Telemetry/Stepdown

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

Cardiovascular Care of Patient

Acute MI *

CHF *

Angina Hypertension *

Cardiomyopathy *

Cardiopulmonary Arrest *

Abdominal Aortic Aneurysm *

Carotid Endarterectomy *

Femoral Popliteal Bypass *

Pre & Post Cardiac Surgery *

Pre & Post Cardiac Cath *

Pre & Post PTCA *

Permanent Pacemaker *

Temporary Pacemaker *

External Pacemaker *

Cardiac Lab Interpretation *

Cardiac Patient/Family Teaching *

Respiratory Care of Patient

Respiratory Assessment *

Assess Lung Sounds *

Chest Percussion *

Establish/Protect Airway *

Chest Tubes/Pleurevac *

Oxygen Therapy *

Drawing ABGs *

Interpretation of ABGs *

Incentive Spirometry *

Suctioning: Oral, Nasotracheal, Endotracheal Tube, Tracheostomy Tube *

Oxygen Equipment Set Up and Maintenance: Nasal Cannula, Non-Rebreather Mask, Venti-Mask, ET *

Intubation/Extubation *

Ambu Bag Pulse Oximetry *

Care of patient with: COPD tracheostomy pulmonary edema ARDS ventilator (A/C, IMV, PEEP) pre/post-op thoracis surgery pneumonia chest tubes asthma emphysema *

Neurology Care of Patient

Neurological Assessment *

Seizure Precautions *

Assessment and Management of Seizure Activity *

Assisting with Lumbar Puncture *

Signs/Symptoms of Increasing ICP *

Glasgow Coma Scale *

Crutchfield Tongs *

Circo-electric Bed *

Halo Traction *

Stryker Frame *

Care of patient with: seizures CNS infection overdose DTs spinal cord injury acute head injury CVA/TIA neuromuscular disease pre/post neuro surgery *

Gastrointestinal Care of Patient

G.I. Assessment *

Bowel Sounds *

Inserting N-G Tubes *

Colostomy Care *

Measurement of I & O *

Administration of Tube Feedings *

Care of patients with: GI bleed NG tube G-tube J-tube abdominal wounds/surgeries inflammatory bowel disease bowel obstruction *

Renal/Genitourinary Care of Patient

Insertion and Care of (Straight Cath, Indwelling Urinary Cath: Male, Female, 3-Way) *

Care of Patient with (Bladder Irrigation, Suprapubic Tube, Nephrostomy Tube, Renal Transplant, Nephrectomy, Renal Transplant, BPH, Pre/Post TURP) *

Orthopedic Care of Patient

Total Knee Replacement *

Bucks Extension *

Cast Care *

Crutch Walking *

K-Wires *

Spica Casts *

Balanced Suspension Traction *

Circulation Checks *

Care of Patient with (Amputation, Rheumatic/Arthritic Disease, Multiple Trauma, Paraplegia, External Fixation, Post Arthroplasty) *

General Care of Patient

Blood Glucose Monitoring *

Dressing Changes *

Universal Precautions *

Isolation *

Discharge Planning *

Care of Patient with (Diabetes, Pressure Sores, Sickle Cell Anemia, Cancer, Alzheimer's Disease, HIV/AIDS) *

Medications Administered

Unit Dose *

Dosage Calculation *

Pouring from Stock Medication *

Administration of Code Cart Emergency Drugs *

Aminophylline *

Ativan *

Atropine *

Chemotherapy Agents *

Corticosteroids *

Decadron *

Digoxin *

Dilantin *

Dobutamine *

Dopamine *

Heparin *

Inhalers *

Lidocaine *

Lopressor *

Magnesium Sulfate *

Nipride *

Nitroglycerin *

Phenobarbital *

Thrombolytic Agents *

Valium *

Verapamil *

IV Therapy

Inserting IVs *

Mixing IV Solutions *

Heparin Locks *

TPN/Hyperalimentation *

IV Push *

IV Drip *

Infusion Pumps *

Syringe Pumps *

Continuous Subcutaneous Infusion Pumps *

PCA Pumps *

Ultrasonic Doppler *

CVP Lines/Measurement of CVP *

Central Line Dressing Change *

Blood/Blood Products Administration *

Ordering/Obtaining from Blood Bank *

Identification/Intercession for Adverse Reaction *

Multi-lumen Central Venous Catheters *

Implanted CVC (Port-a-Cath) *

Assessment of IV Insertion Site *

Assist with Insertion of Central Line *

X-ray/Assessment After Insertion *

Care of Patient with Central Line *

Charge Nurse Experience? *

CPR Certified? *

BCLS Certified? *

ACLS Certified? *

Knowledge of Normal Values? *

Have You Had a Dysrhythmia Course? *

Age Specific Competencies

Infant (Birth - 1 Year) *

Preschooler (Ages 2-5 Years) *

Childhood (Ages 6-12 Years) *

Adolescents (Ages 13-21 Years) *

Young Adults (Ages 22-39 Years) *

Adults (Ages 40-64 Years) *

Older Adults (Ages 65-79 Years) *

Elderly (Ages 80+ Years) *

Telemetry/Stepdown

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