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Travel Nursing Skills Checklists

Congratulations on your decision to apply for a travel nursing position with American Mobile! Before we can offer you a nursing employment opportunity, an electronic skills assessment must be completed. From the nursing skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!


NICU Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
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
 
Couplet care (Mom and Baby Care)
 
Postpartum Unit (Baby Care Only)
 
Newborn Nursery
 
Level II NICU
 
Level III NICU
 
Level IV NICU
 
Patient Populations
1 2 3 4
 
Neonates < 24 Weeks
 
Neonates 24-29 weeks
 
Neonates 30-34 weeks
 
Neonates > 34 Weeks
 
Emergency Response
1 2 3 4
 
Attend High Risk Deliveries
 
Attend Normal Newborn Deliveries
 
Preparation for Transport
 
Transport Neonate
 
CARDIOVASCULAR
1 2 3 4
 
Cardiac Surgery - Immediate Post-op
 
Cardiac Surgery - Pre-op
 
CHF/Pulmonary Edema
 
Congenital Heart Disease/Defects
 
Dysrhythmia Management
 
Hemodynamic Instability
 
Rhythm Interpretation
 
PULMONARY
1 2 3 4
 
Assist with Intubation/Extubation
 
Bronchopulmonary Dysplasia
 
Bubble CPAP
 
Diaphragmatic Hernia
 
ECMO (Circuit Care Only)
 
ECMO (Patient Care Only)
 
Endotracheal Suctioning
 
Fresh Tracheostomy
 
High Frequency Jet Ventilation
 
High Frequency Oscillator Ventilation
 
Inhaled Nitric Oxide
 
Interpretation of ABGs
 
Meconium Aspiration
 
Modes of Ventilation (AC/PC/SIMV/CPAP/BiPAP)
 
Persistent Pulmonary Hypertension
 
Pneumonia
 
Respiratory Distress Syndrome/Failure
 
NEUROLOGICAL
1 2 3 4
 
Hydrocephalus
 
Intraventricular Hemorrhage
 
Meningocele/Myelomeningocele
 
Neonatal Abstinence Syndrome - Eat, Sleep, Console (ESC) Method
 
Neonatal Abstinence Syndrome - Finnegan Score (FNASS) Method
 
Seizures
 
GASTROINTESTINAL
1 2 3 4
 
Colostomy/Ileostomy
 
Gastroschisis/Omphalocele
 
GI Bleeding
 
Inguinal Hernia
 
Necrotizing Enterocolitis
 
FEEDINGS
1 2 3 4
 
Breast Milk Handling/Storage
 
Breast Pump
 
Gavage Feedings
 
NG/OG/NJ Tube Placement and Management
 
RENAL/GENITOURINARY
1 2 3 4
 
Ileal Conduit
 
Malformations of the GU Tract/Kidney
 
Renal Failure
 
Urinary Retention
 
ENDOCRINE/METABOLIC
1 2 3 4
 
Genetic Disorders
 
Hyperbilirubinemia
 
Hypo/Hyperglycemia
 
EENT
1 2 3 4
 
Assist with Lumbar Puncture
 
Cleft Lip
 
Cleft Palate
 
INFECTIOUS DISEASES
1 2 3 4
 
Neonatal Sepsis
 
MEDICATIONS
1 2 3 4
 
Antibiotics/Antivirals
 
Anticonvulsants
 
Bronchodilators
 
Caffeine
 
Digoxin
 
Immunizations
 
IV Vasopressors
 
Prostaglandin
 
Steroids
 
Surfactant
 
VASCULAR ACCESS
1 2 3 4
 
Administration of Blood/Blood Products
 
Central Line Catheter/Dressings
 
Insert PICC lines
 
Management of UAC/UVC Lines
 
Radial Arterial Lines
 
Start IVs
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Universal Protocol Procedures (Time Out)
 
Charge Experience
 
Fall Risk Assessment/Prevention
 
Infection Prevention
 
Isolation Precautions
 
National Patient Safety Goals/Core Measures
 
Pain Assessment & Management
 
Patient/Family Teaching
 
Pressure Ulcer Risk Assessment/Prevention
 
Restraints/Use of Least Restrictive Device
 
Wound Care /Wound Vac
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computerized Physician Order Entry
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
Other: Specify
 
Other: Specify
 
EMR Conversion
 
CERTIFICATIONS * (Current at time of completing this form)
 
BLS
 
S.T.A.B.L.E
 
S.T.A.B.L.E Cardiac
 
PALS
 
NRP
 
CCRN
 
NCC Certification - RNC-NIC
 
IBCLC
 
Other: Specify
NICU Skills Checklist, version 6

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. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

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