Newborn and NICU Skills Checklist

Personal Information
Name
E-Mail address

Please indicate your overall practical experience level with each skill using the key below. All fields are required.

Key
None	No experience
Limited	Requires additional training
Moderate	Have performed and able to do without supervision
Well Skilled	Very experienced and able to perform independently
Proficient	Able to teach and supervise

Specific Pathologic Conditions - Care of a patient with:	None	Limited	Moderate	Well Skilled	Proficient
Infant of a diabetic mother
Hepatitis Surface Antigen+ mother
HIV Positive Mother
Bacterial Sepsis
Viral Sepsis
Exchange transfusion
Congenital Anomalies
Premature infants
Micro-preemies
Acute Renal Failure
DIC
Disorders of internal/external organs
Drug Addiction/withdrawal
Hypo/hyperkalemia
Hypo/hypernatemia
Malformations of the GU tract, kidney
Cleft Lip
Cleft Palate
Procedures	None	Limited	Moderate	Well Skilled	Proficient
Collection of urine specimens
Phototherapy for jaundice
Isolation techniques
Administration of blood/blood products
Drawing blood from a central line
Venus Blood Draw
Heel Stick
Intralipid
Apgar Scoring
Eye Exam (r/o retinopathy)
Screen for hearing loss
Bereavement/postmortem care
Immunization
Cord Care
Neonatal Skin Care
Positioning Devices
Weaning to open crib/bassinet
Weights/bed scale
Calculation of dosage
Emergency drug action & reaction
Eye prophylaxis â€“ Vitamin K
Neonatal Drug action & reaction
Interpretation of Lab Results:
CBC Differential
Blood Culture
Maternal Lab Results
Bilirubin
Urine Test
Collect Culture Specimens
IVs (Starting and managing IVs):
Central Line
Percutaneous arterial line
Percutaneous venous line
Peripheral line/dressing
Umbilical arterial line
Umbilical venous line
Thermo Regulators:
Warming Lights
Isolette
Radiant Warmer
Bililight
Recognition of Heat Loss
Respiratory	None	Limited	Moderate	Well Skilled	Proficient
Assessment of breath sounds
Open ET Catheter Suction
Apnea Monitor
Chest Tube (assist with)
ECMO (extracorporeal membrane oxygenation)
Nitric Oxide
Thoracentesis
Use of Artificial Surfactant
High Frequency Oscillatory Ventilator
Airway Procedures:
Assist with Intubation
Bulb Syringe
CPAP
Endotracheal Tube
Care of an infant with:
Bronchopulmonary Dysplasia
Cardiogenic/hypovolemic shock
Diaphragmatic hernia
Tracheostomy
Meconium aspiration
Hyaline Membrane disease
Persistent Pulmonary Hypertension
Pneumothorax
RDS
Medications:
Aminophylline
Prostaglandin
Cardiovascular - Assessment:	None	Limited	Moderate	Well Skilled	Proficient
Blood Pressure non-invasive
Blood Pressure invasive
Pulses
Perfusion
Heart Sounds/murmurs
Cardiovascular - Procedures:	None	Limited	Moderate	Well Skilled	Proficient
EKG Interpretation
Defibrillation/Cardioversion
Invasive Hemodynamic Monitoring
Cardiac Monitoring
Cardiovascular - Care of an infant with:	None	Limited	Moderate	Well Skilled	Proficient
Cardiac arrest
Cardiac Transplant
Cardiomyopathy
Congenital Heart Defects
Hemodynamic instability
Pre & Post Cardiac Surgery
Pre & Post Cardiac Cath
Cardiovascular - Medications:	None	Limited	Moderate	Well Skilled	Proficient
Digoxin
Dobutamine
Dopamine
Epinephrine
Lidocaine
Nipride
Sodium Bicarbonate
Verapamil
Neurology	None	Limited	Moderate	Well Skilled	Proficient
Assessment of Neuro Signs
Assessment of Fontanels
Anticonvulsant Medication
Glasgow Coma Scale
Assist with Lumbar Puncture
Care of an infant with:
Brain Death/organ procurement
Cephalic Shunt
External VP Shunt
Increased Intracranial Pressure Monitoring
Meningitis
Seizures
Hemorrhage
Gastrointestinal	None	Limited	Moderate	Well Skilled	Proficient
Abdominal Assessment
Bowel Sounds
Suck/Swallow
Assist with Breast Feeding
Bottle Feeding
Breast milk handling/storage
Gavage
Test for Occult Blood
Use and Care of:
Gastrostomy Tube
Jejunal Gastro Tube
Nasogastric/Orogastric Tube
Care of an infant with:
Bowel obstruction
Cleft lip/palate
Colostomy/ileostomy
Esophageal Artesia
Omphalocele
GI Bleeding
Inguinal Hernia
Necrotizing Enterocolitis (NEC)
Pyloric Stenosis
Post Abdominal Surgery
Reflux Precautions
Tracheoespophageal Fistula

Preserving Higher Standards of Patient Care