Critical Care Skills Checklist

Personal Information

Please fill the Recruiter Email correctly for successful application submission.

Candidate Name

Email of Recruiter / POC

Select Submission Date

SSN (Last 4 digits)

Proficiency Scale & Legend

1 No experience; Theory/observed only

2 Limited competency; < 5 times per year; Needs supervision

3 Acceptable competency; > 5 times per year

4 Competent; Performs on a daily or weekly basis; Proficient

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct, and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from the agency.

Personal Information

Proficiency Scale & Legend

Cardiovascular

Assessment

Interpretation Of Lab Results

Equipment Usage & Procedure

Monitoring

Pacemaker

Assisting With:

Care Of The Patient With:

Medications

Pulmonary

Assessment

Equipment Usage & Procedure

Airway Management Devices

Assist With:

O2 Therapy & Med Delivery Systems

Equipment Usage & Procedure

Care Of The Patient With:

Medications

Emr

Pain Management

Care Of The Patient With:

Miscellaneous

Care Of The Patient With:

Neurological

Assessment:

Equipment Usage & Procedure:

Care Of The Patient With:

Medications

Gastrointestinal

Assessment

Interpretation Of Lab Results

Equipment Usage & Procedure

Care Of The Patient With:

Medications

Renal / Genitourinary

Equipment Usage & Procedure

Insertion & Care Of:

Care Of The Patient With:

Endocrine / Metabolic

Interpretation Of Lab Results

Equipment Usage & Procedure

Care Of The Patient With:

Wound Management

Assessment Of:

Equipment Usage & Procedure

Care Of The Patient With:

Phlebotomy / Iv Therapy

Equipment Usage & Procedure

Cryoprecipitate

Care Of The Patient With:

Age Specific Practice Criteria