Neonatal Intensive Care Skills Checklist (NICU) Printed Name: Please enter your experience level according to the Answer Key below: » Answer Key 1 = No Experience 2 = Less than One Year Experience 3 = One Year Consistent Experience 4 = Two + Years of Consistent Experience 5 = Able to Teach and Supervise » CARDIOVASCULAR I. Assessment A. Auscultation (rate, rhythm, volume) B. Blood pressure / invasive (arterial line) C. Blood pressure / non-invasive D. Heart sounds / murmurs E. Perfusion F. Pulses II. Equipment and Procedures A. EKG interpretation B. Defibrillation / cardioversion C. Invasive hemodynamic monitoring D. Central venous pressure III. Care of the Neonate with: A. Cardiac arrest B. Cardiac transplant C. Cardiomyopathy D. Congenital heart disease / defects E. Hemodynamic instability F. Hypovolemic shock G. Post cardiac surgery H. Post interventional cardiac cath IV. Medications A. Dobutamine B. Dopamine C. Epinephrine D. Nipride E. Sodium bicarbonate » PULMONARY I. Assessment A. Breath sounds B. Rate and work of breathing II. Interpretation of Lab Results A. Blood gases B. Interpretation of x-ray reports III. Equipment and Procedures A. Airway management 1. Assist with intubation 2. Bulb syringe 3. CPAP (nasal prongs) 4. Endotracheal tube stabilization 5. Endotracheal tube suctioning a. In-line insertion b. Open ET catheter suction 6. Extubation 7. Intubation 8. Nasal airway / suctioning 9. Oral airway / suctioning 10. Tracheostomy / suctioning B. Apnea monitor C. Cardiac resuscitation D. Chest tube (assist with) 1. Insertion 2. Removal 3. Set-up E. ECMO (extracorporeal membrane oxygenation) F. O2 therapy delivery systems 1. Bag (anesthesia) and mask 2. Bag (self-inflating) and mask 3. Nasal Cannula 4. Nebulizer left-padding 5. Oxyhood 6. Tent 7. Trach collar G. Obtaining blood gases 1. Arterial 2. Heelstick 3. Peripheral 4. Umbilical line H. Thoracentesis I. Use of artificial surfactant J. Ventilator care 1. High frequency jet ventilator 2. Home ventilator 3. CPAP / PEEP 4. IMV 5. Oscillating 6. Pressure ventilator 7. Volume ventilator K. Weaning IV. Care of the Neonate with: A. Bronchopulmonary dysplasia (BPD) B. Cardiogenic / hypovolemic shock C. Diaphragmatic hernia D. Fresh tracheostomy E. Meconium aspiration F. Persistent pulmonary hypertension (PPHN) G. Pneumothorax H. Respiratory distress syndrome (RDS) I. Respiratory failure V. Medications A. Aminophylline B. Prostaglandin » NEUROLOGICAL I. Assessment A. Intracranial pressure monitoring B. Neurological status II. Care of the Neonate with: A. Brain death / organ procurement B. Externalized VP shunt reservoirs C. Increased intracranial pressure D. Meningitis E. Seizures III. Medication A. Anticonvulsant medications » GASTROINTESTINAL I. Assessment A. Abdominal girth B. Bowel sounds C. Suck / swallow II. Equipment and Procedures A. Care of gastrostomy tube B. Feedings 1. Assist with breast feeding 2. Bottle 3. Breast milk handling / storage 4. Gavage C. Hospital grade electric pump D. Placement of intestinal tubes 1. Jejunal gastro 2. Nasogastric / orogastric E. Test for occult blood III. Care of the Neonate with: A. Cleft palate B. Colostomy / ileostomy C. Gastroschisis / omphalocele D. GI bleeding E. Inguinal hernia F. Necrotizing enterocolitis (NEC) G. Post abdominal surgery H. Reflux precautions I. Tracheoesophageal fistula (TEF) » ENDOCRINE / METABOLIC I. Assessment A. Finnegan B. Fluid and electrolyte balance II. Interpretation of Lab Results A. Bilirubin B. Test urine and interpret 1. Glucose 2. Labstix 3. Occult blood 4. pH 5. Specific gravity III. Equipment and Procedures A. Collection of urine specimens 1. Assist with supra pubic tap 2. Catheter 3. Diaper / bag B. Phototherapy for jaundice C. Post circumcision care IV. Care of the Neonate with: A. Acute renal failure B. DIC (disseminated intra vascular coagulation) C. Disorders of internal / external organs D. Drug addiction / withdrawal E. Hypo / hyperkalemia F. Hypo / hypermatremia G. IDM (infant of a diabetic mother) H. Malformations of the GU tract, kidney I. Peritoneal dialysis » INFECTIOUS DISEASES I. Interpretation of Lab Results A. CBC / differential B. Culture reports C. Maternal lab results II. Equipment and Procedures A. Assist with lumbar puncture B. Collect culture specimens C. Isolation techniques D. Standard (universal precautions) III. Care of the Neonate with: A. Hepatitis surface antigen + mother B. HIV positive mother C. Neonatal sepsis D. Standard (universal precautions) IV. Medications - Immunizations A. HBIG B. HBV C. HIB D. Polio E. DPT F. RespiGram / synergis prophylaxis » PHLEBOTOMY / IV THERAPY I. Equipment and Procedures A. Administration of blood / blood products 1. Cryoprecipitate 2. Packed red blood cells 3. Plasma / albumin 4. Whole blood B. Delivery systems 1. IV Pump 2. Syringe pump C. Drawing blood from a central line D. Drawing venous blood E. Hyperalimentation / TPN F. Intralipid G. Managing IV therapy 1. Discontinuing 2. Dressing and tubing change 3. Rate calculation 4. Site and patency assessme nt H. Starting IV's 1. Angiocath 2. Butterfly 3. Heparin lock II. Care of the Neonate with: A. Central line / catheter / dressing 1. Broviac 2. Groshong 3. Hickman 4. Portacath 5. Quinton B. Percutaneous arterial line C. Percutaneous venous line D. Peripheral line / dressing E. PICC (peripherally inserted central catheter) F. Umbilical artery line G. Umbilical venous line » PAIN MANAGEMENT I. Assessment of Pain Level II. Care of the Neonate with: A. Sedation (i.e., morphine) » MISCELLANEOUS I. Assessment A. Apgar scoring B. Eye exam (r/o retinopathy) C. Gestational age 1. Ballard 2. Dubowitz 3. Other (specify): D. Maternal history E. Screen for hearing loss II Equipment and Procedures A. Bereavement / postmortem care B. Consents 1. Immunization 2. Procedural 3. Treatment C. Cord care D. Neonatal skin care E. Positioning devices F. Preparation for transport / transfer G. Thermoregulation 1. Isolette with humidity 2. Radiant warmer 3. Temperature (axillary, rectal, skin) 4. Weaning to open crib / bassinet H. Weights 1. Bed scale 2. Scale III. Medications A. Calculation of dosage B. Emergency drug action and reaction C. Eye prophylaxis - Vitamin K D. Neonatal drug action and reactions Level II Nursery: Years Level III Nursery: Years The information contained within this skills checklist is true and correct to the best of my knowledge. Signature: Date: Return to top