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NICU Skills Checklist

My responses in this checklist represent a true reflection of my experience and comfort level. Please self-rate your comfort level in performing tasks in connection with the below checklist. Rate your level of comfort for each line item by following the below ranking system. Simply fill in the appropriate option immediately following the rating number.

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Level of Comfort/Experience

N/A=Non-applicable
1=Inexperienced in this area
2=Limited comfort/experience in this area
3=Comfortable/experienced in this area
4=Very comfortable/highly experienced in this area

CARDIOVASCULAR	Not Applicable	Inexperienced	Limited Experience	Experienced	Highly Experienced
Auscultation (rate, rhythm, volume)	N/A	1	2	3	4
Blood pressure/invasive (arterial-line)	N/A	1	2	3	4
Blood pressure/non-invasive	N/A	1	2	3	4
Heart sounds/murmurs	N/A	1	2	3	4
Perfusion	N/A	1	2	3	4
Pulses	N/A	1	2	3	4
EKG interpretation	N/A	1	2	3	4
Cardioversion/Defibrillation	N/A	1	2	3	4
Invasive hemodynamic monitoring	N/A	1	2	3	4
Central venous pressure	N/A	1	2	3	4
Cardiac arrest	N/A	1	2	3	4
Congenital heart disease/defects	N/A	1	2	3	4
Hemodynamic instability	N/A	1	2	3	4
Hypovolemic shock	N/A	1	2	3	4
Post cardiac surgery	N/A	1	2	3	4
Dobutamine	N/A	1	2	3	4
Dopamine	N/A	1	2	3	4
Epinephrine	N/A	1	2	3	4
Nipride	N/A	1	2	3	4
Sodium bicarbonate	N/A	1	2	3	4
PULMONARY	Not Applicable	Inexperienced	Limited Experience	Experienced	Highly Experienced
Breath sounds	N/A	1	2	3	4
Rate and work of breathing	N/A	1	2	3	4
Apnea monitor use	N/A	1	2	3	4
Assist with intubation	N/A	1	2	3	4
Bulb syringe	N/A	1	2	3	4
CPAP (nasal cannula)	N/A	1	2	3	4
Endotracheal tube stabilation	N/A	1	2	3	4
Endotracheal tube suctioning	N/A	1	2	3	4
Extubation	N/A	1	2	3	4
Nasal airway/suctioning	N/A	1	2	3	4
Oral airway/suctioning	N/A	1	2	3	4
Tracheostomy care and suctioning	N/A	1	2	3	4
Assist with chest tube insertion/removal/set-up	N/A	1	2	3	4
Oxygen therapy delivery systems:	N/A	1	2	3	4
Anesthesia bag and mask	N/A	1	2	3	4
Self-inflating bag and mask	N/A	1	2	3	4
Nasal cannula	N/A	1	2	3	4
Nebulizer	N/A	1	2	3	4
Oxyhood	N/A	1	2	3	4
Tent	N/A	1	2	3	4
Trach collar	N/A	1	2	3	4
Arterial	N/A	1	2	3	4
Heelstick (Capillary)	N/A	1	2	3	4
Peripheral	N/A	1	2	3	4
Umbilical line	N/A	1	2	3	4
Interpretation of blood gases	N/A	1	2	3	4
Thoracentesis	N/A	1	2	3	4
Use of artificial surfactant	N/A	1	2	3	4
CPAP/PEEP	N/A	1	2	3	4
High frequency jet ventilator	N/A	1	2	3	4
Home ventilator	N/A	1	2	3	4
IMV	N/A	1	2	3	4
Oscillating	N/A	1	2	3	4
Pressure ventilator	N/A	1	2	3	4
Volume ventilator	N/A	1	2	3	4
Weaning from ventilator	N/A	1	2	3	4
Bronchopulmonary dysplasia (BPD)	N/A	1	2	3	4
Cardiogenic shock	N/A	1	2	3	4
Diaphragmatic hernia	N/A	1	2	3	4
Drug addiction/withdrawal	N/A	1	2	3	4
Fresh tracheostomy	N/A	1	2	3	4
Mechonium aspiration	N/A	1	2	3	4
Persistent pulmonary hypertension (PPHN)	N/A	1	2	3	4
Pneumothorax	N/A	1	2	3	4
Respiratory distress syndrome (RDS)	N/A	1	2	3	4
Systemic infection	N/A	1	2	3	4
Respiratory failure	N/A	1	2	3	4
Tetralogy of fallot	N/A	1	2	3	4
Aminophylline	N/A	1	2	3	4
Prostaglandin	N/A	1	2	3	4
NEUROLOGICAL	Not Applicable	Inexperienced	Limited Experience	Experienced	Highly Experienced
Assessment of neurological status	N/A	1	2	3	4
Intracranial pressure monitoring	N/A	1	2	3	4
Care of the neonate with:	N/A	1	2	3	4
Brain death/organ procurement	N/A	1	2	3	4
External VP shunts/reservoirs	N/A	1	2	3	4
Increased intracranial pressure	N/A	1	2	3	4
Seizures	N/A	1	2	3	4
Anticonvulsant medication use	N/A	1	2	3	4
GASTROINTESTINAL	Not Applicable	Inexperienced	Limited Experience	Experienced	Highly Experienced
Abdominal girth	N/A	1	2	3	4
Bowel sounds	N/A	1	2	3	4
Palate	N/A	1	2	3	4
Suck/swallow	N/A	1	2	3	4
Care of gastrostomy tube	N/A	1	2	3	4
Placement of Jejunal tube	N/A	1	2	3	4
Placement of nasogastric (NG) tube	N/A	1	2	3	4
Test for occult blood	N/A	1	2	3	4
Assist with breast feeding	N/A	1	2	3	4
Bottle	N/A	1	2	3	4
Breast milk handling/storage	N/A	1	2	3	4
Gavage	N/A	1	2	3	4
Electric breast pump use	N/A	1	2	3	4
Cleft lip/palate	N/A	1	2	3	4
Colostomy/ileostomy	N/A	1	2	3	4
Gastroschisis/omphalocele	N/A	1	2	3	4
GI bleeding	N/A	1	2	3	4
Inguinal hernia	N/A	1	2	3	4
Necrotizing enterocolitis	N/A	1	2	3	4
Post abdominal surgery	N/A	1	2	3	4
Reflux precautions	N/A	1	2	3	4
Tracheoesophageal fistula	N/A	1	2	3	4
ENDOCRINE/METABOLIC	Not Applicable	Inexperienced	Limited Experience	Experienced	Highly Experienced
Finnegan	N/A	1	2	3	4
Fluid and electrolyte balance	N/A	1	2	3	4
Interpret bilirubin lab result	N/A	1	2	3	4
Interpret urine lab results	N/A	1	2	3	4
Collect of urine specimens:	N/A	1	2	3	4
Assist with supra pubic tap	N/A	1	2	3	4
Catheter	N/A	1	2	3	4
Diaper/bag	N/A	1	2	3	4
Blood glucose testing and interpretation	N/A	1	2	3	4
Phototherapy for jaundice	N/A	1	2	3	4
Post circumcision care	N/A	1	2	3	4
Acute renal failure	N/A	1	2	3	4
DIC (Disseminated intra vascular coagulation)	N/A	1	2	3	4
Hypo/hyperkalemia	N/A	1	2	3	4
Hypo/hypernatremia	N/A	1	2	3	4
IDM (infant of diabetic mother) Hypo and hyperglycemia	N/A	1	2	3	4
Malformations of GU tract and kidney	N/A	1	2	3	4
Peritoneal dialysis	N/A	1	2	3	4
INFECTIOUS DISEASES	Not Applicable	Inexperienced	Limited Experience	Experienced	Highly Experienced
CBC/differential	N/A	1	2	3	4
Culture reports	N/A	1	2	3	4
Maternal lab results	N/A	1	2	3	4
Hepatitis surface antigen positive mother	N/A	1	2	3	4
HIV positive mother	N/A	1	2	3	4
Neonatal sepsis	N/A	1	2	3	4
Assist with lumbar puncture	N/A	1	2	3	4
Collect culture specimens	N/A	1	2	3	4
Immunization administration	N/A	1	2	3	4
Isolation techniques	N/A	1	2	3	4
Universal precautions	N/A	1	2	3	4
IV THERAPY	Not Applicable	Inexperienced	Limited Experience	Experienced	Highly Experienced
Cryoprecipitate	N/A	1	2	3	4
Packed red blood cells	N/A	1	2	3	4
Plasma/albumin	N/A	1	2	3	4
Whole blood	N/A	1	2	3	4
Hyperalimentation /TPN	N/A	1	2	3	4
Intralipid	N/A	1	2	3	4
IV pump	N/A	1	2	3	4
Syringe pump	N/A	1	2	3	4
Drawing blood from central line	N/A	1	2	3	4
Drawing venous blood	N/A	1	2	3	4
Starting IV's	N/A	1	2	3	4
Angiocath	N/A	1	2	3	4
Butterfly	N/A	1	2	3	4
Heparin lock	N/A	1	2	3	4
Managing IV therapy (Site and patency assessment, dressing and tubing change, discontinuing IV)	N/A	1	2	3	4
Broviac	N/A	1	2	3	4
Groshong	N/A	1	2	3	4
Hickman	N/A	1	2	3	4
Portacath	N/A	1	2	3	4
Quinton	N/A	1	2	3	4
Percutaneous arterial line	N/A	1	2	3	4
Percutaneuos venous line	N/A	1	2	3	4
PICC (peripherally inserted central catheter)	N/A	1	2	3	4
Umbilical artery line	N/A	1	2	3	4
Umbilical venous line	N/A	1	2	3	4
OTHER NURSING RESPONSIBLITIES	Not Applicable	Inexperienced	Limited Experience	Experienced	Highly Experienced
Apgar scoring	N/A	1	2	3	4
Eye exam to rule out retinopathy	N/A	1	2	3	4
Gestational age/Ballard	N/A	1	2	3	4
Gestational age/Dubowitz	N/A	1	2	3	4
Maternal history	N/A	1	2	3	4
Pain level assessment	N/A	1	2	3	4
Screen for hearing loss	N/A	1	2	3	4
Bereavement/post mortem care	N/A	1	2	3	4
Calculation of medication dosage for the neonate	N/A	1	2	3	4
Consent use for procedures and treatment	N/A	1	2	3	4
Cord care	N/A	1	2	3	4
Neonatal skin care	N/A	1	2	3	4
Obtain weight (bed scale, scale)	N/A	1	2	3	4
Positioning devices	N/A	1	2	3	4
Preparation for transport or transfer	N/A	1	2	3	4
Isolette with humidity	N/A	1	2	3	4
Radiant warmer	N/A	1	2	3	4
Temperature (axillary, rectal, skin)	N/A	1	2	3	4
Weaning to open crib/bassinet	N/A	1	2	3	4