Please enable JavaScript in your browser to complete this form.Personal InformationName *FirstLastEmail *Phone No experience: requires education, training and supervision Intermittent experience: may need support or supervise Proficient: consistent experience, independent Expert level: can teach/supervise others. Work settingsPediatric CVICU1234Pediatric PACU1234Pediatric Step Down1234PICU1234CardiovascularAquapheresis1234Arrhythmia interpretation1234Cardiac transplant1234Congenital heart disease/repair1234CPR/Cardiac Arrest1234ECMO1234Heart failure1234Hemodynamic monitoring1234Insertion/Management of Pulmonary Artery Pressure (PAP) line1234Management of arterial line1234Pediatric Early Warning Score (PEWS)/Rapid Response Team1234Post Cardiac catheterization1234Post Cardiac surgery1234Post pacemaker insertion1234SVO2 monitoring1234Ventricular Assist Device1234Endocrine/MetabolicBlood glucose monitoring1234Diabetes- hypo/hyperglycemic crisis1234Diabetic ketoacidosis1234Insulin administration1234IV Insulin Pumps1234GastrointestinalAbdominal trauma1234GI bleeding1234Hepatic failure1234Management of gastric tubes1234Necrotizing Enterocolitis (NEC)1234Ostomy management1234Pancreatitis1234Post acute abdominal surgery1234Severe dehydration/gastroenteritis1234INFECTIOUS DISEASEHIV/AIDS1234Hyperthermia management1234Isolation Precautions1234Measles, mumps, chicken pox1234Septic Shock1234Tuberculosis1234IV THERAPY/PHLEBOTOMYAdministration of Blood and Blood Products1234Administration of Chemotherapy1234Care and management of ports1234Central Line Blood Draw1234Central Line/Implanted Line Care1234Monitoring chemotherapy (does not initiate)1234Phlebotomy1234PCA monitoring/set up1234Starting and maintaining IVs1234TPN/Lipids1234Miscellaneous CareBurns1234Ingestion/poison1234Overdose1234Suicidal ideation/attempts1234Trauma1234MEDICATIONS/EMERGENCY MEDICATIONSAutomated Medication Dispensing Systems1234Omnicell1234Pyxis1234Accudose1234Bar Code Medication Administration1234Antiarrhythmics1234Anticoagulation therapy1234Anticonvulsants1234Anti-rejection immunosuppressant1234Anti-Seizure Medications1234Pediatric Dosage Calculations1234Platelet Inhibitors1234Use of Braselow system1234Vasoactive agents1234Emergency MedicationsInhaled Medications1234Narcotics/Opioid Analgesics (IV/Oral/Injection)1234Non-Opioid Analgesics (IV/Oral/Injection)1234Paralytics for rapid intubation1234Procedural Sedation - Recovery1234Reversal Agents1234Steroids (IV/Oral/Inhaled)1234NEUROLOGICAssist with lumbar puncture1234Brain death/organ procurement1234Encephalitis/encephalopathy1234Epilepsy1234Glascow coma scale1234Hydrocephalus/VP shunt1234ICP monitoring/insertion1234Intracranial hemorrhage1234Meningitis1234Near drowning1234Neuromuscular disease1234Post neuro surgery1234Spinal Cord Injury1234Traumatic Brain injury1234ONCOLOGYAcute anemia1234Bone marrow transplant1234Chemotherapy Administration1234Cooling blanket1234Hemophilia Crisis1234Leukemia1234Malignant tumor1234Neutropenic precautions1234Sickle Cell crisis1234OrthopedicCervical traction1234Extremity Fracture/Cast1234Pin Care1234Pinned fractures1234Post vertebral surgery1234Traction - General1234Traction - Halo1234Professional Topic and SkillsEnd of life palliative care1234Fall risk assessment/prevention1234Infection control1234Interpretation and communication of lab values1234National Patient Safety Goals1234Normal growth and development1234Pain assessment and management1234Patient/family teaching1234Pressure ulcer assessment/prevention1234Recognize signs of abuse/neglect1234Restraints/Use of Least Restrictive Device1234Safe environment for age specific care1234Wound assessment/care1234RESPIRATORYAcute Respiratory Distress Syndrome1234Assist/maintain chest tube1234Assist/manage intubation1234Asthma1234Care/maintenance of acute airway1234Chronic respiratory disease1234CO2 monitoring equipment1234Nitric Oxide1234Obtain/interpret Arterial Blood gas1234Pneumonia1234Pulmonary emboli1234Pulmonary hypertension1234Reactive Airway disease1234Respiratory Syncytial Virus1234Tension Pneumothorax1234Tracheostomy care1234Ventilator management1234RENAL/GENITOURINARYAcute/chronic renal failure1234Assessment of fluid balance1234Continuous Renal Replacement Therapy (CRRT)1234Diabetes Insipidus1234Nephrotic syndrome1234Peritoneal dialysis1234Post renal transplant1234Renal replacement therapy1234Syndrome Inappropriate ADH1234Urinary catheter insertion/management1234COMPUTERIZED CHARTINGAllscripts1234Cerner1234EPIC1234McKesson1234Other:1234If other, please specifyAge specific competencyNeonate1234Infant1234Child1234Adolescent1234Young Adult1234Middle Adult1234Older Adult1234Submit