Skill Checklists

Travel Nursing

This checklist was electronically signed on (Today’s date)

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

  • 1 = No Experience

  • 2 = Need Training

  • 3 = Able to perform with supervision

  • 4 = Able to perform independently

Cardiac

Acute Coronary Syndrome

Congestive Heart Failure

Post Open Heart (12-24 hours)

Carotid Endarterectomy

Post Vascular Surgery

Heart Transplant

Pacemaker - Temporary/Permanent

Pacemaker - Epicardial

Sheath Removal

Heart Sounds

Pulmonary

Pneumonia

Respiratory Distress

COPD

Breath Sounds

Post Thoracic Surgery

Chest Tube Placement & Management

Trach Management

Modes of Ventilation (AC/PC/SIMV/CPAP)

Intubation/Extubation

External CPAP/BiPAP

Interpretation of Arterial Blood Gases

NEUROLOGIC & PSYCHIATRIC

Stroke Scale Assessment

CVA

Brain Injury

Post Craniotomy

Spinal Cord Injury

Seizure Disorders

ETOH/Drug Withdrawal

Gastrointestinal

GI Bleeding

GI Surgery

Liver Failure

Pancreatitis

Liver Transplant

Pancreas Transplant

Liver Transplant

Pancreas Transplant

RENAL/GENITOURINARY

Renal Failure

Renal Surgery

Renal Transplant

Arteriovenous Fistula/Shunt

Nephrostomy Tubes

Peritoneal Dialysis

Endocrine / Metabolic

Diabetes - Hypo/Hyperglycemic Crisis

Pituitary Disorders

IV Insulin Protocols

Indwelling Insulin Pumps

MEDICATIONS

Anti-Arrhythmics

Anticoagulants (IV, oral, & injection)

Anti-Hypertensives

Anti-Psychotics

Anti-Seizure Medications

Benzodiazepines

Procedural Sedation

Diuretics

Emergency Medications

Inhaled Medications

Insulin

Titrate Vasoactive Drips

Manage Vasoactive Drips - No Titration

Narcotics/Opioid Analgesics (IV, oral, & injection)

Nitrates (Oral & Topical)

Non-Opioid Analgesics (IV, Oral, & Injection)

Reversal Agents

Steroids (IV, Oral, Inhaled)

Automated Medication Dispensing (i.e. Pyxis, Omnicell)

IV Therapy

Starting Ivs

Central Line Blood Draws

Central Line/Implanted Line Care

Arterial Line Management

TPN & Lipids

Blood Product Administration

Administration of Chemotherapy

Cardiac Monitoring & Emerg. Response

Dysrhythmia Interpretation

Dysrhythmia Management

Obtain 12 Lead EKG

Interpret 12 Lead EKG

Cardioversion

Defibrillation

Malignant Hyperthermia

Professional Knowledge and Skills

National Patient Safety Goals/Core Measures

Fall Risk Assessment/Prevention

Pressure Ulcer Risk Assessment/Prevention

Restraints/Use of Least Restrictive Device

Age Specific/Population-Based Care

Isolation Precautions

Infection Prevention

Pain Assessment & Management

Charge Experience

Interpretation and Communication of Lab Values

Specialty Beds

Age Specific Competencies

Infant (Birth - 1 year)

Preschooler (ages 2-5 years)

Childhood (ages 6-12 years)

Adolescents (ages 13-21 years)

Young Adults (ages 22-39 years)

Adults (ages 40-64 years)

Older Adults (ages 65-79 years)

Elderly (ages 80+ years)

EMR

Epic

Cerner

Eclipsys

McKesson

Meditech

Other Computerized System

Computerized Physician Order Entry

Bar Coding for Medication Administration

EMR Conversion - yes

Certifications

BLS

ACLS

PALS

PCCN

CCRN

Critical Care Course

Telemetry Certificate/Course

I hereby certify that ALL information I have provided on this skills checklist and all other documentation is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.