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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:
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E-mail:
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