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Neonatal ICU

Information

Name *

Last 4 digits of SSN *

Phone *

Email *

Proficiency Scale

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Patient Types

Neonates < 28 Weeks *

Neonates 29 - 34 Weeks *

Neonates > 34 Weeks *

Work Settings

Level II NICU *

Level III NICU *

Level IV NICU *

Cardiovascular

Cardiac Surgery - Pre-op *

Cardiac Surgery - Immediate Post-op *

Congenital Heart Disease/Defects *

CHF/Pulmonary Edema *

Hemodynamic Instability *

Pulmonary

Bronchopulmonary Dysplasia *

Diaphragmatic Hernia *

Fresh Tracheostomy *

Meconium Aspiration *

Persistent Pulmonary Hypertension *

Pneumonia *

Respiratory Distress Syndrome/Failure *

Interpretation of ABGs *

Assist with Intubation/Extubation *

Endotracheal Suctioning *

Chest Tube Placement and Management *

Modes of Ventilation (AC/PC/SIMV/CPAP/BiPAP) *

High Frequency Ventilation *

Inhaled NO *

ECMO *

Neurologic

Ballard/Dubowitz *

Reflexes Based on Gestational Age *

Hydrocephalus *

Intraventricular Hemorrhage *

Meningocele/Myelomeningocele *

Neonatal Abstinence Score/Syndrome *

Seizures *

Gastrointestinal

Colostomy/Ileostomy *

Gastroschisis/Omphalocele *

GI Bleeding *

Necrotizing Enterocolitis *

Post Abdominal Procedure *

Feedings

Breast Milk Handling/Storage *

Breast Pump *

Gavage Feedings *

NG/OG/NJ Tube Placement and Management *

Renal/Endocrine/Genetic

Circumcision Care *

Genetic Disorders *

Hypo/Hyperglycemia *

Infant of Diabetic Mother *

Malformations of the GU Tract/Kidney *

Phototherapy *

Renal Failure *

Infectious Diseases

Neonatal Sepsis *

Septic Work Up *

Assist with Lumbar Puncture *

Medications

Calculation of Neonatal Dosages *

Antibiotics/Antivirals *

Anticonvulsants *

Immunizations *

Digoxin *

IV Vasopressors *

Prostaglandin *

Bronchodilators *

Steroids *

Caffeine *

Surfactant *

Automated Medication Dispensing (i.e. Pyxis, Omnicell) *

IV Therapy

Administration of Blood/Blood Products *

Central Line Catheter/Dressings *

Management of UAC/UVC Lines *

Radial Arterial Lines *

Start IVs *

Cardiac Monitoring & Emergency Response

Attend High Risk Deliveries *

Transport Neonate *

Rhythm Interpretation *

Dysrhythmia Management *

Professional Knowledge and Skills

National Patient Safety Goals/Core Measures *

Bereavement/Postmortem Care *

Neonatal Skin Care *

Pressure Ulcer Risk Assessment/Prevention *

Restraints/Use of Least Restrictive Device *

Patient/Family Teaching *

Age Specific/Population-Based Care *

Isolation Precautions *

Infection Prevention *

Pain Assessment & Management *

Charge Experience *

Interpretation and Communication of Lab Values *

EMR

Epic *

Cerner *

Eclipsys *

McKesson *

Meditech *

Other Computerized System *

Computerized Physician Order Entry *

Bar Coding for Medication Administration *

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