GENERAL INFORMATION

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This profile is for use by healthcare professionals in the NICU discipline and specialty. It will not be a determining factor for the program.

CHECKLIST INSTRUCTIONS

Please mark your level of experience      1. No theory and/or experience      2. Limited experience/need supervision and/or support      3. Experienced/minimal support needed to perform      4. Proficient/can perform independently

PATIENT TYPES

1

2

3

4

Neonates < 28 Weeks

Neonates 29 - 34 Weeks

Neonates > 34 Weeks

WORK SETTINGS

1

2

3

4

Level II NICU

Level III NICU

Level IV NICU

CARDIOVASCULAR

1

2

3

4

Cardiac Surgery - Pre-op

Cardiac Surgery - Immediate Post-op

Congenital Heart Disease/Defects

CHF/Pulmonary Edema

Hemodynamic Instability

PULMONARY

1

2

3

4

Bronchopulmonary Dysplasia

Diaphragmatic Hernia

Fresh Tracheostomy

Meconium Aspiration

Persistent Pulmonary Hypertension

Pneumonia

Respiratory Distress Syndrome/Failure

Interpretation of ABGs

Assist with Intubation/Extubation

Endotracheal Suctioning

Chest Tube Placement and Management

Modes of Ventilation (AC/PC/SIMV/CPAP/BiPAP)

High Frequency Ventilation

Inhaled NO

ECMO

NEUROLOGIC

1

2

3

4

Ballard/Dubowitz

Reflexes Based on Gestational Age

Hydrocephalus

Intraventricular Hemorrhage

Meningocele/Myelomeningocele

Neonatal Abstinence Score/Syndrome

Seizures

GASTROINTESTINAL

1

2

3

4

Colostomy/Ileostomy

Gastroschisis/Omphalocele

GI Bleeding

Necrotizing Enterocolitis

Post Abdominal Procedure

FEEDINGS

1

2

3

4

Breast Milk Handling/Storage

Breast Pump

Gavage Feedings

NG/OG/NJ Tube Placement and Management

RENAL/ENDOCRINE/GENETIC

1

2

3

4

Circumcision Care

Genetic Disorders

Hypo/Hyperglycemia

Infant of Diabetic Mother

Malformations of the GU Tract/Kidney

Phototherapy

Renal Failure

INFECTIOUS DISEASES

1

2

3

4

Neonatal Sepsis

Septic Work Up

Assist with Lumbar Puncture

MEDICATIONS

1

2

3

4

Calculation of Neonatal Dosages

Antibiotics/Antivirals

Anticonvulsants

Immunizations

Digoxin

IV Vasopressors

Prostaglandin

Bronchodilators

Steroids

Caffeine

Surfactant

Automated Medication Dispensing (i.e. Pyxis, Omnicell)

IV THERAPY

1

2

3

4

Administration of Blood/Blood Products

Central Line Catheter/Dressings

Management of UAC/UVC Lines

Radial Arterial Lines

Start IVs

CARDIAC MONITORING & EMERG. RESPONSE

1

2

3

4

Attend High Risk Deliveries

Preparation for Transport

Transport Neonate

Rhythm Interpretation

Dysrhythmia Management

PROFESSIONAL KNOWLEDGE AND SKILLS

1

2

3

4

National Patient Safety Goals/Core Measures

Bereavement/Postmortem Care

Neonatal Skin Care

Pressure Ulcer Risk Assessment/Prevention

Restraints/Use of Least Restrictive Device

Patient/Family Teaching

Age Specific/Population-Based Care

Isolation Precautions

Infection Prevention

Pain Assessment & Management

Charge Experience

Interpretation and Communication of Lab Values

1

2

3

4

EPIC

Cerner

Eclipsys

McKesson

Meditech

Other Computerized System

Computerized Physician Order Entry

Bar Coding for Medication Administration

EMR Conversion

Yes

No

Certifications

1

2

3

4

BLS

NRP

PALS

S.T.A.B.L.E.

NCC Certification - RNC-NIC

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