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
Awareness of HCAHPS
Administrative procedures
MDS Coordinator Admit/discharge patients
Blood glucose monitoring
Coordinate scheduling
Documentation
Dressing changes
Familiarity with advanced directives
HIPPA regulations
Isolation techniques
Observe for adverse medication reaction
Alert licensed staff of medication reaction
Patient education
Position/transfer patients
Prepare reports
Pulse oximetry
Lab draw
Screen/direct provider calls
Screen/direct patient calls
Urine dipstick
Universal precautions
Vital signs
Wound care
Patient's health history
Patient's physical exam
Patient procedures
Diagnostic testing and procedures
Discharge instructions
Therapeutic procedures
Assist with emergency
Perform 12 lead EKG
Use of cardiac monitor
Apply/monitor noninvasive BP monitor
Intake and output
Discontinue peripheral IV
Manual BP
Phlebotomy draws
Apply nasal cannula/face mask
Incentive spirometry
O2 saturation monitor
Assist with lumbar puncture
Neurological evaluation
Seizure precautions
Cast care
Crutch walking
Traction
Assist with feeding
Nutritional evaluation
Instruct/obtain clean catch urine
Straight/Foley catheter female
Straight/Foley catheter male
Vitamins, minerals, herbs
Antibiotics
Antifungal
Antiviral
Psychotropic
Ophthalmic medications
Aural medications
Respiratory system medications
Cardiovascular system medications
Gastrointestinal system medications
Urinary system medications
Reproductive system medications
Endocrine system medications
Musculoskeletal system medications
Nervous system medications
Intramuscular (IM)
Subcutaneous (SQ
Intradermal
Z-track
Newborn/neonate (birth-30 days)
Infant (31 days-1 year)
Toddler (ages 2-3 years)
Preschool (ages 4-5 years)
School age (ages 6-12 years)
Adolescent (ages 13-21 years)
Young adult (ages 22-39 years)
Adult (ages 40-64 years)
Older adult (ages 65-79 years)
Elderly (ages 80+ years)
Copyright © Ambe Healthcare Staffing