Telemetry Checklist

This Skills Checklist is for use by nurses with more than one-year experience in their discipline and specialty. Please be accurate with your assessment.
DIRECTIONS: Please indicate your level of experience by placing a check (X) in the box.
Experience level:
1 NO EXPERIENCE
2 MINIMAL EXPERIENCE - requires supervision/assistance
3 MODERATELY EXPERIENCED - requires initial review, then performs independently
4 VERY EXPERIENCED - proficient

Assessment:

Equipment & Procedures:

Arrhythmia Interpretation:

Hemodynamic monitoring:

Care of the patient with:

Medications:

Assessment:

Equipment and Procedures:

Care of airway management devices/suctioning:

Care of patient on ventilator:

Care of patient with chest tube:

O2 therapy & medication delivery systems:

Care of the patient with:

Assessment

Equipment and procedures:

Care of patient with:

Assessment:

Equipment & procedures:

Management of:

Care of the patient with:

Assessment:

Equipment & procedures:

Care of the patient with:

Care of the patient with:

Medications:

Assessment:

Equipment & procedures:

Care of the patient with:

Equipment & procedures:

Administration of blood/blood products:

Care of the patient with:

Central line/catheter/dressing:

Care of the patient with:

Please check the boxes below for each age group for which you have expertise in providing age-appropriate nursing care.


A. Newborn/Neonatal (birth – 30 days)
B. Infant (30 days – 1 year)
C. Toddler (1 – 3 years)
D. Preschool (3 – 5 years)
E. School Age Children (5 – 12 years)
F. Adolescent (12 – 18 years)
G. Young Adults (18 – 39 years)
H. Middle Adults (40 – 64 years)
I. Older Adults (64 + years)