PACU Skills Checklist Name* First Last Email* Phone*Proficiency: 1 = Minimal Experience 2 = Limited Experience 3 = Competent 4 = Highly SkilledAge Specific CompetencyNeonates / Newborns (Birth - 30 days)* 1 2 3 4 Infants (30 days - 1 year)* 1 2 3 4 Toddler (1 - 3 years)* 1 2 3 4 Preschooler (3 - 5 years)* 1 2 3 4 Older Children (5 - 12 years)* 1 2 3 4 Adolescents (12 - 18 years)* 1 2 3 4 Young Adults (18 - 39 years)* 1 2 3 4 Middle Adults (39 - 64 years)* 1 2 3 4 Older Adults / Geriatrics (64+ years)* 1 2 3 4 ExperienceAdmission to PACU* 1 2 3 4 Physical Assessment of Body Systems* 1 2 3 4 Pulmonary / Abnormal Breathing* 1 2 3 4 Perform Suctioning* 1 2 3 4 O2 Administration* 1 2 3 4 Care of Patient with Chest Tube* 1 2 3 4 Post-Operative Patient Care* 1 2 3 4 Care of Patient with Tubes / Drains* 1 2 3 4 Cardiovascular* 1 2 3 4 Operate & Monitor Unit Equipment* 1 2 3 4 Anesthesia Equipment* 1 2 3 4 ChartingComputer* 1 2 3 4 DARE* 1 2 3 4 APIE* 1 2 3 4 SOAPIE* 1 2 3 4 FOCUS* 1 2 3 4 Discharge Planning* 1 2 3 4 Utilization Review* 1 2 3 4 Chart Review / Audit* 1 2 3 4 Admission to PACUInitial Assessment* 1 2 3 4 Airway Management* 1 2 3 4 Proper Positioning* 1 2 3 4 Vital Signs* 1 2 3 4 Skin Color, Temp, Turgor* 1 2 3 4 Neurological Status* 1 2 3 4 Physical Assessment of Body SystemsRespiratory* 1 2 3 4 Cardiovascular* 1 2 3 4 Neurologic* 1 2 3 4 Gastrointestinal* 1 2 3 4 Genitourinary* 1 2 3 4 Integumentary* 1 2 3 4 Monitor Recovery of Patient From* 1 2 3 4 General Anesthesia* 1 2 3 4 Regional Anesthesia* 1 2 3 4 Local Anesthesia* 1 2 3 4 PulmonaryAuscultate Breath Sounds* 1 2 3 4 Recognize Abnormal Breath Sounds (e.g. Rales, Rhonchi)* 1 2 3 4 Implement Appropriate Nursing Intervention for Abnormal Breath Sounds* 1 2 3 4 Reposition Patient* 1 2 3 4 Pulmonary Toilet* 1 2 3 4 Bronchodilators, Diuretics* 1 2 3 4 Suction, O2* 1 2 3 4 Airway Insertion / Management* 1 2 3 4 Recognize Abnormal Breathing* 1 2 3 4 Assess Respiratory Rate, Rhythm, Depth, & Symmetry* 1 2 3 4 Labored, Dyspneic* 1 2 3 4 Obstructed* 1 2 3 4 Laryngospasm* 1 2 3 4 Insufficient Reversal* 1 2 3 4 Perform SuctioningOral* 1 2 3 4 Nasal* 1 2 3 4 Endotracheal* 1 2 3 4 Tracheal* 1 2 3 4 O2 AdministrationFace-trach Mask* 1 2 3 4 Nasal Cannula* 1 2 3 4 T-Piece* 1 2 3 4 ETT Mechanical Ventilator* 1 2 3 4 Care of Patient with Chest Tube* 1 2 3 4 Set-up Closed Drainage System* 1 2 3 4 Recognize Air Leak* 1 2 3 4 Assess for Subcutaneous Emphysema* 1 2 3 4 Measure Drainage* 1 2 3 4 Troubleshoot Problems* 1 2 3 4 Post-Operative Care for the Following Patient PopulationsThoracic Surgery* 1 2 3 4 Vascular Surgery* 1 2 3 4 Orthopedic Surgery* 1 2 3 4 Neurosurgery* 1 2 3 4 Tonsillectomy / P.E. Tubes* 1 2 3 4 Major Abdominal Surgery* 1 2 3 4 ENT Surgery* 1 2 3 4 Breast Surgery* 1 2 3 4 Genitourinary Surgery* 1 2 3 4 HiddenHiddenHypospadias* 1 2 3 4 Circumcision* 1 2 3 4 Gynecological Surgery* 1 2 3 4 Post-Angiogram* 1 2 3 4 Liver Biopsy* 1 2 3 4 Eye Surgery* 1 2 3 4 Cardiac Surgery* 1 2 3 4 Tubes / DrainsPenrose Drain* 1 2 3 4 Salem* 1 2 3 4 Sump* 1 2 3 4 Davol* 1 2 3 4 Colostomy* 1 2 3 4 Jejunostomy* 1 2 3 4 Ileostomy* 1 2 3 4 Jackson Pratt* 1 2 3 4 T-Tube* 1 2 3 4 Foley Catheter* 1 2 3 4 Urethral* 1 2 3 4 Suprapubic* 1 2 3 4 Cystotomy* 1 2 3 4 NG Tube* 1 2 3 4 CardiovascularPlacement & Care of a Patient on a Cardiac Monitor* 1 2 3 4 Arrhythmia Analysis* 1 2 3 4 Cardioversion & Defibrillation* 1 2 3 4 Assist with Insertion of Temporary Pacemaker* 1 2 3 4 Care of Patient with Permanent / Temporary Pacemaker* 1 2 3 4 Use of Non-Invasive Temporary Pacing Equipment* 1 2 3 4 Care of Patient with Intravascular Hemodynamic Monitoring Equipment* 1 2 3 4 Pulmonary Artery Catheters* 1 2 3 4 Arterial Catheters* 1 2 3 4 Swan-Ganz Catheters* 1 2 3 4 Central Venous Catheters* 1 2 3 4 Subclavian Lines* 1 2 3 4 Epidural Catheters* 1 2 3 4 Hemodynamic Monitoring* 1 2 3 4 Equipment Maintenance* 1 2 3 4 Dressing Changes* 1 2 3 4 Prevention of Complications* 1 2 3 4 Leveling Waveform Analysis* 1 2 3 4 Obtain & Interpret* 1 2 3 4 Cardiac Output* 1 2 3 4 PA Pressure* 1 2 3 4 PCWP / PAWP* 1 2 3 4 CVP* 1 2 3 4 LAP* 1 2 3 4 Identify Usual Dosage, Actions & Side Effects for* 1 2 3 4 Antiarrhythmics* 1 2 3 4 Inotropes* 1 2 3 4 Vasopressors* 1 2 3 4 Vasodilators* 1 2 3 4 Reversal Agents* 1 2 3 4 Beta Blockers* 1 2 3 4 Calcium Channel Blockers* 1 2 3 4 Inhalation Agents* 1 2 3 4 Calculate Infusion Rates in Dosages Ordered* 1 2 3 4 Interpret Blood Lab Values for* 1 2 3 4 Electrolyte Imbalances / ABG's* 1 2 3 4 Operate & Monitor Unit EquipmentPortable Suction Machine* 1 2 3 4 Transport Monitor* 1 2 3 4 Automatic BP Monitor* 1 2 3 4 Blanket Warmer / Bair Hugger* 1 2 3 4 Sequential Compression Device* 1 2 3 4 Pulse Oximeter* 1 2 3 4 Pee Wee Weighing Scale* 1 2 3 4 Hyper / Hypothermia Blanket* 1 2 3 4 Blood Warmer* 1 2 3 4 PACU Stretcher* 1 2 3 4 IV Pumps* 1 2 3 4 Invasive Pressure Monitors* 1 2 3 4 Implements Physician Orders* 1 2 3 4 Collaborate with Surgeon & Anesthesiologist with Regard to Patient Care* 1 2 3 4 Utilizes Appropriate Infection Control Measures* 1 2 3 4 Practice Universal Precautions* 1 2 3 4 Document Interventions, Outcomes, Lab Studies, MD Notifications & Follow-up Care* 1 2 3 4 Perform a Discharge Physical Assessment* 1 2 3 4 Level of Consciousness* 1 2 3 4 Pupillary Reactions* 1 2 3 4 Motor & Sensory Functions* 1 2 3 4 Muscular Strength (e.g. Hand Grasps, Head Lift)* 1 2 3 4 Anesthesia EquipmentBlood Warmer* 1 2 3 4 BP Monitor* 1 2 3 4 Dinamap* 1 2 3 4 Ohmeda* 1 2 3 4 Defibrillator* 1 2 3 4 SAO2 Monitor* 1 2 3 4 Nitrogen Controls* 1 2 3 4 Tanks* 1 2 3 4 Wall Units* 1 2 3 4 Thermia Blankets* 1 2 3 4