PACU RN Skills Assessment Today's Date: MM slash DD slash YYYY Name* First Last Email* Phone*Respiratory, Part 1Assess Respiratory Status 0 1 2 3 Assess Lung Sounds 0 1 2 3 Airway Maintenance - Jaw Thrust 0 1 2 3 Airway Maintenance - Chin Lift 0 1 2 3 Insertion of Oral Airway 0 1 2 3 Insertion of Nasal Airway 0 1 2 3 Removal of Nasal & Oral Airway 0 1 2 3 Administration of Oxygen: Nasal Cannula 0 1 2 3 Administration of Oxygen: Face Masks (With/Without Mist) 0 1 2 3 Administration of Oxygen: Non-Rebreather Mask 0 1 2 3 Administration of Oxygen: Trach Collar 0 1 2 3 Administration of Oxygen: Face TentIncentive Spirometry 0 1 2 3 Suctioning - Nasotracheal 0 1 2 3 Suctioning - ETT or Trach 0 1 2 3 Suctioning - Oropharyngeal 0 1 2 3 Ventilate with Ambu-bag 0 1 2 3 Assist with Intubation (ETT) 0 1 2 3 Respiratory, Part 2ETT - Measure Cuff Pressures 0 1 2 3 ETT - Determine Air Leaks 0 1 2 3 Pulse Oximetry 0 1 2 3 Draw ABGs - Arterial Puncture and Line 0 1 2 3 Interpret ABGs 0 1 2 3 Pressure Ventilators 0 1 2 3 Volume Ventilators 0 1 2 3 End Tidal CO2 Monitor 0 1 2 3 Troubleshoot Ventilator Alarms 0 1 2 3 Charting Respirations w/ Ventilator 0 1 2 3 Weaning From Ventilator 0 1 2 3 ETT Extubation 0 1 2 3 Chest Percussion 0 1 2 3 Chest Tubes 0 1 2 3 Identify & Troubleshoot Airway Problems 0 1 2 3 Displaced ETT 0 1 2 3 Upper Airway Obstruction 0 1 2 3 Bronchospasm 0 1 2 3 Aspiration 0 1 2 3 Pneumothorax 0 1 2 3 Hemothorax 0 1 2 3 Care of Post-Op Thoracic Surgery 0 1 2 3 Care of Post-op ENT Surgery 0 1 2 3 GenitourinaryStraight/Foley Cath Female 0 1 2 3 Straight/Foley Cath Male 0 1 2 3 GU irrigations 0 1 2 3 Suprapubic tube 0 1 2 3 Nephrostomy tube 0 1 2 3 Care of Patient With:Shunts & fistulas 0 1 2 3 Nephrectomy 0 1 2 3 Renal Transplant 0 1 2 3 Mastectomy 0 1 2 3 Hysterectomy 0 1 2 3 Prostate surgery 0 1 2 3 Meds/IV TherapyAdminister PO Medications 0 1 2 3 Administer NG/GT Medications 0 1 2 3 Administer IM & SQ Meds 0 1 2 3 Peripheral IV Insertion 0 1 2 3 Mix IV Infusion w/ Additives 0 1 2 3 Administer IV Medications 0 1 2 3 Use of Heparin/Saline Locks 0 1 2 3 Needle-less Systems 0 1 2 3 Infusion Pumps 0 1 2 3 Discontinue Peripheral IVs 0 1 2 3 Know Anesthetic Agents, Complications & Treatment 0 1 2 3 Knowledge of Inhalants 0 1 2 3 Knowledge of Injectables 0 1 2 3 Knowledge of Narcotics 0 1 2 3 Knowledge of Reversal Agents 0 1 2 3 Knowledge of Muscle Relaxants 0 1 2 3 Knowledge of Local Anesthesia 0 1 2 3 Knowledge of Regional Anesthesia 0 1 2 3 Knowledge of Epidural Anesthesia 0 1 2 3 Knowledge of Spinal Anesthesia 0 1 2 3 Knowledge of Intrathecal Anesthesia 0 1 2 3 Knowledge of AntiEmetic Drugs 0 1 2 3 VascularDraw Venous Blood (Peripheral) 0 1 2 3 Draw Blood from Central Line 0 1 2 3 Interpretation of Lab Results 0 1 2 3 Intake and Output 0 1 2 3 Peripheral Pulses 0 1 2 3 Ultrasonic Doppler 0 1 2 3 Identify & Troubleshoot Edema/Fluid Overload 0 1 2 3 Identify & Troubleshoot Hypovolemia 0 1 2 3 Administer Packed RBCs 0 1 2 3 Administer Whole Blood 0 1 2 3 Plasma/Albumin 0 1 2 3 Cryoprecipitate 0 1 2 3 Fluid Resuscitation (Crystalloids) 0 1 2 3 Care of Patient With:Central Venous Catheter (CVL) 0 1 2 3 Arterial Line 0 1 2 3 Hickman/Broviac Catheters 0 1 2 3 Implantable Venous Port 0 1 2 3 PICC Line 0 1 2 3 Swan Ganz / Pul Art. Catheter 0 1 2 3 Auto Infusion Pump 0 1 2 3 Assist CVL Insertion 0 1 2 3 Assist Arterial Line Insertion 0 1 2 3 Arterial Line D/C 0 1 2 3 OrthopedicCast Care 0 1 2 3 Circulation Assessment 0 1 2 3 Cold Systems 0 1 2 3 Care of Patients With:Continuous Passive Motion (CPM) 0 1 2 3 Skeletal traction 0 1 2 3 Amputation 0 1 2 3 Arthroscopy/Arthrotomy 0 1 2 3 Total Hip Replacement 0 1 2 3 Total Knee Replacement 0 1 2 3 NeurologicalNeurological assessment 0 1 2 3 Glascow Coma Scale 0 1 2 3 Seizure Precautions 0 1 2 3 Intracranial Pressure Monitoring 0 1 2 3 Knowledge of Anticonvulsants 0 1 2 3 Care of Post-Op Craniotomy 0 1 2 3 Care of Post-Op Ophth. Patient 0 1 2 3 Care of Spinal Cord Injury 0 1 2 3 Care of Ventriculostomy 0 1 2 3 ICP Monitoring 0 1 2 3 Care of Spinal Fusion 0 1 2 3 Pain ManagementPain Assessment & Pain Scale 0 1 2 3 Admin of IV Sedation 0 1 2 3 Admin of Narcotic Analgesia 0 1 2 3 PCA Pump 0 1 2 3 Assist w/ Epidural Cath Insertion 0 1 2 3 Assess Epidural Anesthesia Level 0 1 2 3 Assess Spinal Anesthesia Level 0 1 2 3 Auto Med Dispense (Pyxis,SureMed) 0 1 2 3 CardiacAuto BP Monitor (NIBP) 0 1 2 3 Use of Cardiac Monitors 0 1 2 3 Interpretation of Arrhythmias 0 1 2 3 Assist with Code 0 1 2 3 Defibrillation/Cardioversion 0 1 2 3 Use of Warming Blankets 0 1 2 3 Care of Post-Op Cardiac Surgery 0 1 2 3 Care of Patients With:Permanent Pacemaker 0 1 2 3 Temporary Pacemaker 0 1 2 3 Cardiogenic Shock 0 1 2 3 Hypothermia 0 1 2 3 Malignant Hyperthermic Crisis 0 1 2 3 GastrointestinalAssess Bowel Sounds 0 1 2 3 Assess GI Distress/Bleeding 0 1 2 3 Insertion/Monitoring NG Tube 0 1 2 3 Abdominal Wounds 0 1 2 3 Wound Drains 0 1 2 3 Enterostomy Care 0 1 2 3 Care of Post-Op Abd Surgery 0 1 2 3 Care of Liver Transplant 0 1 2 3 General NursingAdmit & Orient patients 0 1 2 3 Discharge/Transfer patients 0 1 2 3 Supervise Unlicensed Personnel 0 1 2 3 Pre-operative Care/Preparation 0 1 2 3 Urine dipstick 0 1 2 3 Blood Glucose Monitoring 0 1 2 3 Positioning / Transferring 0 1 2 3 Restraints 0 1 2 3 Advance Directives 0 1 2 3 Postmortem Care 0 1 2 3 Care of Patient w/ Latex Allergy 0 1 2 3 Isolation Techniques 0 1 2 3 Care of HIV Patient 0 1 2 3 Care of Multiple Trauma Patient 0 1 2 3 Age of Patients Cared For:Newborn (birth-30 days) 0 1 2 3 Infant (30 days - 1 year) 0 1 2 3 Toddler (1 - 3 years) 0 1 2 3 Preschooler (3 - 5 years) 0 1 2 3 School Age (5 - 12 years) 0 1 2 3 Adolescents (12 - 18 years) 0 1 2 3 Young Adults (18 - 39 years) 0 1 2 3 Middle Adults (39 - 64 years) 0 1 2 3 Older Adults (64+ years) 0 1 2 3
[9:30 AM] Katie Iglewski
