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Pediatric RN

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

Newborn/Neonate (birth to 30 days)*

Infant (1 month to 1 year)*

Toddler (1 year to 3 years)*

Preschooler (3 years to 5 years)*

School Age Child (5 years to 12 years)*

Adolescents (12 years to 18 years)*

Young Adults (18 years to 39 years)*

General Skills

Standard Precautions*

Isolation Precautions*

Pediatric Respiratory/Cardiac Arrest*

Adult Respiratory/Cardiac Arrest*

Crash Carts*

Defibrillators*

Care of Patient in Restraints*

Automated Med Dispensing Systems*

Care Planning & Discharge Planning*

Patient/Family Education*

Electronic Documentation*

Patient Head to Toe Assessment*

Normal Growth and Development*

Normal Lab Values*

Recognize Signs of Child Abuse/ Neglect*

Medication/ Immunization Schedule*

Cardiovascular

Blood Pressure (Invasive and Non-Invasive)*

Heart Sounds*

Murmurs*

Perfusion*

Interpretation of Lab Results (ABGs, Hgb/ Hct)*

Basic EKG Interpretation*

Non-Invasive Cardiac Monitoring*

Cardiovascular - Care of Children With

Bacterial Endocarditis*

Cardiac Arrest*

Cardiomyopathy*

Congenital heart Disease/Defects Cardiac Arrest*

Congestive Heart Failure*

Myocarditis*

Pericarditis*

Post Cardiac Cath*

Post Cardiac Surgery*

Rheumatic Fever*

Shock*

Cardiovascular - Medications

Digoxin*

Pulmonary

Breath Sounds*

Rate and Work of Breathing*

Airway Management Devices/ Suctioning*

Apnea Monitor*

Chest Physiotherapy*

Chest Tubes*

End Tidal CO2*

Oximeter*

Water Seal Drainage System*

Oxygen Delivery System

Face Mask*

Hood*

Isolette*

Nasal Cannula*

Tent*

Trach Collar*

Pulmonary - Care of Children With

Asthma*

Bronchiolitis (RSV)*

Bronchopulmonary Dysplasia (BPD)*

Cystic Fibrosis*

Epiglottitis*

LTB/ Croup*

Pertussis*

Pneumonia*

Tonsillitis*

Tuberculosis*

Pulmonary - Medications

Alupent*

Aminophylline*

Isuprel*

Ventolin*

Neurological

Assess Level of Consciousness*

ICP Monitoring*

Orthopedic

Application of Splints*

Cast*

Pinned Fractures*

Traction*

Battered Child Syndrome*

Clubfoot*

Multiple Sclerosis*

Multiple Trauma*

Osteogenic Sarcoma*

Osteomyelitis*

Corticosteroids*

Neurological - Care of Children With

Closed Head Injury*

Encephalitis*

Febrile Seizures*

Meningitis*

Near Drowning*

Neuromuscular Disease*

Spinal Cord Injury*

Neurological - Medications

Clonazepam*

Dilantin*

Phenobarbital*

Tegretol*

Valium*

Gastrointestinal

Abdominal Assessment*

Nutritional Assessment*

Interpretation of Lab Results (serum electrolytes)*

Gastrostomy/ Button*

J-Tubes*

NG and Sump Tubes to Suction*

Placement of Naso/ Orogastric Tube*

Feedings

Bottle*

Breast*

Central Hyperalimentation*

Gavage*

Peripheral Hyperalimentation*

Gastrointestinal - Care of Children With

Anal Fissure*

Cleft Lip/ Palate*

Colostomy*

Diaphragmatic Hernia*

Failure to Thrive (FTT)*

Gastroenteritis/ Dehydration*

GE Reflux*

GI Bleeding*

Ileostomy*

Intestinal Parasites*

Necrotizing Enterocolitis*

Pyloric Stenosis*

Surgical Abdomen*

Ulcerative Colitis*

Ingestion of Foreign Body*

Ingestion of Poisons or Toxins*

Endocrine/Metabolic

Assessment*

Interpretation of Lab Results (glucose, thyroid)*

Blood Glucose Testing*

Endocrine/Metabolic - Care of Children With

Adrenal Disorders*

Cushing's Syndrome*

Juvenile Disorders*

Pituitary Disorders*

Thyroid Malfunction*

Endocrine/Metabolic - Medications

Growth Hormone*

Insulin*

Thyroid*

Genitourinary

Assessment of Fluid Balance*

Interpretation of Lab Results (creatinine, BUN, UA)*

Assist with Suprapubic Tap*

Collection of Urine Specimen*

Catheter

Catheter care*

Insertion of Indwelling - Female*

Insertion of Indwelling - Male*

Straight Cath - Female*

Straight Cath - Male*

Genitourinary - Care of Children With

Circumcision*

Glomerulonephritis*

Hemodialysis*

Hemolytic Uremic Syndrome (HUS)*

Hypospadias*

Ileal Conduit Urinary Diversion*

Infantile Polycystic Disease*

Kidney Transplant*

Nephrotic Syndrome*

Peritoneal Dialysis*

Renal Failure*

Urinary Tract Infection*

Wilm's Tumor*

Genitourinary - Medications

Prednisone*

Anticholinergics*

Medication Administration for Children

Calculation of Pediatric Doses*

Eye/ Ear Installations*

Knowledge of Emergency Drugs*

Knowledge of Routine Pediatric Drugs*

Metered Dose Inhaler*

Phlebotomy/IV Therapy

Drawing Blood from Central Lines*

Drawing Venous Blood*

Starting IVs (angiocath, butterfly, heparin lock)*

Administration of Blood/Blood Products

Cryoprecipitate*

Packed Red Blood Cells*

Whole Blood*

Fresh Frozen Plasma*

Venous Access

Central Line/ Catheter/ Dressing*

Broviac*

Groshong*

Hickman*

Portacath*

Quinton*

Cutdown Line/ Dressing*

Peripheral Line/ Dressing*

Infectious Disease/Immunosuppression

Interpretation of Lab Results (blood count)*

Isolation*

Fever Management*

Infectious Disease - Care of Children With

Anemia*

Bone Marrow Transplant*

Depressed Immune System*

Disseminated Intravascular Coagulation (DIC)*

Hemophilia*

Hodgkin's Lymphoma*

Infectious Mononucleosis*

Leukemia*

Malignant Tumors*

Sickle Cell Anemia*

Spleen Trauma/ Splenectomy*

AIDS*

Common Childhood-Communicable Diseases*

Cytomegalovirus (CMV)*

Hepatitis*

Kawasaki Disease*

Lyme Disease*

Psychiatric

Drug/ ETOH Overdose/ Withdrawal*

Psychiatric Hold*

Suicidal Patient*

Anorexia/ Bulimia*

Depression*

Wound Management

Penrose Drains*

Would Irrigation/ Dressing Change*

Assess Skin for Impending Breakdown*

Assess Stasis Ulcers*

Surgical Wound Healing*

First Degree Burns*

Second Degree Burns*

Third Degree Burns*

Pressure Sores*

Stages Decubitus Ulcers*

Sterile Dressing Changes*

Surgical Wounds with Drain(s)*

Traumatic Wounds*

Use of Low Airloss Beds*

Wound Care/ Irrigations*

Pain Management

Assessment of Pain Level/ Tolerance*

Pain Management - Care of Children With

Epidural Anesthesia/ Analgesia*

IV Conscious Sedation*

Narcotic Analgesia*

Chemotherapy Cert

Do you have a chemotherapy cert?*

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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