PEDIATRIC NURSING KNOWLEDGE & SKILLS CHECKLIST

DIRECTIONS: Please indicate your level of experience by

NAME:       placing a check (√) in the box. Experience level:
ID #:       1 NO EXPERIENCE
DATE:       2 MINIMAL EXPERIENCE-requires supervision/assistance
3 MODERATELY EXPERIENCED-requires initial review,
This Skills Checklist is to be used by nurses with more then performs independently
than one year experience in their discipline and specialty. 4 VERY EXPERIENCED- proficient
Please be accurate with your assessment.

DESCRIPTION 1 2 3 4
DESCRIPTION 1 2 3 4 c. Chest physiotherapy
NEUROLOGICAL: d. Chest tubes
1. Assessment – level of consciousness e. End tidal CO2
2. Equipment & Procedures: f. Oximeter
a. Application of splints g. O2 therapy & medication delivery:
b. Assist with lumbar puncture (1) Bag and mask
c. Cast (2) Isolette
d. ICP monitoring (3) Nasal cannula
e. Pinned fractures (4) Nebulizer
f. Traction (5) Oxyhood
3. Care of child with: (6) Tent
a. Battered child syndrome (7) Trach collar
b. Closed head trauma h. Water seal drainage system
c. Clubfoot 3. Care of the patient with:
d. Encephalitis a. Bronchiolitis (RSV)
e. Febrile seizures b. Bronchopulmonary dysplasia (BPD)
f. Meningitis c. Cystic fibrosis
g. Multiple trauma d. Epiglottitis
h. Near drowning e. LTB/Croup
4. Medications: f. Pertussis
a. Corticosteroids g. Pneumonia
b. Dilantin (Phenytoin) h. Tonsilitis
c. Phenobarbital i. Tuberculosis
RESPIRATORY j. Asthma
1. Assessment: 4. Medications:
a. Breath sounds a. Alupent (Meraproteranol)
b. Rate and work of breathing b. Aminophylline (Theophylline)
2. Equipment & procedures: c. Isuprel (Isoproterenol)
a. Airway management d. Ventolin (Albuterol)
(1) bulb syringe CARDIOVASCULAR
(2) Nasal airway/suctioning 1. Assessment:
(3) Oral airway/suctioning a. Auscultation (rate, rhythm, volume)
(4) Tracheostomy/suctioning b. Blood pressure/non-invasive
b. Apnea monitor c. Heart sounds/murmurs
d. Perfusion

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 PEDIATRIC NURSING KNOWLEDGE & SKILLS CHECKLIST

Name:       ID #:     

DESCRIPTION 1 2 3 4 DESCRIPTION 1 2 3 4
2. Interpretation of lab results: j. Pyloric stenosis
a. Arterial blood gases k. Surgical abdomen
b. Hemoglobin & hematocrit ENDOCRINE/METABOLIC
3. Equipment & procedures: 1. Assessment
Basic EKG interpretation 2. Equipment & procedures:
4. Care of the child with: a. Blood glucose testing type:      
a. Bacterial endocarditis 3. Care of the child with:
b. Bowel obstruction a. Adrenal Disorders
c. Cardiac arrest b. Cushing’s syndrome
d. Cardiomyopathy c. Juvenile diabetes
e. Myocarditis d. Pituitary disorders
f. Congenital heart defects/disease e. Thyroid malfunction
g. Pericarditis 4. Medications:
h. Post cardiac Surgery a. Growth hormone
i. Rheumatic fever b. Insulin
j. Tracheoesophageal fistula c. Thyroid
GASTROINTESTINAL 5. Interpretation of lab results:
1.Assessment: a. Blood glucose
a. Abdominal b. Thyroid studies
b. Nutritional RENAL/GENITOURINARY
2. Equipment & procedures: 1. Assessment of fluid balance
a. Feedings: 2. Interpretation of lab results
(1) Assist with breast feeding a. BUN & creatinine
(2) Bottle b. Urinalysis
(3) Central Hyperalimentation 3. Equipment & procedures:
(4) Gavage a. Assist with supra-pubic tap
(5) Peripheral Hyperalimentation b. Catheter insertion
b. Jejunal feeding (1) Catheter care
c. NG and sump tubes to suction (2) Female
d. Penrose drains (3) Male
e. Placement of naso/Orogastric tube (4) Straight
f. Wound irrigation/dressing change (5) Indwelling
3. Care of the child with: c. Collection of urine specimen
a. Anal fissure 4. Care of the child with:
b. Cleft lip/palate a. Circumcision
c. Colostomy b. Hemodialysis
d. Diaphrogmatic hernia c. Ileal conduit ureteral
e. Failure to thrive (FTT) d. Nephrotic syndrome
f. Gastroenteritis/dehydration e. Peritoneal dialysis
g. GI bleeding f. Renal failure
h. Ileostomy g. Urinary tract infection
i. Intestinal parasites h. Wilm’s tumor

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 PEDIATRIC NURSING KNOWLEDGE & SKILLS CHECKLIST

Name:       ID #:      

DESCRIPTION 1 2 3 4 DESCRIPTION 1 2 3 4
ONCOLOGY c. Blood gases
1. Assessment of nutritional status 2. Care of the child with:
2. Care of the child with: a. Central line/catheter/dressing:
a. Disseminated intravascular coagulation (DIC) (1) Broviac
b. Inpatient chemotherapy (2) Groshong
c. Anemia (3) Hickman
d. Leukemia (4) Portacath
e. Malignant tumors (5) Quinton
f. Depressed immune system b. Cutdown line/dressing
g. Sickle cell anemia c. Peripheral line/dressing
h. Hemophilia 3. Fever management
i. Hodgkin’s disease 4. Isolation
j. Infectious mononucleosis 5. AIDS
k. Spleen trauma/splenectomy 6. Common childhood communicable
3. Medication: diseases
a. Chemotherapy certification? Yes No 7. Cytomegalo virus (CMV)
b. Calculation of pediatric doses 8. Hepatitis
c. Eye/ear installations 9. Lyme disease
d. Knowledge of emergency drugs COMPUTERIZED CHARTING
e. Knowledge of routine pediatric drugs 1. Cerner
f. Metered dose inhaler 2. Eclipsys
g. Prednisone 3. Epic
4. Interpretation of lab results: 4. McKesson
a. Blood chemistry 5. Meditech
b. Blood counts 6. Other:
5. Equipment & procedures- reverse isolation Other:
a. Administration of blood/blood products: Other:
(1) Cryoprecipitate
(2) Packed red blood cells
(3) Whole blood
b. Drawing blood from central line
c. Drawing venous blood
d. Starting IVs
(1) Angiocath
(2) Butterfly
(3) Heparin lock.
c. Knowledge of emergency drug action and reaction
d. Pediatric drug actions & reactions
MISCELLANEOUS
1. Interpretation of lab values:
a. Blood Chemistry
b. Blood hematology

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 PEDIATRIC NURSING KNOWLEDGE & SKILLS CHECKLIST

MY EXPERIENCE IS PRIMARILY IN:

Name:      
NEUROLOGY       years
Please check the boxes below for each age group for PULMONARY       years
which you have expertise in providing age-appropriate SURGICAL       years
nursing care. MEDICAL       years
CARDIAC CARE       years
A. Newborn/Neonatal (birth – 30 days) TELEMETRY       years
B. Infant (30 days – 1 year)
C. Toddler (1 – 3 years) I HAVE CURRENT CERTIFICATIONS FOR:
D. Preschool (3 – 5 years)
E. School Age Children (5 – 12 years) TYPE COURSE DATE (MM/DD/YY)
F. Adolescent (12 – 18 years) ARRHYTHMIA      
G. Young Adults (18 – 39 years) CRITICAL CARE      
H. Middles Adults (40 – 64 years) ACLS      
I. Older Adults (64 + years) BCLS      
TNCC      
EXPERIENCE WITH AGE GROUPS: NRP      
1. Able to assess age appropriate behavior, motor skills PALS      
and physiological norms. NALS      
BTLS      
A B C D E F G H I CCRN      
Other            
Other            
2. Able to adapt care according to normal growth and
development.
The information I have provided in this knowledge and
A B C D E F G H I skills checklist it true and accurate to the best of my
knowledge.

3. Able to communicate and instruct patient according to            

their age, maturity and comprehension ability. Signature (Written/Electronic) Date
ID #:      
A B C D E F G H I
This skills checklist has been reviewed and approved by
Nicole Bloxham, RN.
4. Able to provide a safe environment according to the
specific needs of various age groups.            
Signature (Written/Electronic) Date
A B C D E F G H I ID #:      

Please return to: Northwest Nurse Staffing Company, PA

ATTN: Records Dept.
Fax: (866) 352-4338

Email: records@nns-ic.com

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