King Abdulaziz Medical Cities (National Guard Hospitals)

Riyadh (Central) - KAMC Al Hassa (Eastern) - King Abdulaziz Hospital No Preference

Jeddah (Western) - KAMC Dammam (Eastern) - Al Imam Abdulrahman Bin Faisal Hospital

GENERIC CLINICAL CHECKLIST

AREA - INTENSIVE CARE UNIT - ADULT

IMPORTANT

Before proceeding with this Skills Checklist, please read the following statement:

Demonstration of skills stated will be expected during your 90 days probationary period. Inability to
demonstrate the skills stated will result in termination of your employment during the probationary period.

I have read the above statement, and I acknowledge my clear understanding of this statement.

Name: ________________________ Signature: __________________ Date: ________________

AIM OF CHECKLIST:
This checklist will be used to assess your suitability for placement. Provide additional information as needed
to facilitate a comprehensive review of your skills and experience.

Staff Nurses are expected to work independently and relatively autonomously. As a minimum Staff Nurses are for example expected to be
able to interpret cardiac rythms in lead II, which goes beyond the sole recognition of changes, calculating drug infusions in mg/min,
mcg/kg/min and mg/kg/min. The nurse must be able to administer and maintain multiple Inotropes. Experience with Intra Cranial Pressure
Monitoring via ventriculostomy catheter, and intracranial drainage should go beyond monitoring of the patient. Please keep these aspects in
mind filling out the checklist. Competency levels may differ between hospitals.

EXPERIENCE KEY: (Patricia Benner's Model of Nursing Skills Acquisition - "Novice to Expert")
1 - Novice - no background experience related to this function
2 - Advanced Beginner - sufficient knowledge to understand the contextual nature of the function, able to perform routine functions independently, requires
assistance when setting priorities in complex situations.
3 - Competent - views actions as part of an over-all plan, knows what aspects of current and contemplated situations are most important, needs to gain speed and
flexibility to be proficient.
4 - Proficient - perceives situations and functions as a whole, has knowledge of the typical events to expect in a given situation and the appropriate responses,
flexible in decision making.
5 - Expert - enormous background and experience, can grasp situations intuitively, mastery in performance, incorporates elements of innovation and creativity in
clinical experience.

FREQUENCY KEY:
1 - Never performed the skill
2 - At least once or twice a year
3 - At least once per month
4 - At least once per week
5 - At least daily
FREQUENCY EXPERIENCE
1 2 3 4 5 1 2 3 4 5
I. NEUROLOGICAL
- coma
- craniotomy
- head injury
- meningitis
- ICP monitoring
- intracranial drainage
- medical/neuro. disorders
- spinal cord injury
- spinal surgery
- status epilepticus
- brain stem death
- epidural catheter

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 FREQUENCY EXPERIENCE
1 2 3 4 5 1 2 3 4 5
II. RESPIRATORY
- chronic obstructive pulmonary disease
- severe acute asthma
- pneumonia
- pulmonary embolism
- pneumonectomy
- adult respiratory distress syndrome (ARDS)
- long term ventilation
- weaning difficulties
- insertion of percutaneous tracheostomy
- short term ventilation
- pleural chest drainage
- bi-pap
- flail chest
III. CARDIOVASCULAR
- acute myocardial infarction
- unstable angina
- cardiac arrhythmias
- congestive heart failure
- pulmonary oedema
- cardiogenic shock
- post cardiac surgery
- abdominal aortic aneurysm
- central venous pressure monitoring
- arterial pressure monitoring
- pulmonary artery pressure monitoring
- pacemaker : - permanent
- trans venous
- trans cutaneous
- intra-aortic balloon pump
- two or more inotrope infusions
IV. ASSESSMENT & CARE OF THE CARDIOVASCULAR
PATIENT
Peripheral Vascular Assessment:
a) Pulses
Interpretation of Laboratory Studies
a) Chemistries, Cardiac Enzymes, Troponin
b) Fluids & Electrolytes
c) Hematology & Coagulation Studies
d) Arterial Blood Gas Determination
I.V. Therapy
a) IV insertion
b) IV assessment and maintenance
c) Troubleshooting
Patient transport and transfer
High-risk patient assessment
V. CARDIAC PATHOPHYSIOLOGY: ETIOLOGY,
PATHO-PHYSIOLOGY, CLINICAL MANIFESTATION AND
TREATMENTS OF:
a) Coronary Artery Disease Atherosclerosis
b) Angina: Stable, Unstable & Variant
c) Myocardial Infaction
d) Heart Failure
e) Shock
f) Valvular Heart Disease
g) Cardiomyopathies
h) Pericardial Diseases
i) Systemic & Pulmonary Hypertension
j) Hereditary Diseases
k) Pulmonary Diseases
l) Arterial Diseases
m) Infectious Diseases
n) Tumours
o) Cerebrovascular Diseases
p) Congenital Anomalies:
i) Fetal Embryology/Circulation/Transition
ii) Common Anomalies

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iii) Palliative & Corrective Surgical Interventions
iv) Catheter Interventions
VI. PHARMACOLOGY
Medical and Legal Aspects, Documentation
Sympathetic/Parasympathetic Nervous Systems
Indications, Contraindications, Mechanism of
Action,Normal Dosages, Side Effects, Patient Care
Considerations
Pharmacokinetics & Pharmacodynamics of:
a) Vasopressors and Vasodilators
b) Diuretics
c) Antihypertensives
d) Local Anesthetics
e) Anticoagulants
f) Thrombolytics
g) Nitrates
h) Dysrhythmics
i) Antianginal
j) Calcium Channel Blockers
k) Contrast Media
l) Cardiac Glycosides
m) Analgesics
n) Sedatives
o) Insulin Therapy
p) Steroids
q) ACE Inhibitors
r) Antiemetics
s) Antibiotics
t) Antihistamines
u) Oxygen
v) Beta Blockers
w) Antiplatelet Agents
x) ACLS
y) Conscious Sedation
z) Routes of Administration
VII. RENAL
- acute renal failure
- chronic renal failure
- continuous renal replacement therapy (CRRT)
- “prisma”
- “BSM 22”
- intermittent hemodialysis
- urethral catheterization - female
- male
VIII. GASTROINTESTINAL
- liver transplantation (immediate)
- liver cirrhosis
- oesophageal varices
- Sengstaken - Blakemore tube
- acute pacreatitis
- hepatic failure
IX. HEMATOLOGICAL
- disseminated intravascular coagulopathy
X. METABOLIC
- enteral nutrition
- parenteral nutrition
- acid - base imbalance
- diabetic emergencies
XI. TRAUMA RELATED
- multiple trauma
- faciomaxillary injury
- multiple fractures
- burns
- pelvic injury
- poisoning
- drug overdose
1. Basic Cardiac Life Support

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 FREQUENCY EXPERIENCE
1 2 3 4 5 1 2 3 4 5
2. Advanced Cardiac Life Support
3. Intravenous Line Insertion
4. Phlebotomy
5. ECG Interpretation
6. Care of the intubated/ventilated patient
7. Care of pleural chest drains
8. Interpretation of arterial blood gases
9. Interpretation of hemodynamic pressures and related therapy

10. Cardiac output measurement

11. Pulmonary capillary wedge pressure measurement
12. Care of a patient with multiple inotropic infusions of high
acuity
13. Management and interpretation of intracranial pressure
monitoring.
14. Physical Assessment.
15. Knowledge of normal laboratory results.
16. Management of continuous dialysis.
17. Care of the spinal injured patient.
18. Use of the Glasgow coma scale.
20. Charge Nurse duties

XII. EXPERIENCE

[ ] High Acuity Unit [ ] Low Acuity Unit [ ] Mixed Acuities

1. Years of nursing experience as a registered nurse: Total : _____ ICU: _____

2. Length of ICU course with certificate: _____ Year obtained:

3. Number of utilized beds in your present ICU: _____

4. Average number of patients in the unit per day: _____

5. Average number of ventilated patients in the ICU per day:

6. Average nurse to patient ratio: _____ to _____

GENERAL NURSING KNOWLEDGE YES NO

Knowledge of evidence-based practice
Knowledge of reflective practice
Knowledge of nursing critical thinking

COMPUTER SKILLS YES NO

Microsoft Word
Internet (email and www searches)
Email - name the application e.g. Outlook, Express

Electronic Medical Records - name the system, e.g. Per Se,

Oracle, Cerner, etc.

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