Name

Date

Signature_________________________________________
 

Key to competency level
1 Have not performed
2 Minimal Experience
3 Competent
4 Able to Teach
 
 
 

Critical Care Skills List
	1	2	3	4
Patient Rights	_	_	_	_
Communicates and obtains information while respecting patients  rights, privacy and confidentiality	_	_	_	_
Involves the patient and family in care and planning	_	_	_	_
Provides accurate information to patient and family in a timely manner.	_	_	_	_
Meets patient and families needs	_	_	_	_
_	_	_	_	_
Neurology	_	_	_	_
Neuro Assessment/Neuro Vitals	_	_	_	_
ICP Monitoring	_	_	_	_
Seizure Precautions	_	_	_	_
Stryker Frame	_	_	_	_
Crutchfield Tongs	_	_	_	_
Halo Traction	_	_	_	_
Care of patient with:	_	_	_	_
- Spinal Cord Injury	_	_	_	_
-Pre/Post Neurological Surgery	_	_	_	_
-CNS Infections	_	_	_	_
-Drug Overdose	_	_	_	_
-Acute Head Injury	_	_	_	_
-Cerebral Aneurysm	_	_	_	_
-Acute/Chronic CVA/TIA	_	_	_	_
_	_	_	_	_
Cardiovascular	_	_	_	_
Use of Cardiac Monitors	_	_	_	_
Recognizing Arrythmias	_	_	_	_
Interpreting 12 Lead EKG	_	_	_	_
Cardiopulmonary Arrests	_	_	_	_
Cardioversion /Defibrillation	_	_	_	_
lntra-Aortic Balloon Pump	_	_	_	_
Care of Immediate Open Heart Patient	_	_	_	_
Care of 24-48 hr. Post-Op Open Heart Patient	_	_	_	_
Pre/Post-Op Cardiac Transplant	_	_	_	_
Pre/Post-Op Angioplasty	_	_	_	_
Percutaneous Transluminal Coronary Angioplast	_	_	_	_
Sheath Removal	_	_	_	_
Post-Op Vascular Surgery Patient (i.e. Aneurysms)	_	_	_	_
Care of Acute MI	_	_	_	_
Angina (acute and chronic)	_	_	_	_
Pre/Post Cardiac Catherization	_	_	_	_
Care of Patient with Pacemaker Including:	_	_	_	_
-assisting with insertion	_	_	_	_
-management of External/Transcutaneous	_	_	_	_
-management of Temporary (Single & Dual Chamber)	_	_	_	_
-management of Permanent	_	_	_	_
Care of Patient with:	_	_	_	_
-Valvular Disease	_	_	_	_
-Cardiogenic/Hypovolemic Shock	_	_	_	_
Hemodynamic Monitoring Set up and Care of Patient with:	_	_	_	_
-Central Venous Pressure Line	_	_	_	_
-Subclavian Lines	_	_	_	_
-Swan Ganz Catheter	_	_	_	_
-Arterial Catheter	_	_	_	_
Obtaining and Interpreting Hemodynamic Measurements:	_	_	_	_
-CVP	_	_	_	_
-PAP/PCWP	_	_	_	_
-CO	_	_	_	_
_	_	_	_	_
Use and Administration of the following medications:	_	_	_	_
-Amiodarone	_	_	_	_
-Atropine	_	_	_	_
-Digitalis	_	_	_	_
-Dobutamine	_	_	_	_
-Dopamine	_	_	_	_
-Epinephrine	_	_	_	_
-Heparin	_	_	_	_
-Insulin	_	_	_	_
-Ispuprel	_	_	_	_
-Lidocaine	_	_	_	_
-Nipride	_	_	_	_
-Nitrogycerine	_	_	_	_
-Procainamide	_	_	_	_
-Thrombolytics	_	_	_	_
-Verapamil	_	_	_	_
_	_	_	_	_
Pulmonary	_	_	_	_
Assessment of Breath Sounds	_	_	_	_
Assist with set-up and Maintenance of Chest Tubes	_	_	_	_
Use of Chest Drainage Systems	_	_	_	_
Assist with Intubation/Extubation	_	_	_	_
Use of Ambu Bage	_	_	_	_
Administer Oxygen (Nasal Canula, Mask, ETT)	_	_	_	_
Assist with and set up for Bronchoscopy	_	_	_	_
Ventilators:	_	_	_	_
Use  and complications of  Peep	_	_	_	_
Use  and complications of  CPAP	_	_	_	_
Use  and complications of  IMV	_	_	_	_
Weaning	_	_	_	_
ABG analysis	_	_	_	_
Oxygen Saturation Monitor	_	_	_	_
Care of Patient with:	_	_	_	_
Pulmonari Emboli	_	_	_	_
Tracheostomy	_	_	_	_
Pre/Post Thoracic Surgery	_	_	_	_
-COPD	_	_	_	_
-ARDS	_	_	_	_
-CHF	_	_	_	_
-Tuberculosis	_	_	_	_
_	_	_	_	_

 
 
 
 

Gastrointestinal	_	_	_	_
Assessment of Bowel Sounds	_	_	_	_
Identification of Abnormalities	_	_	_	_
Stool Tests	_	_	_	_
Insert/Maintain Feeding/NG tubes	_	_	_	_
Administration of Tube Feedings	_	_	_	_
Checking tube feeding Residuals	_	_	_	_
Care of patient with Ostomy	_	_	_	_
Care of Acute GI Bleed	_	_	_	_
Abdominal Wounds or Infections	_	_	_	_
Pre/Post Op GI Surgery	_	_	_	_
Dehiscence	_	_	_	_
Care of Patient on Total Parental nutrition	_	_	_	_
_	_	_	_	_
_		_	_	_
Genitourinary/Renal	_	_	_	_
Ability to Insert/Maintain Urinary Drainage Tubes	_	_	_	_
Care of Patients with:	_	_	_	_
-Acute/Chronic Renal Failure	_	_	_	_
-Post Renal/Genitourinary Surgery	_	_	_	_
-Pre/Post Op Renal Transplant	_	_	_	_
-Suprapubic Catheters	_	_	_	_
Administration of Peritoneal Dialysis	_	_	_	_
Administration of Hemodialysis	_	_	_	_
Care of Patient on Dialysis	_	_	_	_
Assessment of Fluid and Electrolyte Problems	_	_	_	_
Urine tests	_	_	_	_
_	_	_	_	_
Endocrine	_	_	_	_
Care of Diabetic Patient:	_	_	_	_
Administration of IV insulin drip	_	_	_	_
Capillary Blood Glucose Checks	_	_	_	_
Care of Patient in Diabetic Ketoacidosis	_	_	_	_
_	_	_	_	_
_	_	_	_	_
Oncology	_	_	_	_
Isolation/Universal Precautions	_	_	_	_
Chemo Agents Mixing/Adminstering	_	_	_	_
_	_	_	_	_
Musculoskeltal	_	_	_	_
Casts	_	_	_	_
Collars	_	_	_	_
Slings/splints	_	_	_	_
Skeletal traction	_	_	_	_
Skin traction	_	_	_	_
Braces	_	_	_	_
Beds i.e. Clinitron, Rotorest,	_	_	_	_
Total Knee Replacement	_	_	_	_
Care of Patient on CPM	_	_	_	_
Care of Patients with :	_	_	_	_
Joint Disorders	_	_	_	_
Bone Disorders	_	_	_	_
Amputation	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_

 

Miscellaneous	_	_	_	_
Pain Management	_	_	_	_
Burn Patients	_	_	_	_
Use of Hypothermia Blanket	_	_	_	_
Insertion of IV's	_	_	_	_
IV Therapy	_	_	_	_
Set up for Cut Down	_	_	_	_
Care of PICC line	_	_	_	_
Care of Central line	_	_	_	_
Administration of Blood and Blood Products	_	_	_	_
Blood Warmer	_	_	_	_
Obtaining Blood from Venous Blood	_	_	_	_
Obtaining Blood from Arterial Line	_	_	_	_
Obtaining Blood from Central Line	_	_	_	_
Obtaining Blood for Mixed Venous gases	_	_	_	_
Obtaining ABG's by Arterial Stick	_	_	_	_
Knowledge of Serum Lab Values	_	_	_	_
Specimen Collections	_	_	_	_
Care of Drains/Tubes (i.e. hemovac etc)	_	_	_	_
Infectious Disease are of	_	_	_	_
TB	_	_	_	_
Hepatitis B	_	_	_	_
AIDS	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_

 

Area of Clinical Experience	Years	Months	Credentials    /   Expiration Dates
ICU	_	_	ACLS	_
Neuro/Trauma ICU	_	_	PALS	_
Medical Surgical ICU	_	_	NALS	_
CCU	_	_	BLS	_
CVICU	_	_	IABP	_
OR	_	_	IV Certified	_
PACU	_	_	_	_
ER	_	_	Licences      / Expiry Date	Number
NICU	_	_	_	_
PICU	_	_	_	_
Peds	_	_	_	_
Med/Surg	_	_	_	_
Telemetry	_	_	_	_
Psych	_	_	_	_
Ortho	_	_	_	_
L&D	_	_	_	_
Mother and Baby	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_
_	_	_	_	_