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CHECKLIST_
NAME: 7. Closures
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
ASSESSMENT DESCRIPTION 1 2 3 4
1. Pain Assessment/Reassessment 8. Cardiac Catheterization-Pediatric/Neonatal R/L
2. Blood Pressure-Invasive/Non-Invasive: a. Shunt Detection and Calculation
a. Right Heart Assessment Interventional/Invasive Procedures
b. 12 Lead Interpretation 9. Angioplasty
c. Waveform Assessment 10. Arrhythmia Ablation
d. Arrhythmia Interpretation 11. Debulking
CARDIOVASCULAR 12. Stent Placement
1. Heart Sounds 13. Thrombolysis
2. Basic Arrythmias Interpretation 14. Angiojet
3. 12 Lead EKG Interpretation 15. Directional Coronary Atherectomy
4. Emergency Defibrillation 16. Pericardiocentesis
5. Controlled Cardioversion 17. Pericardial taps
6. CBP Monitoring Via Water 18. Rotational Coronary Atherectomy
7. Manometer (Rotoblade)
8. Radial Art-Lines 19. Transluminal Extraction Catheter
9. Cardiac Enzymes Interpretation 20. Non-Cardiac Angioplasty
10. Iso Enzymes Interpretation 21. Heart Biopsies
11. Interpretation of Clogs 22. Atherectomies
12. Thrombolytic Studies 23. Valvuloplasty
13. Electrophysiological Studies 24. Pacemaker Placement
14. Cardiac Rehab a. Temporary
15. Patient Teaching b. Permanent
GASTROINTESTINAL c. Pacemaker Pockets/Suturing
1. Bowel sounds assessment d. AICD Pacemakers
2. Insertion of nasogastric tube 25. Insertion of:
PROCEDURES a. Intra-aortic balloon pump
1. Cardiac Catheterization-Adult R/L b. Inter Coronary Stents
2. Aortography c. Pediatric cardio catheterization
3. Internal Mammary Angiography First-line emergency drugs
4. Pulmonary Angiography 26. Administer:
5. Saphenous Vein Graft Angiography a. Bretylium
6. Ventricular Assist Device b. Epinephrine
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c. Atropine
d. Lidocaine
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NAME: 13. Assist with intubation / extubation
ID #: DESCRIPTION 1 2 3 4
DATE: NEUROLOGICAL
1. Assess the level of consciousness
2. Seizure precautions
DESCRIPTION 1 2 3 4 Use of hypo/ hyperthermia blanket with:
PROCEDURES (CONT) a. Emphysema
Interventional/Invasive Procedures (cont) b. Status Asthmaticus
e. Analgesics c. ARDS
f. Reversal Agents d. Post-thoracotomy
g. Sedatives 3. Sedation monitoring
h. Tranquilizers Care of Patient:
Drips: 4. With Alzheimer’s
i. Cardizem (Diltiazem hydrochloride) 5. With overdose
j. Dobutamine (Dobutrex) 6. In restraints
k Dopamine (Intropin) INFUSION THERAPY
l. Heparin 1. Administer and mix IV medications
m. Lidocaine (Xylocaine) 2. Infusion pump
n. Nipride (Nitroprusside) 3. Long-term central lines (Hickman,
o. Nitroglycerine (Tridil) Broviac, Groshong, PICC)
p. Verapamil ( Calan, Isoptin, Verelan) 4. Phlebotomy/ venous blood draw
Care of the patient with: 5. Administration of blood and blood
27. FemStop Device products
28. Vasoseal, AngioSeal, PerClose 6. IV insertion
RENAL EQUIPMENT
1. Straight and foley catheter insertion 1. Automatic Implantable Cardiac
2. Three-way foley/ bladder irrigation Defibrillator
management with continuous epidural 2. Calculation of Valve Parameters
drip 3. Cardioversion
PULMONARY 4. Defibrillation
1. Assess breath sounds 5. Intra Aortic Balloon Pump (IABP)
2. Assess breathing patterns 6. Lead Placement
3. Pulse oximetry 7. SVO2 Recording
4. Orophryngeal suctioning 8. Ventilator Management
5. Tracheostomy suctioning 9. Hemodynamic Monitoring Record
6. Collect sputum specimen (via Values
suctioning) MISCELLANEOUS
7. Establish airway 1. Sterile/aseptic techniques
8. ABG’s interpretation 2. Isolation techniques
9. Ambushing techniques 3. PCA Pumps
Care of patient with : 4. Knowledge of normal serum lab values
a. Pulmonary edema 5. Titration of IV drips
b. Pulmonary emboli 6. Automatic B/P cuffs
c. Chest tubes 7. Care of HIV/AIDS patient
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8. Care of the diabetes patient
9. National patient safety goals
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