Skills Checklist – Telemetry

CARE OF PATIENTS WITH*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Abdominal Aortic Aneurysm
Angina
Cardiac Arrest
Cardiac Catherization
Cardiogenic Shock
Carotid Endarterectomy
Congestive Heart Failure
Cardiac Stents
Deep Vein Thrombosis
Post Acute MI (>48 hrs)
Post Angioplasty
Asthma
Bronchoscopy
COPD
Fresh Tracheostomy
Pneumonia
Pneumothorax
CVA/TIA
Heart Transplant
Head Injuries/Intercranial bleeds
Respiratory Distress
Assess Breath Sounds
Stroke Scale Assessment
Seizures
Spinal Cord Injuries
Renal Failure
Dsyrhythmia Interpretation
Hepatic Failure
Hepatitis
GI Bleed
TURP/TURBP
Total Hip Replacement
Total Knee Replacement
Diabetes Insipidus
Diabetes Mellitus
Leukemia
Malignant Tumors
Pituitary Disorders
Burns
Delirium Tremens
HIV/AIDS

MEDICATION ADMINISTRATION*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Aminophylline
Antibiotics
Anticoagulants
Antihypertensives
Beta-Blockers
Ca+ Channel Blockers
Chemotherapeutic Agents
Corticosteroids
Digoxin
Heparin
Insulin
Antiarrhythmics
Nitroglycerine
Oral Hypoglycemics
Antipsychotics
Antiseizure
Procedural Sedation
Benzodiazepines
Thrombolytics
TPN Administration
Patient Controlled Analgesia (PCA)
Blood/Blood Product Administration
Diuretics
CAD Pump
Emergency Medications
Inhaled Medications
Insulin Pump
Non-opiod Analgesics
Reversal Agents
Automated Dispensers (Pyxis)
IV Insulin Protocol

PROCEDURES/SKILLS*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
A-V Fistula Care
Foley/Straight Cath insertion & care
Central line care
Chest tube & drainage system
CVP Measurment
Cardioversion
Defibrillation
EKG - obtaining 12 lead
EKG arrhythmia interpretation
EKG - lead placement
Femoral Sheaths-Mgmt/Discontinuing
Continuous Tube Feeding
Glascow Coma Scale
Gastric Suction
Interpretation of Lab Results
Intestinal Tract Tube Insertion/Care
Oxygen Therapy Administration
Assist with Intubation/Extubation
Pacemaker
Peritoneal Dialysis
Specimen Collection
Blood
Suctioning
Temperature
Wound/Ostomy Care
Pressure Ulcers

ASSESSMENT/OTHER*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Assess Breath Sounds
Assess Heart Sounds
Charge Nurse responsibilities
Circulation Checks
Patient Teaching
Neurological Assessments
Pain Management
IV Conscious Sedation
Patient Controlled Analgesia (PCA)

EQUIPMENT*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Automatic BP cuffs
Cardiac/Tele Monitor
Femoral Hemostasis Devices
Glucometer
EQUIPMENT - SPECIALTY BEDS*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Ventilator Management/Troubleshooting

Age Group Experience*

Do you speak any languages other than English?*
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Confirmation*
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Date
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