Hudson Staffing Travel Nurses & Allied Health Careers
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Hudson Staffing Travel Nurses| NICU Online Checklist
NICU Online Checklist

Thank you for your decision to apply for a travel nursing position with Hudson Staffing! Before we can offer you a nursing employment opportunity in the NICU field, an electronic skills assessment must be completed. Please, complete the nursing skills checklist below, and be sure to review your information thoroughly before clicking the submit button.

GENERAL INFORMATION        
Note: * Denotes a required field.
Please enter your full name as it appears on your Social Security Card:

First Name
 
Middle Name
 
Last Name
 *


Please enter the Last Four digits of your Social Security Number:

 -   -   *       Please check here if you do not hold a valid social security card.


Please provide your contact information:

Phone Number
 *
E-mail Address
 *
Confirm E-mail Address
 *
Type your e-mail address again above.
       
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
Please read and agree to the statements below by marking the checkbox. You will not be able to submit until you have marked the checkbox.

* I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize Hudson Staffing to release this NICU Skills Checklist to the client facilities in relation to consideration of employment as a healthcare professional with those facilities.




Privacy Note: Hudson Staffing will record anonymous electronic information about your connection when you click on the submit button. This information is used for security purposes only. This information will include your IP Address (44.192.65.228) which will be used as a digital signature.



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Phone: 1(866)256-8773
E-mail: info@hudsonstaffing.net

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