TELEMETRY/STEPDOWN CARE SKILLS CHECKLIST

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Job Description: Provides professional nursing care for assigned patients in the telemetry/stepdown/progressive 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. 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
	1 2 3 4
CARDIOVASCULAR
Assessment
Auscultation (rate, rhythm)
Heart sounds/murmurs
Pulses/circulation checks
Interpretation of lab results
Cardiac enzymes/isoenzymes
Coagulation studies
Equipment and procedures
A) Monitoring/telemetry
1) Arrhythmia interpretation
2) Basic 12 lead interpretation
3) Lead placement: 5 electrode tele
4) Lead placement: I, III, V-leads
5) Lead placement: Lead II and MCL1
B) Pacemaker
1) Permanent
2) Temporary epicardial wires
3) Temporary external pacing
4) Temporary transvenous
C) Assist with
1) Arterial line insertion
2) Central line insertion
D) Hemodynamic monitoring
1) A-line (radial)
2) CVP monitoring
3) Femoral artery sheath removal
4) Swan-Ganz
E) Perform
1) Controlled cardioversion
2) Emergency defibrillation
Care of patient with
Abdominal aortic bypass
Aneurysm
Angina
Cardiac arrest
Cardiomyopathy
Carotid endarterectomy
Congestive heart failure (CHF)
Femoral-popliteal bypass
Post acute MI (24 - 48 hrs)
Post angioplasty
Post arthrectomy (DCA)
Post CABG (24 hours)
Post cardiac cath
Post stent placement
Medications
Atropine
Bretylium (Bretylol)
Cardizem (Diltiazem hydrochloride)
Digoxin (Lanoxin)
Dobutamine (Dobutrex)
Dopamine (Intropin)
Epinephrine (Adrenalin)
Heparin
Lidocaine (Xylocaine)
Nipride (Nitroprusside)
Nitroglycerine (Tridil)
Oral anticoagulants
Oral and IVP antihypertensives
Oral and topical nitrates
Verapamil (Calan, Isoptin, Verelan)
PULMONARY
Assessment
Breath sounds
Breathing patterns
Interpretation of lab results
Arterial blood gases
Blood chemistry
Equipment & procedures
A) Assist with intubation
B) Assist with thoracentesis
C) Care of airway management devices/suctioning
1) Endotracheal tube/suctioning
2) Nasal airway/suctioning
3) Oropharyngeal/suctioning
4) Oximetry
5) Sputum specimen collection
6) Tracheostomy/suctioning
D) Care of patient on ventilator
1) Extubation
2) Weaning modes
E) Care of patient with chest tube
1) Assist with set-up and insertion
2) Mediastinal tube removal
3) pleural tube removal
4) Use of Pleurevac or Thoraclex
5) Use of water seal drainage system
F) Chest physiotherapy
G) Establishing an airway
H) Incentive spirometry
I) O2 therapy & medication delivery systems
1) Ambu bag and mask
2) ET tube
3) External CPAP
4) Face masks
5) Inhalers
6) Nasal cannula
7) Portable O2 tank
8) Tracheostomy
9) Transtracheal cannulation
J) Oral airway insertion
Care of the patient with
ARDS
Bronchoscopy
COPD
Fresh tracheostomy
Lobectomy
Pneumonectomy
Pneumonia
Pulmonary edema
Pulmonary embolism
Status asthmaticus
Thoracotomy
Tuberculosis
Medications
Alupent (Metaproterenol sulfate)
Aminophylline (Theophylline)
Bronkosol (Isoetharine hydrochloride)
Corticosteroids
Ventolin (Albuterol)
NEUROLOGICAL
Assessment
Cerebellar function
Cranial nerves
Glasgow coma scale
Level of consciousness
Pathologic reflexes
Equipment and procedures
Assist with lumbar puncture
Halo traction
Nerve stimulator
Rotation bed
Seizure precautions
Use of hyper/hypothermia blanket
Care of the patient with
Aneurysm precautions
Basal skull fracture
Closed head injury
Coma
CVA
DTs
Encephalitis
Externalized VP shunts
Meningitis
Multiple sclerosis
Neuromuscular disease
Post craniotomy
Seizures
Spinal cord injury
Medications
Carbamazepine (Tegretol)
Carbidopa-Levodopa (Sinemet)
Clonazepam (Klonopin)
Decadron (Dexamethasone)
Dilantin (Phenytoin)
Lorazepam (Ativan)
Methylprednisolone (Solu-Medrol)
Phenobarbital
Valium (Diazepam)
GASTROINTESTINAL
Assessment
Abdominal/bowel sounds
Fluid balance
Nutritional
Interpretation of blood chemistry
Equipment and procedures
A) Administration of tube feeding
1) Feeding pump
2) Gravity feeding
B) Flexible feeding tube (i.e., Corpak, Dobhoff)
C) Placement of nasogastric tube
D) Salem sump to suction
E) Saline lavage
Management of
Gastrostomy tube
Jejunostomy tube
PPN (peripheral parenteral nutrition)
TPN and lipids administration
T-tube
Care of the patient with
Bowel obstruction
Colostomy
ERCP
Esophageal bleeding
GI bleeding
GI survery
Hepatitis
Ileostomy
Inflammatory bowel disease
Liver failure
Liver transplant
Pancreatitis
Paralytic ileus
Whipple procedure
RENAL/GENITOURINARY
Assessment
A-V fistula/shunt
Fluid & electrolyte balance
Interpretation of BUN & Creatinine
Equipment & procedures
A) Insertion & care of straight and Foley catheter
1) Female
2) Male
B) Supra-pubic
C) Bladder irrigation
1) Continuous
2) Intermittent
D) Specimen collection
1) Routine
2) 24-hour
E) Nephrostomy tube care
F) Manual CAPD administration
G) Peritoneal dialysis via Automatic cycler
Care of the patient with
Hemodialysis