PCU/STEPDOWN KNOWLEDGE & SKILLS

CHECKLIST__________
NAME:       a. Acute MI
ID #:      
DATE:       DIRECTIONS: Please indicate your level of experience by
placing a check (√) in the box. Experience level:
1 NO EXPERIENCE
This Skills Checklist is for use by nurses with more than 2 MINIMAL EXPERIENCE-requires supervision/assistance
one year experience in their discipline and specialty.
Please be accurate with your assessment. 3 MODERATELY EXPERIENCED-requires initial review,
then performs independently
4 VERY EXPERIENCED- proficient
DESCRIPTION 1 2 3 4
PHLEBOTOMY/IV THERAPY DESCRIPTION 1 2 3 4
1. Draw Blood b. CHF
a. Venous Stick c. Angina
b. Central Line d. Hypertension
c. Arterial Line e. Cardiomyopathy
2. IV Push f. Cardiopulmonary Arrest
3. IV Drip: g. Abdominal Aortic Aneurysm
a. Calculations h. Pre/Post Cardiac Surgery
b. Titration i. Carotid Endarterectomy
4. Obtain IV Access j. Femoral Popliteal Bypass
5. Mix IV Medications k. Permanent Pacemaker
6. Regulate IV’s l. Temporary Pacemaker
7. IV Infusion Pumps m. External Pacemaker
8. Central Line Dressing Changes n. Pre/Post Cardiac Cath
9. Chemotherapy Administration o. Pre/Post PTCA
10. Blood/Blood Product Administration 11.Cardiac Lab Interpretation(CPK, Iso
11. TPN/PPN Administration Enzymes)
12. Multi-Lumen Central Catheters 12. Cardiac Rehab/Patient Teaching
13. Continuous Subcutaneous Infusion 13. Use and Administration of:
Pumps a. Atropine
14. PCA Pumps (Patient Controlled b. Digoxin
Analgesia) c. Dopamine
CARDIOVASCULAR d. Dobutamine
1. Cardiac Monitors e. Heparin
2. Rhythm Strip Measurements f. Verapamil
3. Recognize & Interpret Dysrhythmias g. Lopressor
4. Obtain 12 Lead EKG’s h. Lidocaine
5. CPR i. Nitroglycerine
6. Cardioversion/Defibrillation j. Nipride
7. Pulse Checks k. Thrombolytic Agents
8. Use of Doppler l. Code art/ Emergency Drugs
9. Automatic BP Cuff RESPIRATORY
10. Care of the Patient with: 1. O2 Masks/Cannulas
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CHECKLIST__________
2. Ambu Bag
3. Chest PT

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NAME:       b. CVA/TIA
ID #:       DESCRIPTION 1 2 3 4
DATE:       c. DT’s
d. Spinal Cord Injury
e. Pre/Post Neuro Surgery
DESCRIPTION 1 2 3 4 f. Halo Traction
RESPIRATORY (CONT) g. Multiple Sclerosis
4. Incentive Spirometry h. Overdose
5. Instruction of Coughing/Deep 6. Use and Administration of:
Breathing a. Decadron
6. Nebulizer Set Up b. Dilantin
7. Suctioning: c. Phenobarbitol
a. Oral d. Magnesium Sulfate
b. Tracheostomy Tube e. Valium
c. Endotracheal Tube f. Ativan
8. Use of Pleurevac GASTROINTESTINAL
9. Interpret ABG’s 1. NG Tube Care and Maintenance
10. Arterial Line Maintenance 2. NG Tube Insertion
11. Sputum Specimen Collection 3. Bowel Preparation
12. Pulse Oximetry 4. Enterostomal Care
13. Care of the Patient with: 5. Care of the Patient with:
a. Pulmonary Edema a. Tube Feedings
b. COPD b. Ileostomy
c. ARDS c. Colostomy
d. Ventilator d. Pancreatitis
e. Tracheostomy e. GI Bleed
f. Pre/Post Thoracic Surgery f. Bowel Obstruction
g. Pneumonia g. Whipple Procedure
h. Chest Tubes h. Liver Transplant
i. Asthma i. Abdominal Wounds/Surgeries
j. Emphysema j. Hemovac
14. Assist with Intubation/Extubation k. Gastrostomy Tube/Jejunostomy Tube
15. Weaning Patient Off Ventilator GENITOURINARY/RENAL
16. Use and Administration of: 1. Urinary Catheter Insertion
a. Aminophylline 2. Bladder Irrigations:
b. Coricosteroids a. Continuous
c. Inhalers b. Intermittent
NEUROLOGICAL 3. Electrolyte Imbalance/ Replacement
1. Neuro Assessment 4. Care of the Patient with:
2. Glasgow Coma Scale a. Peritoneal Dialysis
3. Seizure Precautions b. Hemodialysis
4. Assist with Lumbar Puncture c. T.U.R.P.
5. Care of the Patient with: d. Shunts & Fistulas
a.Acute Head Injury e. Nephrectomy
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f. Supra-Pubic Catheter
g. Nephrostomy Tube

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NAME:       6. Other:
ID #:      
DATE:      

ORTHOPEDICS
1. Cast Care
2. Tractions
a. Skin
b. Skeletal
3. ROM
4. Use of Assistive Devices
5. Care of the Patient with:
a. Total Joint Replacement
b. Amputation
MISCELLANEOUS
1. F.S. Glucose Monitoring
2. Dressing Changes
3. Use of Air Fluidized Beds
4. Normal Serum Lab Values
5. Universal Precautions - Isolation
6. Care of Patient with:
a. Pressure Sores
b. Sickle Cell Anemia
c. Cancer
d. Alzheimer’s Disease
e. HIV/AIDS
f. Diabetes
7. Discharge Planning
AGE OF PATIENTS CARED FOR
1. Infants & Toddlers (ages 0-3 years)
2. Young Children (ages 4-6 years)
3. Older Children (ages 7-12 years)
4. Adolescent (ages 13-20 years)
5. Young Adults (ages 21-39 years)
6. Middle Adults (ages 40-64 years)
7. Older Adults (ages 65-79 years)
8. Older Adults (ages 80 + years)
COMPUTERIZED CHARTING
1. Cerner
2. Eclipsys
3. Epic
4. McKesson
5. Meditech
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 PCU/STEPDOWN KNOWLEDGE & SKILLS
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Name:       MY EXPERIENCE IS PRIMARILY IN:

Please check the boxes below for each age group for NEUROLOGY       years
which you have expertise in providing age-appropriate PULMONARY       years
nursing care. SURGICAL       years
MEDICAL       years
A. Newborn/Neonatal (birth – 30 days) CARDIAC CARE       years
B. Infant (30 days – 1 year) TELEMETRY       years
C. Toddler (1 – 3 years)
D. Preschool (3 – 5 years) I HAVE CURRENT CERTIFICATIONS FOR:
E. School Age Children (5 – 12 years)
F. Adolescent (12 – 18 years) TYPE EXPIRATION DATE (MM/DD/YY)
G. Young Adults (18 – 39 years) ARRHYTHMIA      
H. Middle Adults (40 – 64 years) CRITICAL CARE      
I. Older Adults (64 + years) ACLS      
BLS      
EXPERIENCE WITH AGE GROUPS: TNCC      
1. Able to assess age appropriate behavior, motor skills NRP      
and physiological norms. PALS      
NALS      
A B C D E F G H I Other            
Other            
Other            
2. Able to adapt care according to normal growth and Other            
development.
The information I have provided in this knowledge and
A B C D E F G H I skills checklist it true and accurate to the best of my
knowledge.

3. Able to communicate and instruct patient according to            

their age, maturity and comprehension ability. Signature (Written/Electronic) Date
ID #:      
A B C D E F G H I
This skills checklist has been reviewed and approved by
Nicole Bloxham, RN.
4. Able to provide a safe environment according to the
specific needs of various age groups.            
Signature (Written/Electronic) Date
A B C D E F G H I ID #:      
Please return to: Northwest Nurse Staffing Company, PA
ATTN: Records Dept.
Fax: (866) 352-4338

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 PCU/STEPDOWN KNOWLEDGE & SKILLS
CHECKLIST__________
Email: records@nns-ic.com

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