Skills Checklist – Pediatrics

CARE OF PATIENTS WITH*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Pre & Post Cardiac Surgery
Colostomy/Iloestomy
Renal Failure
Congenital Heart Disease
Kawasaki's Disease
Asthma
Croup
Epiglottitis
Pneumonia
Respiratory Synticial Virus (RSV)
Rheumatic Fever
Tuberculosis
Closed Head Injuries
Encephalitis
Epilepsy
Reye's Syndrome
Seizures
Gastroenteritis
Juvenile Diabetes
Poison Ingestion/Overdose
Tonsillitis
Urinary Tract Infection
Hepatitis
Osteomyelitis
Fractures - Pinned Traction
Devised Traction (casts, splints, braces)
Pituitary Disorders
Thyroid Dysfunction
Anemia
Hemophilia
Leukemia
Bone Marrow Transplant
Hodgkin's Disease
Malignant Tumors
Childhood Communicable Diseases
Cytomegalovirus (CMV)
HIV/AIDS
Burns
Battered Child Syndrome
Child Abuse/Neglect
Failure to Thrive
Multiple Trauma
Developmental Delay
Cleft Lip/Palate

MEDICATION ADMINISTRATION*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Pediatric Calculations
Antihyperintensives
Anticoagulants
Antiseizure
Benzodiazepines
Diuretics
Narcotics/Opiods
Emergency Medication
Reversal Agents
Steroids IV/Oral
Procedural Sedation
Automated Medication Dispensing
Inhaled Medications
Non-Narcotic Agents
Insulin
Continuous IV infusion
Eye/ear Installations
IM Injections
Rectal Infusion/Suppository
SQ Injections
Z-track Injections

PROCEDURES/SKILLS*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Cast Care
Chemotherapy - Peds Protocols
Chest tube & drainage system
Breastfeeding - assist
Bottle
Continuous tube feeding
Gavage, intermittent
Hemodynamic Monitoring, non-invasive
Interpretation of Lab Results
Intestinal Tract Tube Insertion/Care
Intravenous Infusions
Blood & Blood Products
Central line care
Peripheral IV insertion & care
Oxygen Therapy Administration
Peritoneal Dialysis
Suctioning
Temperature
Wound/Ostomy Care
Pressure Ulcers
Patient Controlled Analgesia (PCA)

PROCEDURES/SKILLS - SPECIMEN COLLECTION (BLOOD)*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Central line
Heel stick
Venous stick
PROCEDURES/SKILLS - SPECIMEN COLLECTION (CULTURES)*
Rarely Some Experience Proficient Trainer / Preceptor N/A
General
PROCEDURES/SKILLS - SPECIMEN COLLECTION (URINE)*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Catheter
Diaper
Suprapubic tap (assist)
Urine bag

ASSESSMENT/OTHER*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Abdominal Girth Measurement
Isolation Precautions
Assess Breath Sounds
Assess Heart Sounds
Infection Prevention
Recognize/Report Signs of Abuse
Circulation Checks
Pain Assessment and Management
Fontanel Assessment
Head Circumference Measurement
Neurological Assessments
Patient Teaching
Use of Restraints
Vital Signs

EQUIPMENT*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Apnea Monitor
Glucometer
Specialty Beds

Age Group Experience*

Do you speak any languages other than English?*
- No
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Confirmation*
- I attest that the information I have given is both true and, to the best of my knowledge, represents an accurate self assessment of my professional skills and/or education.
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Date
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