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Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently

General Skills Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Normal growth & development
Immunizations
Provide safe environment for age specific care
Recognize signs of failure to thrive
Recognize signs of abuse/neglect
Advanced directives
Awareness of HCAHPS
Patient/family teaching
Lift/transfer devices
Specialty beds
Restrictive devices (restraints)
End of life care/pallative care
Wound assessment & care
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Bar coding for medication administration
Diabetic care & education
Blood Glucose Monitoring (BGM)
Insulin administration
National Patient Safety Goals
Accurate patient identification
Effective communication
Interpretation & communication of lab values
Medication administration (PO,IM,IV,PR)
Labeling (medications & specimens)
Medication reconciliation
Anticoagulation therapy
Monitoring conscious sedation
Pain assessment & management
Use of PCA (IV, intrathecal, epidural)
Infection control
Universal precautions
Isolation
Minimize risk for falls
Prevention of pressure ulcers
IV Therapy
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Starting & maintaining peripheral IVs
Blood draw: venous
Central line care (includes Broviac/PICC/Groshong/Hickman)
Blood draw: central line
Care & management of ports
TPN & lipids
Administration of blood & blood products
Administration of chemotherapy
Monitoring chemotherapy (does not initiate)
Cardiovascular Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Pediatric assessment
Cardiac monitoring & emergency care
Obtains 12 lead EKG
Basic EKG interpretation
Use of rapid response teams
Cardiac arrest/CPR
Administration of PALS protocols & medications
Use of Broslow system
Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Cogenital heart defects
Congestive heart failure
Post cardiac cath
Post cardiac surgery
Cardiomyopathy
Pericarditis
Shock
Rheumatic fever
Heart transplant
Bacterial endocarditis
Medications
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Antidysrythmics
Antihypertensives
Cardiac glycoside (digoxin)
Pulmonary Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Respiratory assessment
Rate & work of breathing
Equipment & Procedures
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Oral/nasal suctioning
Tracheostomy care and suctioning
Chest Physiotherapy (CPT)
Pulse oximeter
Ventilator management
O2 (NC/mask/oxyhood)
Assist with chest tube insertion & management
Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Asthma
RSV (Respiratory Syncytial Virus)
Bronchopulmonary Dysplasia (BPD)
Cystic fibrosis
Croup
Pneumonia
Epiglottitis
Tuberculosis
Medications
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Alupent
Aminophylline (obsolete medication)
Ventolin
Inhaled corticosteroids
Respigam/synergis
Neurological Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Pediatric neurological assessment
Assist with lumbar puncture
ICP monitoring
Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Battered child syndrome
Depression
TBI (Traumatic Brain Injury)
Encephalitis
Meningitis
Neuromuscular disease
Spinal cord injury
Seizures
Hydrocephalus
VP shunt
Epilepsy
Near drowning
Medications
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Stimulants (Ritalin, Adderall)
Steroids (Decadron, Solu-Medrol)
Anticonvulsants (Dilantin, phenobarbital)
Orthopedics Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Assessment of circulation checks
Equipment & Procedures
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Devised traction (splints, casts, braces)
Pinned traction
Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Osteomylitis
Fractures
Post Harrington rod insertion
Gastrointestinal Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
GI assessment
Abdominal girth measurement
Equipment & Procedures
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Feedings
Bottle
Breast
Gavage
Gastrostomy
Nasojejunal
Nasogastric and sump tubes to suction
Placement of oro/nasogastric tubes
Colostomy/ileostomy care
Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Anorexia/bulimia
Tracheoesophageal Fistula (TEF)
Gastroschisis/omphalocele
Necrotizing Enterocolitis (NEC)
Crohn’s disease
Cleft lip/palate
Gastroenteritis
Pyloric stenosis
Ulcerative colitis
GE reflux
GI bleeding
Intestinal parasites
Small bowel transplant
Surgical abdomen
Renal/GU Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Assessment of fluid balance
Equipment & Procedures
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Assist with suprapubic tap
Peritoneal dialysis
Insertion & care of Foley catheter
Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Glomerular nephritits
Ilial conduit ureteral
Nephrotic syndrome
Wilm’s tumor
UTI
Hemolytic uremic syndrome
Kidney transplant
Endocrine System Experience - Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Onset diabetes
Diabetic ketoacidosis
Adrenal disorders
Cushing’s syndrome
Pituitary disorders
Pancreas transplant
Thyroid malfunction
Medications
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Insulin administration
Insulin pumps
Thyroid
Growth hormone
Hematology/Oncology Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Assist with bone marrow aspiration
Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Anemia
Bone marrow transplant
Leukemia
Sickle cell disease
Hemophilia
Malignant tumors
Spleen trauma/spleenectomy
Neutropenic fever
Sepsis
Hodgkin’s
Infectious Diseases Experience - Care of Child with:
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Common childhood communicable diseases
HIV/CMV/AIDS
Hepatitis
Kawasaki disease
Age Specific Competencies Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Newborn/neonate (birth-30 days)
Infants (31 days-1 year)
Toddler (ages 2-3 years)
Preschool (ages 4-5 years)
School age (ages 6-12 years)
Adolescent (ages 13-21 years)
ATTESTATION *