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Neonatal Intensive Care

This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Fusion Medical Staffing.

  • 0 = Not Applicable
  • 1 = No Experience
  • 2 = Some Experience
  • 3 = Intermittent Experience
  • 4 = Experienced
  • 5 = Very Experienced
*Required
n/a
1
2
3
4
5

* Required

Age of Patients Cared For

Neonate < 23 Weeks*

Neonate 23-28 Weeks*

Neonate 29-32 Weeks*

Neonate > 32 Weeks*

Full Term Newborn*

Neurological

Assessment Of Neurological Status*

Intracranial Pressure Monitoring*

Neurological - Care of Neonates With

Spina Bifida*

Myelomeningocele*

Brain Death/Organ Procurement*

Externalized VP Shunt/Reservoirs*

Intraventricular Hemorrhage*

Increased Intracranial Pressure*

Meningitis*

Seizures*

Anticonvulsant Medications*

Cardiovascular

Assessment/Auscultation (rate, rhythm, volume)*

Blood Pressure/Invasive (arterial line)*

Blood Pressure/Non-invasive*

Heart Sounds/Murmurs*

Perfusion*

Pulses*

EKG Interpretation/Rhythm Recognition*

Defibrillation/Cardioversion*

Invasion Hemodynamic Monitoring*

Central Venous Pressure*

Cardiovascular - Care of Neonates With

Cardiac Arrest*

Cardiac Transplant*

Cardiomyopathy*

Congenital Heart Disease/Defects*

Hemodynamic Instability*

Cardiogenic/Hypovolemic Shock*

Post Cardiac Surgery*

Post Cardiac Cath*

Hyper/Hypotension*

Knowledge and Use of

Vasopressin*

Digoxin*

Dobutamine*

Dopamine*

Epinephrine*

Nipride*

Sodium Bicarbonate*

Respiratory

Assessment of Breath Sounds*

Rate and Work of Breathing*

Interpretation of ABGs*

Assist with Chest Tube Insertion*

Assist With Chest Tube Removal*

ECMO (Extracorporeal Membrane Oxygenation)*

Thoracentesis*

Use of Artificial Surfactant*

Airway Management

Assist with Intubation*

Bulb Syringe*

Endotracheal Tube Suctioning*

In-Line Suction*

Open ET Catheter Suction*

Extubation*

Nasal/Oral Airway/Suctioning*

Tracheostomy/Suctioning*

Apnea Monitor*

Respiratory Insufficiency*

Respiratory Arrest*

O2 Therapy Delivery Systems

Bag and Mask*

Nasal Cannula*

Nebulizer*

Oxyhood/Tent*

Trach Collar*

Obtaining Labs

Arterial*

Heelstick*

Peripheral*

Umbilical Line*

Use of Ventilators

CPAP/PEEP*

High Frequency Jet Ventilator*

Home Ventilator*

IMV*

Oscillating*

Pressure Ventilator*

Volume Ventilator*

CO2 Monitoring*

Weaning*

Respiratory - Care of Neonates With

Apnea*

Meconium Aspiration*

Persistent Pulmonary Hypertension (PPHN)*

Bronchopulmonary Dysplasia (BPD)*

Diaphragmatic Hernia*

Fresh Tracheostomy*

Pneumothorax*

Respiratory Distress Syndrome (RDS)*

Respiratory Failure*

Knowledge and Use of

Aldactazide*

Lasix*

Caffeine*

Prostaglandin*

Bronchodilators*

Steroids*

Gastrointestinal

Abdominal Girth*

Bowel Sounds*

Palate*

Suck/Swallow*

Care of Gastrostomy Tube*

Test for Occult Blood*

Feedings

Assist with Breast Feeding*

Bottle*

Breast Milk Handling/Storage*

Gavage*

Hospital Grade Electronic Breast Pump*

Placement of Intestinal Tubes

Jejunal/Gastro*

Nasogastric/Orogastric*

Gastrointestinal - Care of Neonate With

Cleft lip/Palate*

GI Bleed*

Ostomy*

Post Abdominal Surgery*

Inguinal hernia*

Necrotizing Enterocolitis*

Gastroschesis/Omphalocele*

Reflux*

Tracheoesophageal Fistula (TEF)*

Renal/GU/Metabolic/Endocrine General Skills

Fluid & Electrolyte Balance*

Calculating Output*

Knowledge/Interpretation of Lab results/Chemistry*

Bilirubin*

Glucose*

Labstix*

Occult Blood*

pH*

Specific Gravity*

Collection of Urine Specimens

Assist with Suprapubic Tab*

Catheter

Diaper/Bag*

Phototherapy for Jaundice*

Post Circumcision Care*

Renal/GU/Metabolic/Endocrine - Care of Neonates With

Acute Renal Failure*

DIC (disseminated Intravascular Coagulation)*

Disorders of Internal/External Organs*

Drug Addiction/Withdrawal*

Hyper/Hypokalemia*

Hyper/Hyponatremia*

Infant of Diabetic Mother- Monitor for Hyper/Hypoglycemia*

Malformations of the GU Tract, Kidney*

Peritoneal Dialysis*

Infectious Diseases

Assist with Lumbar Puncture*

Collect Culture Specimens*

Isolation Techniques*

Standard Precautions*

Knowledge of Lab Results

CBC/Differential*

Culture Reports*

Maternal Lab Results*

Infectious Diseases - Care of Neonates With

Hepatitis Surface Antigen + Mother*

HIV Positive Mother*

Neonatal Sepsis*

Knowledge and Use of

Antibiotics*

HBIG*

HBV*

HIB*

RespiGam/Synagis Prophylaxis*

Medication Skills/Knowledge and Use Of

Calculation of Dosage*

Prep and Administration of Emergency Meds*

Emergency Drug Action & Reaction*

Eye Prophylaxis – Vitamin K*

Neonatal Drug Action & Reactions*

Computerized/Automated Medication Administration System*

Pain Management

Assessment Of Pain Level Using Age Appropriate Scales*

Care of Neonate with Sedation*

Use of Sedation Reversal Agents*

IV Therapy/Phlebotomy - Administration Of Blood/Blood Products

Cryoprecipitate*

Packed Red Blood Cells*

Plasma/Albumin*

Whole Blood*

Drawing Blood from Central Line*

Drawing Venous Blood*

IV Therapy/Phlebotomy - Delivery Systems

IV Pump*

Syringe Pump*

Hyperalimentation/TPN/PPN*

Intralipid*

IV Therapy/Phlebotomy - Managing IV Therapy

Insertion*

Discontinuation*

Dressing & Tubing Change*

Rate Calculation*

Site & Patency Assessment*

IV Therapy/Phlebotomy - Care of Neonates With

Central Line/Catheter/Dressing*

Broviac*

Groshong*

Hickman*

Port-A-Cath*

Quinton*

Percutaneous Arterial Line*

PICC (peripherally inserted central catheter)*

Umbilical Artery Line*

Umbilical Venous Line*

Other/Misc

Crash Carts*

Defibrillators*

Computerized Charting System*

Apgar Scoring*

Eye Exam (r/o retinopathy)*

Cord Care*

Neonatal Skin Care*

Positioning Devices*

Preparation for Transport/Transfer*

Gestational Age

Car Seat Safety*

Ballard*

Dubowitz*

Maternal History*

Screen for Hearing Loss*

Equipment & Procedures*

Bereavement/Postmortem Care*

Consents*

Immunization*

Procedural*

Treatment*

Family Teaching/Education*

Care Planning*

Thermoregulation

Isolette with Humidity*

Radiant Warmer*

Temperature (auxillary, rectal, skin)*

Weaning To Open Crib/Bassinet*

Weights

Bed Scale*

Scale*

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Experience with ventilators?*

Experience with cardiac monitors?*

NRP current?*

STABLE current?*

Age-Appropriate Care: Ability to adapt care to incorporate normal growth and development, adapt method and terminology of client instructions as it relates to the age and comprehension level of the client, and to ensure a safe environment - reflecting specific needs of the client and various age groups.

Application Agreement

The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Fusion Medical Staffing. Submit this skills evaluation with your initial application. To be updated annually.

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