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Hudson Staffing Travel Nurses| NICU Online Checklist
NICU Online Checklist
Thank you for your decision to apply for a travel nursing position with
Hudson Staffing
! Before we can offer you a nursing employment opportunity in the NICU field, an electronic skills assessment must be completed. Please, complete the nursing skills checklist below, and be sure to review your information thoroughly before clicking the submit button.
GENERAL INFORMATION
Note:
*
Denotes a required field.
Please enter your full name as it appears on your Social Security Card:
First Name
Middle Name
Last Name
*
Please enter the Last Four digits of your Social Security Number:
-
-
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Please check here if you do not hold a valid social security card.
Please provide your contact information:
Phone Number
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E-mail Address
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Confirm E-mail Address
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Type your e-mail address again above.
This profile is for use by healthcare professionals in the NICU discipline and specialty.
It will not be a determining factor for the program.
CHECKLIST INSTRUCTIONS
Please mark your level of experience
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
PATIENT TYPES
1
2
3
4
Neonates < 28 Weeks
Neonates 29 - 34 Weeks
Neonates > 34 Weeks
WORK SETTINGS
1
2
3
4
Level II NICU
Level III NICU
Level IV NICU
CARDIOVASCULAR
1
2
3
4
Cardiac Surgery - Pre-op
Cardiac Surgery - Immediate Post-op
Congenital Heart Disease/Defects
CHF/Pulmonary Edema
Hemodynamic Instability
PULMONARY
1
2
3
4
Bronchopulmonary Dysplasia
Diaphragmatic Hernia
Fresh Tracheostomy
Meconium Aspiration
Persistent Pulmonary Hypertension
Pneumonia
Respiratory Distress Syndrome/Failure
Interpretation of ABGs
Assist with Intubation/Extubation
Endotracheal Suctioning
Chest Tube Placement and Management
Modes of Ventilation (AC/PC/SIMV/CPAP/BiPAP)
High Frequency Ventilation
Inhaled NO
ECMO
NEUROLOGIC
1
2
3
4
Ballard/Dubowitz
Reflexes Based on Gestational Age
Hydrocephalus
Intraventricular Hemorrhage
Meningocele/Myelomeningocele
Neonatal Abstinence Score/Syndrome
Seizures
GASTROINTESTINAL
1
2
3
4
Colostomy/Ileostomy
Gastroschisis/Omphalocele
GI Bleeding
Necrotizing Enterocolitis
Post Abdominal Procedure
FEEDINGS
1
2
3
4
Breast Milk Handling/Storage
Breast Pump
Gavage Feedings
NG/OG/NJ Tube Placement and Management
RENAL/ENDOCRINE/GENETIC
1
2
3
4
Circumcision Care
Genetic Disorders
Hypo/Hyperglycemia
Infant of Diabetic Mother
Malformations of the GU Tract/Kidney
Phototherapy
Renal Failure
INFECTIOUS DISEASES
1
2
3
4
Neonatal Sepsis
Septic Work Up
Assist with Lumbar Puncture
MEDICATIONS
1
2
3
4
Calculation of Neonatal Dosages
Antibiotics/Antivirals
Anticonvulsants
Immunizations
Digoxin
IV Vasopressors
Prostaglandin
Bronchodilators
Steroids
Caffeine
Surfactant
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
IV THERAPY
1
2
3
4
Administration of Blood/Blood Products
Central Line Catheter/Dressings
Management of UAC/UVC Lines
Radial Arterial Lines
Start IVs
CARDIAC MONITORING & EMERG. RESPONSE
1
2
3
4
Attend High Risk Deliveries
Preparation for Transport
Transport Neonate
Rhythm Interpretation
Dysrhythmia Management
PROFESSIONAL KNOWLEDGE AND SKILLS
1
2
3
4
National Patient Safety Goals/Core Measures
Bereavement/Postmortem Care
Neonatal Skin Care
Pressure Ulcer Risk Assessment/Prevention
Restraints/Use of Least Restrictive Device
Patient/Family Teaching
Age Specific/Population-Based Care
Isolation Precautions
Infection Prevention
Pain Assessment & Management
Charge Experience
Interpretation and Communication of Lab Values
1
2
3
4
EPIC
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
EMR Conversion
Yes
No
Certifications
1
2
3
4
BLS
NRP
PALS
S.T.A.B.L.E.
NCC Certification - RNC-NIC
Please read and agree to the statements below by marking the checkbox.
You will not be able to submit until you have marked the checkbox.
*
I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize Hudson Staffing to release this NICU Skills Checklist to the client facilities in relation to consideration of employment as a healthcare professional with those facilities.
Privacy Note:
Hudson Staffing will record anonymous electronic information about your connection when you click on the submit button. This information is used for security purposes only. This information will include your IP Address (3.235.176.80) which will be used as a digital signature.
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Hudson Staffing
Phone:
1(866)256-8773
E-mail:
info@hudsonstaffing.net
Your resource for traveling nurse and allied health career opportunities.
Copyright (C) 2013 Hudson Staffing. All rights reserved.