General ICU Skills Checklist

General ICU All the fields are mandatory

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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 : -	1 = Never Performed	2 = Limited Experience	3 = Comfortable Performing	4 = Proficient
Frequency : -	1 = Never	2 = Sometimes	3 = Often	4 = Always

General ICU Pharmacology

Propofol (Diprivan)

1

2

3

4

1

2

3

4

Valium (Diazepam)

1

2

3

4

1

2

3

4

Verapamil (Calan, Isoptin, Verelan)

1

2

3

4

1

2

3

4

Vecuronium

1

2

3

4

1

2

3

4

Ventolin (Albuterol)

1

2

3

4

1

2

3

4

Versed

1

2

3

4

1

2

3

4

Management of Epidural Administration

1

2

3

4

1

2

3

4

Alupent (Metaproterenol)

1

2

3

4

1

2

3

4

Amicar

1

2

3

4

1

2

3

4

Aminophylline (Theophylline)

1

2

3

4

1

2

3

4

Amiodarone (Cordarone)

1

2

3

4

1

2

3

4

Atropine

1

2

3

4

1

2

3

4

AquaMephyton (Vitamin K)

1

2

3

4

1

2

3

4

Apresoline

1

2

3

4

1

2

3

4

Ativan

1

2

3

4

1

2

3

4

Bretylium (Bretylol)

1

2

3

4

1

2

3

4

Corticosteroids

1

2

3

4

1

2

3

4

Decadron (Dexamethasone)

1

2

3

4

1

2

3

4

Digoxin (Lanoxin)

1

2

3

4

1

2

3

4

Dilantin (Phenytoin)

1

2

3

4

1

2

3

4

Diltiazem (Cardizem)

1

2

3

4

1

2

3

4

Dobutamine (Dobutrex)

1

2

3

4

1

2

3

4

Dopamine (Intropin)

1

2

3

4

1

2

3

4

Epinephrine (Adrenalin)

1

2

3

4

1

2

3

4

Esmolol (Brevibloc)

1

2

3

4

1

2

3

4

Fentanyl

1

2

3

4

1

2

3

4

Furosemide (Lasix)

1

2

3

4

1

2

3

4

Heparin Drip

1

2

3

4

1

2

3

4

Inderal (Propranolol)

1

2

3

4

1

2

3

4

Inocor (Amrinone)

1

2

3

4

1

2

3

4

Kayexelate

1

2

3

4

1

2

3

4

Ketamine

1

2

3

4

1

2

3

4

Lactulose (Cephulac)

1

2

3

4

1

2

3

4

Levophed

1

2

3

4

1

2

3

4

Lidocaine

1

2

3

4

1

2

3

4

Metoprolol (Lopressor)

1

2

3

4

1

2

3

4

Neosynephrine

1

2

3

4

1

2

3

4

Nimbex

1

2

3

4

1

2

3

4

Nipride (Nitroprusside)

1

2

3

4

1

2

3

4

Nitroglycerin (Tridil)

1

2

3

4

1

2

3

4

Norepinephrine

1

2

3

4

1

2

3

4

Phenobarbital

1

2

3

4

1

2

3

4

Pitressin (Vasopressin)

1

2

3

4

1

2

3

4

Precedex

1

2

3

4

1

2

3

4

Procainamide (Pronestyl)

1

2

3

4

1

2

3

4

Sodium Bicarbonate

1

2

3

4

1

2

3

4

Succinylcholine

1

2

3

4

1

2

3

4

Perform calculations for weight-based dosages

1

2

3

4

1

2

3

4

Perform calculations for oral & parenteral dosages

1

2

3

4

1

2

3

4

Assess for drug toxicity

1

2

3

4

1

2

3

4

Administer reversal agents when indicated (Narcan, Romazicon, etc.)

1

2

3

4

1

2

3

4

Assess appropriate fluid replacement (isotonic, hypotonic, hypertonic, crystalloid)

1

2

3

4

1

2

3

4

Titrate vasopressors to effect/parameters

1

2

3

4

1

2

3

4

Assess for therapeutic response

1

2

3

4

1

2

3

4

Perform & manage dosage drip calculations

1

2

3

4

1

2

3

4

Barbiturate induced coma

1

2

3

4

1

2

3

4

Provision of Care Proficiency Frequency

SIADH

1

2

3

4

1

2

3

4

Addison’s Disease

1

2

3

4

1

2

3

4

Diabetes mellitus

1

2

3

4

1

2

3

4

Diabetic ketoacidosis

1

2

3

4

1

2

3

4

Diabetes Insipidus

1

2

3

4

1

2

3

4

Hyperthyroidism

1

2

3

4

1

2

3

4

Hypothyroidism

1

2

3

4

1

2

3

4

Insulin Shock

1

2

3

4

1

2

3

4

Thyroidectomy

1

2

3

4

1

2

3

4

Cushing’s Syndrome

1

2

3

4

1

2

3

4

Administration of D50

1

2

3

4

1

2

3

4

Manage insulin drip

1

2

3

4

1

2

3

4

Fingerstick Blood Glucose

1

2

3

4

1

2

3

4

Implementation of Sliding Scale

1

2

3

4

1

2

3

4

Blood glucose monitoring devices

1

2

3

4

1

2

3

4

Use of Insulin Pen

1

2

3

4

1

2

3

4

Use of Lancet

1

2

3

4

1

2

3

4

Restraints (types, duration, assessment, protocols, and standards)

1

2

3

4

1

2

3

4

Therapeutic patient positioning

1

2

3

4

1

2

3

4

Implementation of Core Measures

1

2

3

4

1

2

3

4

Exploratory laparotomy

1

2

3

4

1

2

3

4

Splenectomy

1

2

3

4

1

2

3

4

Hypovolemic Shock

1

2

3

4

1

2

3

4

Cardiogenic Shock

1

2

3

4

1

2

3

4

Septic Shock

1

2

3

4

1

2

3

4

Anaphylactic shock

1

2

3

4

1

2

3

4

Disseminated intravascular coagulation (DIC)

1

2

3

4

1

2

3

4

Organ/tissue donation

1

2

3

4

1

2

3

4

Sickle Cell Anemia

1

2

3

4

1

2

3

4

Multi-system organ failure

1

2

3

4

1

2

3

4

Alcohol Overdose

1

2

3

4

1

2

3

4

Gunshot Wounds

1

2

3

4

1

2

3

4

Cancer

1

2

3

4

1

2

3

4

AIDS

1

2

3

4

1

2

3

4

Drug Overdose

1

2

3

4

1

2

3

4

Follow current ACLS Guidelines

1

2

3

4

1

2

3

4

Obtain & utilize crash cart

1

2

3

4

1

2

3

4

Administer medications used in emergency situations

1

2

3

4

1

2

3

4

Operate defibrillator

1

2

3

4

1

2

3

4

Assist with therapeutic hypothermia

1

2

3

4

1

2

3

4

Perform comprehensive multi-system assessment

1

2

3

4

1

2

3

4

Assessment of pain level

1

2

3

4

1

2

3

4

Assessment of therapeutic response

1

2

3

4

1

2

3

4

PICC Line

1

2

3

4

1

2

3

4

Epidural anesthesia/analgesia

1

2

3

4

1

2

3

4

IV conscious sedation

1

2

3

4

1

2

3

4

Patient controlled analgesia

1

2

3

4

1

2

3

4

Broviac Catheter

1

2

3

4

1

2

3

4

Groshong

1

2

3

4

1

2

3

4

Hickman

1

2

3

4

1

2

3

4

Portacath

1

2

3

4

1

2

3

4

Quinton

1

2

3

4

1

2

3

4

Peripheral line/dressing

1

2

3

4

1

2

3

4

Blood counts

1

2

3

4

1

2

3

4

ABG's

1

2

3

4

1

2

3

4

BUN/Creatinine

1

2

3

4

1

2

3

4

Coagulation Studies

1

2

3

4

1

2

3

4

Electrolytes

1

2

3

4

1

2

3

4

Cardiac Enzymes

1

2

3

4

1

2

3

4

Blood glucose

1

2

3

4

1

2

3

4

Thyroid Panel

1

2

3

4

1

2

3

4

Interpretation of Oximetry Values

1

2

3

4

1

2

3

4

Auscultate breath sounds

1

2

3

4

1

2

3

4

Identify adventitious lung sounds

1

2

3

4

1

2

3

4

Auscultate for confirmation of ET Tube placement

1

2

3

4

1

2

3

4

Implement Ventilator Acquired Pneumonia protocols

1

2

3

4

1

2

3

4

Assess and confirm proper Vent settings

1

2

3

4

1

2

3

4

Manage patient on mechanical ventilation

1

2

3

4

1

2

3

4

Assist and manage patient weaning from artificial pulmonary support

1

2

3

4

1

2

3

4

Assist with post-extubation care

1

2

3

4

1

2

3

4

Maintain pulmonary stability post-extubation

1

2

3

4

1

2

3

4

Application of BiPAP

1

2

3

4

1

2

3

4

Application of CPAP

1

2

3

4

1

2

3

4

Application of Oximetry

1

2

3

4

1

2

3

4

Tuberculosis

1

2

3

4

1

2

3

4

Acute Pneumonia

1

2

3

4

1

2

3

4

ARDS

1

2

3

4

1

2

3

4

Chest Trauma

1

2

3

4

1

2

3

4

COPD

1

2

3

4

1

2

3

4

Cor Pulmonale

1

2

3

4

1

2

3

4

Fresh Tracheostomy

1

2

3

4

1

2

3

4

Lobectomy

1

2

3

4

1

2

3

4

Near Drowning

1

2

3

4

1

2

3

4

Pneumonectomy

1

2

3

4

1

2

3

4

Pulmonary Edema

1

2

3

4

1

2

3

4

Pulmonary Hypertension

1

2

3

4

1

2

3

4

Pulmonary Embolism

1

2

3

4

1

2

3

4

Respiratory Arrest

1

2

3

4

1

2

3

4

Status Asthmaticus

1

2

3

4

1

2

3

4

Thoracotomy

1

2

3

4

1

2

3

4

Perform Chest Tube Set-up

1

2

3

4

1

2

3

4

Monitor & record chest tube output

1

2

3

4

1

2

3

4

Identify and troubleshoot clotted chest tube

1

2

3

4

1

2

3

4

Identify and troubleshoot patient bleeding from chest tube

1

2

3

4

1

2

3

4

Identify and troubleshoot presence of air leak

1

2

3

4

1

2

3

4

Perform ET Tube suctioning

1

2

3

4

1

2

3

4

Perform NT (Nasotracheal) suctioning

1

2

3

4

1

2

3

4

Perform suctioning of Tracheostomy

1

2

3

4

1

2

3

4

Collection of Sputum via NT Suction

1

2

3

4

1

2

3

4

Collection of Sputum Specimen via ET (closed system)

1

2

3

4

1

2

3

4

Assist with extubation of patient

1

2

3

4

1

2

3

4

NIH Stroke Scale

1

2

3

4

1

2

3

4

S/S indicating type of stroke (hemorrhagic vs. ischemic)

1

2

3

4

1

2

3

4

Cranial Nerves

1

2

3

4

1

2

3

4

Glasgow Coma Scale

1

2

3

4

1

2

3

4

Pathologic Reflexes

1

2

3

4

1

2

3

4

Reflex/Motor Deficits

1

2

3

4

1

2

3

4

Visual/Communication Deficits

1

2

3

4

1

2

3

4

CVA

1

2

3

4

1

2

3

4

TIA

1

2

3

4

1

2

3

4

Encephalopathy

1

2

3

4

1

2

3

4

Aneurysm Precautions

1

2

3

4

1

2

3

4

Basilar Skull Fracture

1

2

3

4

1

2

3

4

Closed Head Injury

1

2

3

4

1

2

3

4

Coma

1

2

3

4

1

2

3

4

Seizure Disorder

1

2

3

4

1

2

3

4

DT's

1

2

3

4

1

2

3

4

Encephalitis

1

2

3

4

1

2

3

4

Externalized VP shunts

1

2

3

4

1

2

3

4

Increased ICP

1

2

3

4

1

2

3

4

Laminectomy

1

2

3

4

1

2

3

4

Meningitis

1

2

3

4

1

2

3

4

Metastatic tumor/intracranial tumor resection

1

2

3

4

1

2

3

4

Multiple Sclerosis

1

2

3

4

1

2

3

4

Post Craniotomy

1

2

3

4

1

2

3

4

Spinal cord injury

1

2

3

4

1

2

3

4

Ventriculostomy

1

2

3

4

1

2

3

4

Neurogenic Shock

1

2

3

4

1

2

3

4

Lumbar puncture

1

2

3

4

1

2

3

4

Intracranial pressure monitoring

1

2

3

4

1

2

3

4

Nerve stimulators

1

2

3

4

1

2

3

4

Rotating bed

1

2

3

4

1

2

3

4

Seizure precautions

1

2

3

4

1

2

3

4

Spinal precautions

1

2

3

4

1

2

3

4

Styker frame

1

2

3

4

1

2

3

4

Use of hyper/hypothermia blanket

1

2

3

4

1

2

3

4

Assessment Proficiency Frequency

Normal Heart Tones (i.e.: S1, S2)

1

2

3

4

1

2

3

4

Abnormal heart tones (i.e.: murmur, gallop, friction rub)

1

2

3

4

1

2

3

4

Identification of PMI (Point Maximal Intensity)

1

2

3

4

1

2

3

4

Blood Pressure (non-invasive)

1

2

3

4

1

2

3

4

Pulses/Circulation via palpation

1

2

3

4

1

2

3

4

Pulses/Circulation via doppler

1

2

3

4

1

2

3

4

Insertion site invasive lines

1

2

3

4

1

2

3

4

12-lead EKG interpretation

1

2

3

4

1

2

3

4

EKG Changes for MI

1

2

3

4

1

2

3

4

Rhythm interpretation

1

2

3

4

1

2

3

4

S/S DVT

1

2

3

4

1

2

3

4

Obtain Cardiac Output

1

2

3

4

1

2

3

4

Obtain MAP

1

2

3

4

1

2

3

4

PCWP Measurement

1

2

3

4

1

2

3

4

Obtain CVP Measurement

1

2

3

4

1

2

3

4

Removal of radial arterial line

1

2

3

4

1

2

3

4

Removal of femoral sheath

1

2

3

4

1

2

3

4

Perform Venipuncture

1

2

3

4

1

2

3

4

Obtain lab specimens from A-line

1

2

3

4

1

2

3

4

Obtain lab specimens from Central Line

1

2

3

4

1

2

3

4

Perform 12-lead EKG

1

2

3

4

1

2

3

4

Proper Cardiac Monitor lead placement

1

2

3

4

1

2

3

4

AAA (Abdominal Aortic Aneurysm)

1

2

3

4

1

2

3

4

Aortic Stenosis

1

2

3

4

1

2

3

4

Cardiomyopathy

1

2

3

4

1

2

3

4

Cardiac Arrest

1

2

3

4

1

2

3

4

Cardiac Catheterization

1

2

3

4

1

2

3

4

Carotid Endarterectomy

1

2

3

4

1

2

3

4

Cardiac Tamponade

1

2

3

4

1

2

3

4

CHF

1

2

3

4

1

2

3

4

MI

1

2

3

4

1

2

3

4

Mitral Valve Stenosis

1

2

3

4

1

2

3

4

Myocardial Contusion

1

2

3

4

1

2

3

4

Post cardiac surgery complications

1

2

3

4

1

2

3

4

Pericardial Window

1

2

3

4

1

2

3

4

Post AICD Insertion

1

2

3

4

1

2

3

4

Pericardial Effusion

1

2

3

4

1

2

3

4

Pericarditis

1

2

3

4

1

2

3

4

Fresh Post-op CABG

1

2

3

4

1

2

3

4

LVAD

1

2

3

4

1

2

3

4

RVAD

1

2

3

4

1

2

3

4

Fem-Pop Bypass

1

2

3

4

1

2

3

4

Set-Up for Cardioversion

1

2

3

4

1

2

3

4

Cardioversion

1

2

3

4

1

2

3

4

Central Line Insertion

1

2

3

4

1

2

3

4

CAVH-D

1

2

3

4

1

2

3

4

Arterial Line Insertion

1

2

3

4

1

2

3

4

Pulmonary Artery Catheter Insertion

1

2

3

4

1

2

3

4

Chest Tube Insertion

1

2

3

4

1

2

3

4

Chest Tube Removal

1

2

3

4

1

2

3

4

Emergency Tracheostomy

1

2

3

4

1

2

3

4

Pericardiocentesis

1

2

3

4

1

2

3

4

Thoracentesis

1

2

3

4

1

2

3

4

Transesophageal Echocardiogram

1

2

3

4

1

2

3

4

Emergency Intubation

1

2

3

4

1

2

3

4

Blood and blood product administration

1

2

3

4

1

2

3

4

Blood transfusion reactions

1

2

3

4

1

2

3

4

Management of Arterial Line

1

2

3

4

1

2

3

4

Management of Pulmonary artery catheter

1

2

3

4

1

2

3

4

Management of CVP Line

1

2

3

4

1

2

3

4

Zero and calibration of transducers

1

2

3

4

1

2

3

4

Assess adequate perfusion with invasive lines

1

2

3

4

1

2

3

4

Waveform interpretation

1

2

3

4

1

2

3

4

Determination of appropriate timing

1

2

3

4

1

2

3

4

Perfusion assessment

1

2

3

4

1

2

3

4

Recognize IABP complications

1

2

3

4

1

2

3

4

PPM

1

2

3

4

1

2

3

4

Transvenous

1

2

3

4

1

2

3

4

Transcutaneous

1

2

3

4

1

2

3

4

Recognition of failure to sense, capture

1

2

3

4

1

2

3

4

Manipulation of TPM settings

1

2

3

4

1

2

3

4

Troubleshoot TPM settings

1

2

3

4

1

2

3

4

Arterial waveform

1

2

3

4

1

2

3

4

Pulmonary artery catheter waveform

1

2

3

4

1

2

3

4

PCWP waveform

1

2

3

4

1

2

3

4

CVP waveform

1

2

3

4

1

2

3

4

SVO2 Data

1

2

3

4

1

2

3

4

PVR

1

2

3

4

1

2

3

4

SVR

1

2

3

4

1

2

3

4

A-V Fistula/Shunt

1

2

3

4

1

2

3

4

Fluid Status

1

2

3

4

1

2

3

4

Acute Renal Failure

1

2

3

4

1

2

3

4

CAVH dialysis

1

2

3

4

1

2

3

4

Hemodialysis

1

2

3

4

1

2

3

4

CRRT

1

2

3

4

1

2

3

4

Peritoneal dialysis

1

2

3

4

1

2

3

4

Nephrectomy

1

2

3

4

1

2

3

4

Renal Transplant

1

2

3

4

1

2

3

4

Renal Rejection Syndrome

1

2

3

4

1

2

3

4

TURP

1

2

3

4

1

2

3

4

Urinary diversion (i.e.: ileal, conduit nephrostomy)

1

2

3

4

1

2

3

4

Urinary tract infection

1

2

3

4

1

2

3

4

CRRT

1

2

3

4

1

2

3

4

CAVH dialysis

1

2

3

4

1

2

3

4

Hemodialysis

1

2

3

4

1

2

3

4

Bladder Irrigation

1

2

3

4

1

2

3

4

Insertion of Male Foley Catheter

1

2

3

4

1

2

3

4

Insertion of Female Foley Catheter

1

2

3

4

1

2

3

4

Suprapubic Catheter

1

2

3

4

1

2

3

4

Procedures Proficiency Frequency

Sterile dressing changes

1

2

3

4

1

2

3

4

Wound care/irrigations

1

2

3

4

1

2

3

4

Burns

1

2

3

4

1

2

3

4

Pressure Sores

1

2

3

4

1

2

3

4

Staged Decubitus Ulcers

1

2

3

4

1

2

3

4

Surgical Wounds w/drains

1

2

3

4

1

2

3

4

Traumatic Wounds

1

2

3

4

1

2

3

4

Skin intact

1

2

3

4

1

2

3

4

Stasis Ulcers

1

2

3

4

1

2

3

4

Surgical Wound Healing

1

2

3

4

1

2

3

4

Air fluidized, low airloss beds

1

2

3

4

1

2

3

4

Turn, cough, and deep breathing technique

1

2

3

4

1

2

3

4

Splinting technique post-op

1

2

3

4

1

2

3

4

Use of incentive spirometer

1

2

3

4

1

2

3

4

Importance of increasing mobility post-op when applicable

1

2

3

4

1

2

3

4

Provide care for end-of-life decisions that families face in ICU such as withdrawal of life support

1

2

3

4

1

2

3

4

Adhere to legal procedures regarding notification of organ donation provider

1

2

3

4

1

2

3

4

Demonstrate Spiritual and Cultural Considerations for the Critical Care patient

1

2

3

4

1

2

3

4

Provide for the integration of comfort care and death with dignity

1

2

3

4

1

2

3

4

Demonstrate effective coping skills in caring for the critical care patient

1

2

3

4

1

2

3

4

Assessment Proficiency Frequency

Bowel Sounds

1

2

3

4

1

2

3

4

Nutritional status

1

2

3

4

1

2

3

4

Proper N/G Tube placement

1

2

3

4

1

2

3

4

Blunt Abdominal Trauma

1

2

3

4

1

2

3

4

Bowel Obstruction

1

2

3

4

1

2

3

4

Colostomy

1

2

3

4

1

2

3

4

ERCP

1

2

3

4

1

2

3

4

Esophageal Bleed

1

2

3

4

1

2

3

4

GI Bleed

1

2

3

4

1

2

3

4

GI Surgery

1

2

3

4

1

2

3

4

Hemicolectomy

1

2

3

4

1

2

3

4

Hepatitis

1

2

3

4

1

2

3

4

Ileostomy

1

2

3

4

1

2

3

4

Inflammatory Bowel Disease

1

2

3

4

1

2

3

4

Liver Failure

1

2

3

4

1

2

3

4

Liver Transplant

1

2

3

4

1

2

3

4

Pancreatitis

1

2

3

4

1

2

3

4

Paralytic Ileus

1

2

3

4

1

2

3

4

Penetrating trauma

1

2

3

4

1

2

3

4

Small bowel resection

1

2

3

4

1

2

3

4

Administration of tube feeding

1

2

3

4

1

2

3

4

Balloon tamponade (Sengstaken Blakemore)

1

2

3

4

1

2

3

4

Continuous Suction

1

2

3

4

1

2

3

4

Flexible feeding tube (Dobhoff)

1

2

3

4

1

2

3

4

Gravity feeding

1

2

3

4

1

2

3

4

Iced saline lavage

1

2

3

4

1

2

3

4

Insertion and maintenance of N/G Tube

1

2

3

4

1

2

3

4

Insertion and maintenance of Rectal Tube

1

2

3

4

1

2

3

4

PPN (peripheral parenteral nutrition)

1

2

3

4

1

2

3

4

Removal of N/G Tube

1

2

3

4

1

2

3

4

TPN and lipids administration

1

2

3

4

1

2

3

4

Utilization of feeding pump

1

2

3

4

1

2

3

4

Infant (Birth to 1 year)

1

2

3

4

1

2

3

4

Toddler (1-3 years)

1

2

3

4

1

2

3

4

Pre-school (3-6 years)

1

2

3

4

1

2

3

4

School Age (6-12 years)

1

2

3

4

1

2

3

4

Adolescent (12-18 years)

1

2

3

4

1

2

3

4

Young Adult (18-30 years)

1

2

3

4

1

2

3

4

Mature Adult (30-60 years)

1

2

3

4

1

2

3

4

Elderly (>60 years)

1

2

3

4

1

2

3

4

Years Experience in Clinical Specialty :

Most recent facility worked at :

I hereby certify that ALL information I have provided to Clover Health Services, 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.