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
Advanced directives
2. Awareness of HCAHPS
3. Patient/family teaching
Discharge planning
5. UR/medicare review
6. Lift/transfer devices
7. Specialty beds
8. Restrictive devices (restraints)
9. End of life care/palliative care
10. Automated Medication Dispensing System, Pyxis, Omnicell, or other
11. National Patient Safety Goals
12. Accurate patient identification
13. Effective communication
14. Awareness of patient rights
15. Interpretation & communication of lab values
16. Medication administration
17. Labeling (medications & specimens)
18. Medication reconciliation
19. Anticoagulation therapy
20. Pain assessment & management
21. Infection control
22. Universal precautions
Isolation
24. Minimize risk for falls
25. Prevention of pressure ulcers
Assessment of heart sounds
Identification of arrhythmias (rate/rhythm)
Pacemakers/AID’s
Cardiac arrest/CPR
Hypertension
Pre/post MI
CHF
Post cardiac surgery
Fluid & electrolyte imbalances
Anticoagulants
Antiarrhythmics
Beta blockers
Nitroglycerin
Diuretics
1. Assessment/auscultation of lung sounds
Establishing an airway
Chest PT
Incentive spirometry
Supplemental oxygen (cannula, facemask)
Tracheostomy care
Suctioning (tracheostomy & nasotracheal)
Nebulizer use
Care of Patient with Pneumonia
Care of Patient with Asthma
Care of Patient with COPD
Care of Patient with Emphysema
Use & Administration of Bronchodilators
Use & Administration of Expectorants
Use & Administration of Corticosteroids
Assessment of neuro signs
Seizure precautions
Care of Patient with TBI (Traumatic Brain Injury: history of)
Care of Patient with Seizure activity
Care of Patient with Spinal cord injury
Care of Patient with Stroke (CVA)
Care of Patient with Multiple sclerosis
Care of Patient with Alzheimer’s disease
Care of Patient with Parkinson’s disease
Care of Patient with ALS (Amyotrophic Lateral Sclerosis)
Use & Administration of Antiseizure medications
Use & Administration of Antiemetics
Use & Administration of Laxatives
Use & Administration of Enemas
Use & Administration of Bowel prep
NG tube (insertion/removal)
Long term feeding tubes (dobhoff/keofeed)
Gastrostomy tube
Tube feedings
Monitoring input/output
Care of Patient with Colostomy/ileostomy
Care of Patient with GI bleed
Care of Patient with Feeding devices/adaptive equipment
Care of Patient with Dietary restrictions
Care of Patient with GT/PEG feedings
Foley catheter insertion/removal
GU irrigations
Nephrostomy tube
Suprapubic catheter
Ileo conduit
Use of bladder scan equipment
Care of Patient with Shunts and fistulas
Care of Patient with Straight catheterizations
Care of Patient with Incontinence/bladder training
Care of Patient with Chronic renal failure/dialysis
Care of Patient with Peritoneal dialysis
Total joint replacement
Arthroscopic surgery
Cast care
Pulse/CMS checks
Suture/staple removal
Prosthesis application
Standard extremity braces
Care of patients with Amputation
Care of patients with Stump wrapping
Care of patients with Laminectomy
Care of patients with Assistive devices
Care of patients with CPM machines
PARAGON
Cerner
Epic
Eclipsys
McKesson
Meditech
Other Computer System
Computerized Physician Order Entry
Wound care/surgical
Wound care/medical
Dressing changes
Skin assessment
Wound vac
