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.
| WORK SETTINGS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Pediatric MedSurg |
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| Pediatric Step Down/Telemetry |
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| Pediatric Oncology |
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| Pediatric Ortho |
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| Pediatric Neuro |
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| CARDIOVASCULAR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Congenital Heart Disease/Repair |
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| Pre Cardiac Surgery |
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| Post Cardiac Surgery |
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| Heart Sounds |
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| PULMONARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Reactive Airway Disease |
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| RSV |
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| Tuberculosis |
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| Esophageal Atresia |
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| Epiglottitis |
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| Tonsillitis |
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| Laryngotracheobronchitis (Croup) |
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| ENT Surgery |
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| Oxygen Delivery Systems |
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| Tracheostomy Management |
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| Oral Suctioning |
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| Deep Suctioning |
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| Management of Chest Tubes |
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| Apnea Monitor |
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| Home Ventilator Therapy |
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| NEUROLOGIC/ORTHOPEDIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Brain Injury |
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| Spinal Cord Injury |
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| Seizure Disorders |
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| Meningitis |
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| Neuromuscular Disease |
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| Extremity Fracture/Cast |
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| Post Vertebral Surgery |
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| Traction - General |
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| Traction - Halo |
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| Pin Care |
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| VP Shunts/Internal/External |
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| GASTROINTESTINAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Cleft Lip/Palate |
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| Inflammatory Bowel Disease |
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| Colostomy/Ileostomy |
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| Surgical Drains |
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| Failure to Thrive |
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| Feeding Intolerance |
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| Gastroenteritis/Dehydration |
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| Bowel Obstruction |
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| Short Gut Syndrome |
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| Breastfeeding Support/Handling of Breast Milk |
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| RENAL/GENITOURINARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Circumcision |
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| Testicular Torsion |
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| Glomerulonephritis |
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| Renal Failure |
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| Renal Transplant |
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| Urinary Retention |
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| Bladder Scan |
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| Insertion/Management of Bladder Catheters |
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| Management of Suprapubic Catheters |
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| ENDOCRINE/METABOLIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Diabetes - Hypo/Hyperglycemia |
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| Diabetic Ketoacidosis |
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| IV Insulin Pumps |
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| Indwelling Insulin Pumps |
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| Hyperbilirubinemia |
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| Bili Bed |
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| ONCOLOGY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Chemotherapy Administration |
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| Hodgkin's Disease |
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| Hemophilia |
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| Sickle Cell Anemia |
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| Leukemia |
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| Solid Tumors |
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| Bone Marrow Transplant |
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| INFECTIOUS DISEASE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Childhood Communicable Diseases |
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| Hepatitis |
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| HIV |
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| Kawasaki Disease |
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| MEDICATIONS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Pediatric Dosage Calculations |
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| Anti-Hypertensives |
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| Anticoagulants |
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| Anti-Seizure Medications |
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| Benzodiazepines |
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| Digoxin |
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| Diurectics |
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| Emergency Medications |
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| Inhaled Medications |
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| Insulin |
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| Narcotics/Opioid Analgesics (IV/Oral/Injection) |
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| Non-Opioid Analgesics (IV/Oral/Injection) |
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| Procedural Sedation - Recovery |
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| Reversal Agents |
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| Steroids (IV/Oral/Inhaled) |
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| Automated Medication Dispensing (i.e. Pyxis, Omnicell) |
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| IV THERAPY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Starting Ivs |
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| Central Line Blood Draw |
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| Central Line/Implanted Line Care |
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| TPN/Lipids |
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| Blood Product Administration |
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| Administration of Chemotherapy |
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| CARDIAC MONITORING & EMERG. RESPONSE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Pediatric Early Warning Score (PEWS)/Rapid Response Team |
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| Dysrhythmia Interpretation |
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| Dysrhythmia Management |
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| PROFESSIONAL KNOWLEDGE AND SKILLS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| National Patient Safety Goals/Core Measures |
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| Recognize/Report Signs of Abuse |
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| Fall Risk Assessment/Prevention |
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| Pressure Ulcer Risk Assessment/Prevention |
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| Restraints/Use of Least Restrictive Device |
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| Normal Growth and Development |
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| Age Specific/Population Based Care |
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| Patient Family Teaching |
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| Isolation Precautions |
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| Infection Prevention |
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| Reporting Communicable Diseases |
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| Pain Assessment & Management |
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| Charge Experience |
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| Interpretation and Communication of Lab Values |
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| EMR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Epic |
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| Cerner |
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| Eclipsys |
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| McKesson |
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| Meditech |
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| Other Computerized System |
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| Computerized Physician Order Entry |
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| Bar Coding for Medication Administration |
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| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Infant (Birth - 1 year) |
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| Preschooler (ages 2-5 years) |
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| Childhood (ages 6-12 years) |
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| Adolescents (ages 13-21 years) |
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| Young Adults (ages 22-39 years) |
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| Adults (ages 40-64 years) |
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| Older Adults (ages 65-79 years) |
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| Elderly (ages 80+ years) |
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