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Hudson Staffing Travel Nurses| Intermediate Care/PCU/Stepdown/Telemetry Online Checklist
Intermediate Care/PCU/Stepdown/Telemetry 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 Intermediate Care/PCU/Stepdown/Telemetry 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:
-
-
*
Please check here if you do not hold a valid social security card.
Please provide your contact information:
Phone Number
*
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 Intermediate Care/PCU/Stepdown/Telemetry 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
Cardiac
1
2
3
4
Acute Coronary Syndrome
Congestive Heart Failure
Post Open Heart (12-24 hours)
Carotid Endarterectomy
Post Vascular Surgery
Heart Transplant
Pacemaker - Temporary/Permanent
Pacemaker - Epicardial
Sheath Removal
Heart Sounds
PULMONARY
1
2
3
4
Pneumonia
Respiratory Distress
COPD
Breath Sounds
Post Thoracic Surgery
Chest Tube Placement & Management
Trach Management
Modes of Ventilation (AC/PC/SIMV/CPAP)
Intubation/Extubation
External CPAP/BiPAP
Interpretation of Arterial Blood Gases
Neurologic & Psychiatric
1
2
3
4
Stroke Scale Assessment
CVA
Brain Injury
Post Craniotomy
Spinal Cord Injury
Seizure Disorders
ETOH/Drug Withdrawal
GASTROINTESTINAL
1
2
3
4
GI Bleeding
GI Surgery
Liver Failure
Pancreatitis
Liver Transplant
Pancreas Transplant
RENAL/GENITOURINARY
1
2
3
4
Renal Failure
Renal Surgery
Renal Transplant
Arteriovenous Fistula/Shunt
Nephrostomy Tubes
Peritoneal Dialysis
Endocrine Metabolic
1
2
3
4
Diabetes - Hypo/Hyperglycemic Crisis
Pituitary Disorders
IV Insulin Protocols
Indwelling Insulin Pumps
MEDICATIONS
1
2
3
4
Anti-Arrhythmics
Anticoagulants (IV, oral, & injection)
Anti-Hypertensives
Anti-Psychotics
Anti-Seizure Medications
Benzodiazepines
Procedural Sedation
Diuretics
Emergency Medications
Inhaled Medications
Insulin
Titrate Vasoactive Drips
Manage Vasoactive Drips - No Titration
Narcotics/Opioid Analgesics (IV, oral, & injection)
Nitrates (Oral & Topical)
Non-Opioid Analgesics (IV, Oral, & Injection)
Reversal Agents
Steroids (IV, Oral, Inhaled)
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
IV THERAPY
1
2
3
4
Starting IVs
Central Line Blood Draws
Central Line/Implanted Line Care
Arterial Line Management
TPN & Lipids
Blood Product Administration
Administration of Chemotherapy
CARDIAC MONITORING & EMERG. RESPONSE
1
2
3
4
Dysrhythmia Interpretation
Dysrhythmia Management
Obtain 12 Lead EKG
Interpret 12 Lead EKG
Cardioversion
Defibrillation
Malignant Hyperthermia
PROFESSIONAL KNOWLEDGE AND SKILLS
1
2
3
4
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
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
Specialty Beds
EMR
1
2
3
4
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
EMR Conversion (5)
Yes
No
CERTIFICATIONS
BLS
ACLS
PALS
PCCN
CCRN
Critical Care Course
Telemetry Certificate/Course
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 Intermediate Care/PCU/Stepdown/Telemetry 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.