= Skills Checklist =

ICU Skills

Please rank the following skills on a scale of 1 to 4

1 = No theory and/or experience
2 = Limited experience
3 = Experienced/minimal support needed to perform
4 = Proficient

  • General Skills

  • Infusion Pump

  • Neuro General Skills

  • Neuro – Care of Patient with:

  • Cardiac General Skills

  • Cardiac – Care of Patient with:

  • Knowledge and Use Of:

  • Respiratory General Skills

  • Respiratory – Care of Patient with:

  • Knowledge and Use of:

  • Gastrointestinal General Skills and Patient Care of:

  • Knowledge and Use of:

  • Genitourinary/Renal General Skills

  • Endocrine General Skill and Patient Care with:

  • Vascular General Skills

  • Other:

  • Date Format: MM slash DD slash YYYY