PACU Skills Checklist

Name*
First Last
Email*
Phone*
Proficiency:
1 = Minimal Experience
2 = Limited Experience
3 = Competent
4 = Highly Skilled
Age Specific Competency
Neonates / 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
Experience
Admission 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
Charting
Computer*
- 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 PACU
Initial 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 Systems
Respiratory*
- 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
Pulmonary
Auscultate 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 Suctioning
Oral*
- 1
- 2
- 3
- 4
Nasal*
- 1
- 2
- 3
- 4
Endotracheal*
- 1
- 2
- 3
- 4
Tracheal*
- 1
- 2
- 3
- 4
O2 Administration
Face-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 Populations
Thoracic 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
Hypospadias*
- 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 / Drains
Penrose 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
Cardiovascular
Placement & 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 Equipment
Portable 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 Equipment
Blood 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

Proficiency:

Age Specific Competency

Experience

Charting

Admission to PACU

Physical Assessment of Body Systems

Pulmonary

Perform Suctioning

O2 Administration

Post-Operative Care for the Following Patient Populations

Tubes / Drains

Cardiovascular

Operate & Monitor Unit Equipment

Anesthesia Equipment