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

WORK SETTINGS 1 2 3 4
     Pediatric MedSurg
     Pediatric Step Down/Telemetry
     Pediatric Oncology
     Pediatric Ortho
     Pediatric Neuro
CARDIOVASCULAR 1 2 3 4
     Congenital Heart Disease/Repair
     Pre Cardiac Surgery
     Post Cardiac Surgery
     Heart Sounds
PULMONARY 1 2 3 4
     Reactive Airway Disease
     RSV
     Tuberculosis
     Esophageal Atresia
     Epiglottitis
     Tonsillitis
     Laryngotracheobronchitis (Croup)
     ENT Surgery
     Oxygen Delivery Systems
     Tracheostomy Management
     Oral Suctioning
     Deep Suctioning
     Management of Chest Tubes
     Apnea Monitor
     Home Ventilator Therapy
NEUROLOGIC/ORTHOPEDIC 1 2 3 4
     Brain Injury
     Spinal Cord Injury
     Seizure Disorders
     Meningitis
     Neuromuscular Disease
     Extremity Fracture/Cast
     Post Vertebral Surgery
     Traction - General
     Traction - Halo
     Pin Care
     VP Shunts/Internal/External
GASTROINTESTINAL 1 2 3 4
     Cleft Lip/Palate
     Inflammatory Bowel Disease
     Colostomy/Ileostomy
     Surgical Drains
     Failure to Thrive
     Feeding Intolerance
     Gastroenteritis/Dehydration
     Bowel Obstruction
     Short Gut Syndrome
     Breastfeeding Support/Handling of Breast Milk
RENAL/GENITOURINARY 1 2 3 4
     Circumcision
     Testicular Torsion
     Glomerulonephritis
     Renal Failure
     Renal Transplant
     Urinary Retention
     Bladder Scan
     Insertion/Management of Bladder Catheters
     Management of Suprapubic Catheters
ENDOCRINE/METABOLIC 1 2 3 4
     Diabetes - Hypo/Hyperglycemia
     Diabetic Ketoacidosis
     IV Insulin Pumps
     Indwelling Insulin Pumps
     Hyperbilirubinemia
     Bili Bed
ONCOLOGY 1 2 3 4
     Chemotherapy Administration
     Hodgkin's Disease
     Hemophilia
     Sickle Cell Anemia
     Leukemia
     Solid Tumors
     Bone Marrow Transplant
INFECTIOUS DISEASE 1 2 3 4
     Childhood Communicable Diseases
     Hepatitis
     HIV
     Kawasaki Disease
MEDICATIONS 1 2 3 4
     Pediatric Dosage Calculations
     Anti-Hypertensives
     Anticoagulants
     Anti-Seizure Medications
     Benzodiazepines
     Digoxin
     Diurectics
     Emergency Medications
     Inhaled Medications
     Insulin
     Narcotics/Opioid Analgesics (IV/Oral/Injection)
     Non-Opioid Analgesics (IV/Oral/Injection)
     Procedural Sedation - Recovery
     Reversal Agents
     Steroids (IV/Oral/Inhaled)
     Automated Medication Dispensing (i.e. Pyxis, Omnicell)
IV THERAPY 1 2 3 4
     Starting IVs
     Central Line Blood Draw
     Central Line/Implanted Line Care
     TPN/Lipids
     Blood Product Administration
     Administration of Chemotherapy
CARDIAC MONITORING & EMERG. RESPONSE 1 2 3 4
     Pediatric Early Warning Score (PEWS)/Rapid Response Team
     Dysrhythmia Interpretation
     Dysrhythmia Management
PROFESSIONAL KNOWLEDGE AND SKILLS 1 2 3 4
     National Patient Safety Goals/Core Measures
     Recognize/Report Signs of Abuse
     Fall Risk Assessment/Prevention
     Pressure Ulcer Risk Assessment/Prevention
     Restraints/Use of Least Restrictive Device
     Normal Growth and Development
     Age Specific/Population Based Care
     Patient Family Teaching
     Isolation Precautions
     Infection Prevention
     Reporting Communicable Diseases
     Pain Assessment & Management
     Charge Experience
     Interpretation and Communication of Lab Values
EMR 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
     PALS
     CPHON
     Chemo Certification
     PICC Certification
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 Pediatric 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 (34.237.51.159) which will be used as a digital signature.



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

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