PCU_STEPDOWN_SKILLS

		REGISTERED NURSE PCU STEPDOWN CHECKLIST
NAME

LAST 4 OF SSN

DATE

	I hereby certify that ALL information I have provided to IMCS Group on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.
Proficiency Scale:	1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently

Rating Stars (Click)	A. Phlebotomy/IV Therapy		1	2	3	4
	Draw Blood:
	Venous Stick
	Central Line
	Arterial Line
	IV Push
	IV Drip:
	Calculations
	Titration
	Obtain IV Access
	Mix IV Medications
	Regulate IV’s
	IV Infusion Pumps
	Central Line Dressing Changes
	Chemotherapy Administration
	Blood/Blood Product Administration
	TPN/PPN Administration
	Multi-Lumen Central Catheters
	Continuous Subcutaneous Infusion Pumps
	PCA Pumps (Patient Controlled Analgesia)
Rating Stars (Click)	B. Cardiovascular		1	2	3	4
	Cardiac Monitors
	Rhythm Strip Measurements
	Recognize & Interpret Dysrhythmias
	Obtain 12 Lead EKG’s
	CPR
	Cardioversion/Defibrillation
	Pulse Checks
	Use of Doppler
	Automatic BP Cuff
Rating Stars (Click)	Care of the Patient with:		1	2	3	4
	Acute MI
	CHF
	Angina
	Hypertension
	Cardiomyopathy
	Cardiopulmonary Arrest
	Abdominal Aortic Aneurysm
	Pre/Post Cardiac Surgery
	Carotid Endarterectomy
	Femoral Popliteal Bypass
	Permanent Pacemaker
	Temporary Pacemaker
	External Pacemaker
	Pre/Post Cardiac Cath
	Pre/Post PTCA
	Cardiac Lab Interpretation (CPK, Iso Enzymes)
	Cardiac Rehab/Patient Teaching
Rating Stars (Click)	Use and Administration of:
	Atropine
	Digoxin
	Dopamine
	Dobutamine
	Heparin
	Verapamil
	Lopressor
	Lidocaine
	Nitroglycerine
	Nipride
	Thrombolytic Agents
	Code Cart/Emergency Drugs
Rating Stars (Click)	C. Respiratory		1	2	3	4
	O2 Masks/Cannulas
	Ambu Bag
	Chest PT
	Incentive Spirometry
	Instruction of Coughing/Deep Breathing
	Nebulizer Set Up
Rating Stars (Click)	Suctioning:		1	2	3	4
	Oral
	Tracheostomy Tube
	Endotracheal Tube
	Use of Pleurevac
	Interpret ABG’s
	Arterial Line Maintenance
	Sputum Specimen Collection
	Pulse Oximetry
Rating Stars (Click)	Care of the Patient with:		1	2	3	4
	Pulmonary Edema
	COPD
	ARDS
	Ventilator
	Tracheostomy
	Pre/Post Thoracic Surgery
	Pneumonia
	Chest Tubes
	Asthma
	Emphysema
	Assist with Intubation/Extubation
	Weaning Patient off Ventilator
Rating Stars (Click)	Use and Administration of:		1	2	3	4
	Aminophylline
	Corticosteroids
	Inhalers
Rating Stars (Click)	D. Neurological		1	2	3	4
	Neuro Assessment
	Glasgow Coma Scale
	Seizure Precautions
	Assist with Lumbar Puncture
Rating Stars (Click)	Care of the Patient with:		1	2	3	4
	Acute Head Injury
	CVA/TIA
	DT’s
	Spinal Cord Injury
	Pre/Post Neuro Surgery
	Halo Traction
	Multiple Sclerosis
	Overdos
Rating Stars (Click)	Use and Administration of:		1	2	3	4
	Decadron
	Dilantin
	Phenobarbitol
	Magnesium Sulfate
	Valium
	Ativan
Rating Stars (Click)	E. Gastrointestinal		1	2	3	4
	NG Tube Care and Maintenance
	NG Tube Insertion
	Bowel Preparation
	Enterostomal Care
Rating Stars (Click)	Care of the Patient with:		1	2	3	4
	Tube Feedings
	Ileostomy
	Colostomy
	Pancreatitis
	GI Bleed
	Bowel Obstruction
	Whipple Procedure
	Liver Transplant
	Abdominal Wounds/Surgeries
	Hemovac
	Gastrostomy Tube/Jejunostomy Tube
Rating Stars (Click)	F. Genitourinary/Renal		1	2	3	4
	Urinary Catheter Insertion
Rating Stars (Click)	Bladder Irrigations:		1	2	3	4
	Continuous
	Intermittent
	Electrolyte Imbalance/Replacement
Rating Stars (Click)	Care of the Patient with:		1	2	3	4
	Peritoneal Dialysis
	Hemodialysis
	T.U.R.P
	Shunts & Fistulas
	Nephrectomy
	Supra-Pubic Catheter
	Nephrostomy Tube
Rating Stars (Click)	G. Orthopedics		1	2	3	4
	Cast Care
Rating Stars (Click)	Tractions:		1	2	3	4
	Skin
	Skeleta
	ROM
	Use of Assistive Devices
Rating Stars (Click)	Care of the Patient with:		1	2	3	4
	Total Joint Replacement
	Amputation
Rating Stars (Click)	H. Miscellaneous		1	2	3	4
	F.S. Glucose Monitoring
	Dressing Changes
	Use of Air Fluidized Beds
	Normal Serum Lab Values
	Universal Precautions - Isolation
Rating Stars (Click)	Care of the Patient with:		1	2	3	4
	Pressure Sores
	Sickle Cell Anemia
	Cancer
	Alzheimer’s Disease
	HIV/AIDS
	Diabetes
	Discharge Planning
Rating Stars (Click)	EMR		1	2	3	4
	Epic
	Cerner
	Eclipsys
	McKesson
	Meditech
	Other Computerized System
	Computerized Physician Order Entry
	Bar Coding for Medication Administration
MY EXPERIENCE IS PRIMARILY IN:
Unit	No. of Years	Unit	No. of Years
BURN		POST PARTUM
CRITICAL UNIT		LABOR & DELIVERY
PACU		NEWBORN NURSERY
NEUROLOGY		LEVEL II NICU
TELEMETRY		LEVEL III NICU
MEDICAL		PICU
SURGICAL		PEDIATRICS
ONCOLOGY		OB/GYN
ORTHOPEDICS		PSYCHIATRY
OPERATING ROOM		RRT
EMERGENCY ROOM		CRT
TRAUMA CENTER LEVEL 1
COMMUNITY ER
RURAL ER
Rating Stars (Click)	Age Specific Competencies		1	2	3	4
	Newborn/Neonatal (birth – 30 days)
	Infant (30 days-1 year)
	Toddler (1-3 years)
	Preschool (3-5 years)
	School Age Children (5-12 years)
	Adolescent (12-17 years)
	Young Adults (18-44 years)
	Middle Adults (45-64 years)
	Older Adults (>65 years)