PICU SKILLS CHECKLIST
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Job Description: Pediatric Intensive Care Registered Nurse
Provides professional nursing care for assigned patients in the pediatric intensive care unit. Performs assessments, evaluation and documents the nursing process as needed. Education requires a minimum of an associate's degree and is licensed as a registered nurse with at least 2 years of clinical experience. Must be familiar with standard concepts, practices, and procedures within the critical care nursing field as it applies to pediatric population. Performs a variety of tasks and demonstrates critical thinking skills and scientific judgment. Works under general supervision; typically reports to a supervisor and/or manager. A certain degree of creativity and latitude is required.
KEY: For each criteria
Score 1: Two plus years Expert Experience
Score 2: One-Two Years Current Experience
Score 3: Less than one year or Intermittent Experience
Score 4: Theory, no experience

CRITERIA SCORE
1234
1. NEUROLOGICAL
Assessment 
a. Level of consciousness
b. Fontanels
c. Pupil size and Response
d. Intracranial Pressure Monitoring
e. Assist with lumbar puncture
f. ICP monitoring
Care of the child with 
Closed head trauma 
a. Reye's syndrome
b. Encephalitis
c. Febrile seizures
d. Meningitis
e. Multiple sclerosis
f. Spina Bifida
g. Near drowning
h. Coma
i. Post neurosurgery
j. Spinal cord injury
k. Status epilepticus
Medications 
a. Clonopin (Clonazapam)
b. Corticosteroids
c. Dilantin (Phenytoin)
d. Phenobarbital
e. Tegretol (Carbamazepine)
f. Valium (Diazepam)
2. CARDIOVASCULAR
Assessment 
a. Auscultation (rate, rhythm, volume)
b. Blood pressure/non-invasive
c. Heart sounds/murmurs
d. Perfusion
e. Central Venous Pressure
f. Non-invasive Cardiac Monitoring
g. Pulmonary Artery/Capillary Wedge
h. Invasive Hemodynamic Monitoring
i. Arterial blood gases
j. Hemoglobin & hematocrit
k. Equipment & procedures
l. Basic EKG interpretation
Care of the child with 
a. Bacterial endocarditis
b. Cardiac arrest
c. Cardiomyopathy
d. Congenital heart defects/disease
e. Congestive heart failure
f. Hypovolemic shock
g. Pericarditis
h. Post cardiac cath
i. Post cardiac surgery
j. Rheumatic fever
k. Tracheoesophageal fistula
l. Cardiac Transplant
m. Post Cardiac surgery
n. Post interventional Cardiac Cath
Medications 
a. Digoxin (Lanoxin)
b. Dobutamine (Dobutrex)
c. Dopamine (Intropin)
d. Epinephrine (Adrenaline)
e. Nipride (Nitropursside)
f. Nitroglycerine (Tridil)
g. Sodium Bicarbonate
3. ORTHOPEDICS
Equipment and Procedures
Specialized Orthopedic Bed
Application of splints
Care of the child with 
a. Pinned fractures
b. Traction
c. Clubfoot
d. Neuromuscular disease
e. Osteomyelitis
f. Post vertebral surgery
g. Cervical Traction
4. GASTROINTESTINAL
Assessment 
a. Abdominal
b. Nutritional
Procedures 
a. Central hyperalimentation
b. Gavage
c. Peripheral hyperalimentation
d. Gastrostomy/button
e. I-tubes
f. Jejunal feeding
g. NG and sump tubes to suction
h. Placement of naso/orogastric tube
i. Wound irrigation/dressing change
Care of the child with 
a. Gastroenteritis/Severe Dehydration
b. Cleft lip/palate
c. Colostomy
d. Pacreatitis
e. Post Abdominal Surgery
f. Stress Ulcer
g. Diaphragmatic hernia
h. Failure to thrive (FTT)
i. GE reflux
j. GI bleeding
k. Ileostomy
l. Intestinal parasites
m. Pyloric stenosis
n. Ulcerative colitis
o. Bowel obstruction
5. PULMONARY
Assessment 
a. Breath sounds
b. Rate and work of breathing
Equipment & Procedures 
a. Airway management devices/suctioning
b. Bulb syringe
c. Tracheostomy/suctioning
d. Assist with Intubation
e. Endotraceal Tube Suctioning
f. In-Line Suction
g. Open ET Catheter Suction
h. Extubation
i. Nasal Airway/Suctioning
j. Oral Airway/Suctioning
k. Apnea monitor
l. Chest physiotherapy
m. Obtaining Blood Gases
            Arterial
            Heelstick
            Peripheral
n. Chest tubes
            Insertion
            Removal
            Set-up
o. ECMO
p. End tidal CO2
q. Oximeter
r. Oxygen therapy delivery systems
            Face mask
            Oxyhood
            Isolette
            Nasal cannula
            Tent
            Trach collar
s. Vent Care
t. CPAP/PEEP
u. High Frequency Jet Ventilator
v. IMV
w. Pressure Ventilator
x. Volume Ventilator
Care of the child with 
a. Asthma
b. Bronchiolitis (RSV)
c. Bronchopulmonary dysplasia (BPD)
d. Cystic fibrosis
e. Epiglottitis
f. LTB/croup
g. Pertussis
h. Pneumonia
i. Tonsillitis
j. Tuberculosis
k. Respiratory Failure
l. Foreign Body Aspiration
m. Fresh Tracheostomy
Medications 
a. Alupent (Metaproteranol)
b. Aminophylline (Theophylline)
c. Isuprel (Isoproterenol)
d. Ventolin (Albuterol)
6. INFECTIOUS DISEASES
a. CBC/Differential
b. Culture Reports
c. Collect Culture Specimens
d. Isolation Techniques
Care of the child with 
a. Cytomegalo Virus
b. HIV/AIDS
c. Septic Shock
d. Tuberculosis
e. Common childhood - communicable diseases
7. MISCELLANEOUS
Assessment 
a. Normal growth and development
b. Normal laboratory values
c. Recognize signs of abuse or neglect
d. Medication - immunization schedule
Care of the child with 
a. Anorexia/bulimia
b. Craniofacial reconstruction
c. Depression
d. ENT surgery
e. Eye surgery
f. Ingestion of foreign body
g. Ingestion of poison or toxins
h. Plastic surgery
i. Suicidal threats/actions
8. WOUND MANAGEMENT
Assessment 
a. Skin for impending breakdown
b. Stasis ulcers
c. Surgical wound healing
Equipment & procedures 
a. 1st degree burns (throughout body)
b. 2nd degree burns
c. 3rd degree burns
d. Pressure sores
e. Staged decubitus ulcers
f. Sterile dressing changes
g. Surgical wounds with drain(s)
h. Traumatic wound care
i. Use of air fluidized, low airloss beds
j. Wound care/irrigations
9. PAIN MANAGEMENT
Assessment of pain level/tolerance 
Care of the child with 
a. Epidural anesthesia/analgesia
b. IV conscious sedation