 2 3 4 Acute/Chronic CVA* 1 2 3 4 Transiet ischemic attack* 1 2 3 4 Hemorrhagic Stroke* 1 2 3 4 Ischemic stroke* 1 2 3 4 PulmonaryAssessment of breath sounds* 1 2 3 4 Assist with set-up maintenance of chest tubes* 1 2 3 4 Use of chest drainage systems* 1 2 3 4 Assist with intubation/extubation* 1 2 3 4 Ambu Bagging technique* 1 2 3 4 Administer oxygen (nasal cannula, mask, endotracheal)* 1 2 3 4 Assist with and setting up for bronchoscopy* 1 2 3 4 GastrointestinalAssessment of bowel sounds* 1 2 3 4 Identification of abnormalities* 1 2 3 4 Stool tests* 1 2 3 4 Insert/Maintain Feeding tubes/NG Tubes* 1 2 3 4 Identification of NG/tube feeding placement* 1 2 3 4 Administration of tube feedings* 1 2 3 4 Checking tube feeding residuals* 1 2 3 4 Care of ostomy patient* 1 2 3 4 Care of patient on total parenteral nutrition* 1 2 3 4 Genitourinary/RenalAbility to insert/maintain urinary drainage tubes* 1 2 3 4 Administer peritoneal dialysis* 1 2 3 4 Administer CRRT* 1 2 3 4 Administer Hemodialysis* 1 2 3 4 Care of patient receiving dialysis* 1 2 3 4 Assessment of fluid and electrolyte problems* 1 2 3 4 ICU MedicationsAmiodarone* 1 2 3 4 Atropine* 1 2 3 4 Digitalis* 1 2 3 4 Dobutamine* 1 2 3 4 Dopamine* 1 2 3 4 Epinephrine* 1 2 3 4 Heparin* 1 2 3 4 Insulin* 1 2 3 4 Isuprel* 1 2 3 4 Lidocaine* 1 2 3 4 Nipride* 1 2 3 4 Nitroglycerin* 1 2 3 4 Procainamide* 1 2 3 4 Sodium Bicarbonate* 1 2 3 4 Thrombolytics* 1 2 3 4 Verapamil* 1 2 3 4 Mannitol* 1 2 3 4 Pain ManagementPain assessment using pain scales* 1 2 3 4 Epidural analgesia* 1 2 3 4 IV conscious sedation* 1 2 3 4 Patient controlled analgesic (PCA)* 1 2 3 4 Narcotic Agents* 1 2 3 4 Non-narcotic agents* 1 2 3 4 Non-pharmacological measures* 1 2 3 4 Other Procedures/skillsIntra aortic balloon pump* 1 2 3 4 Albumin Transfusion* 1 2 3 4 Auto infusion* 1 2 3 4 Cryoprecipitate transfusion* 1 2 3 4 Fresh Frozen Plasma (FFP) Transfusion* 1 2 3 4 Packed RBCs Transfusion* 1 2 3 4 Whole Blood transfusion* 1 2 3 4 Platelets transfusions* 1 2 3 4 Intracranial pressure monitoring* 1 2 3 4 Central line care* 1 2 3 4 Hyperalimentation* 1 2 3 4 Intralipids* 1 2 3 4 Isolation Procedures* 1 2 3 4 Lumbar Puncture (assist with)* 1 2 3 4 Nerve Stimulators* 1 2 3 4 A/V Fistula care* 1 2 3 4 Bronchoscopy* 1 2 3 4 Case Care* 1 2 3 4 Chest physiotherapy* 1 2 3 4 Bladder irrigation* 1 2 3 4 Gastric Lavage/Gavage* 1 2 3 4 Electronic DocumentationAthena* 1 2 3 4 Greenway Primesuite* 1 2 3 4 Allscripts* 1 2 3 4 Care360* 1 2 3 4 CPSI* 1 2 3 4 eCLinicalWorks* 1 2 3 4 Eclipsys* 1 2 3 4 EPIC* 1 2 3 4 MACLAB* 1 2 3 4 McKesson/Paragon* 1 2 3 4 Meditech* 1 2 3 4 PACS* 1 2 3 4 Quadramed* 1 2 3 4 Sorian* 1 2 3 4 * I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form.** I hereby consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*Name* First Last Email* Phone*TODAY'S DATE* MM slash DD slash YYYY
