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.
CARDIOVASCULAR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Open Heart Recovery |
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AAA Repair |
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Vascular Surgery |
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Pacemaker-Permanent & Temporary |
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Cardioversion |
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AICD Insertion |
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Cardiac Arrest |
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Cardiac Tamponade |
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CHF/Pulmonary Edema |
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Abnormal Heart Sounds/Murmurs |
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Pulses/Circulation Checks |
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PULMONARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Ventilator Management |
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Fresh Tracheostomy |
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Thoracotomy/Lobectomy/Pneumonectomy |
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Pneumothorax/Hemothorax |
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Laryngospasm |
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Pulmonary Embolism |
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COPD |
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ABG Interpretation |
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NEUROLOGIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Post Craniotomy |
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Anterior/Posterior Spinal Fusion |
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Carotid Endardarectomy |
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Spine Surgery |
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CVA |
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Stroke Scale |
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Glascow Coma Scale |
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Spinal Precautions |
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Hypothermia Protocol |
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Hypo/Hyperthermia Blanket |
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Sedation Scales/Levels |
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GASTROINTESTINAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Pancreas/Liver Transplant |
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Colon Surgery |
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Colostomy/Ileostomy |
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ERCP |
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G Tube/J Tube Management |
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T Tube Management |
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RENAL/GENITOURINARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Renal Surgery |
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TURP |
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Arteriovenous Fistula/Shunt |
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Nephrostomy Tubes |
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ENDOCRINE METABOLIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Diabetes - Hypo/Hyperglycemic Crisis |
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IV Insulin Protocols |
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ORTHOPEDIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Laminectomy |
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Total Joint Replacement |
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Amputation |
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Open Reduction/Internal Fixation |
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General Orthopedic Surgeries |
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CPM/Traction |
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Circulation Checks |
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WOUND MANAGEMENT | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Surgical Drains |
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Wound Vac |
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Surgical Wound Assessment |
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Skin Assessment for Breakdown |
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Staging Decubitus Ulcers |
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MEDICATIONS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Procedural Sedation |
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Anesthesia Medications |
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Anti-Arrhythmics |
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Anticoagulants |
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Anti-Hypertensives |
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Anti-Seizure Medications |
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Benzodiazepines |
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Emergency Medications |
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Insulin |
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Narcotics/Opioid Analgesics |
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Nitrates |
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Non-Opioid Analgesics |
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Reversal Agents |
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Steroids |
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Automated Medication Dispensing (i.e. Pyxis, Omnicell) |
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IV THERAPY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Starting Ivs |
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Central Line Blood Draws |
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Central Line/Implanted Line Care |
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Blood Product Administration |
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CARDIAC MONITORING & EMERG. RESPONSE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Malignant Hyperthermia |
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Dysrhythmia Interpretation |
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Dysrhythmia Management |
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12 Lead EKG |
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PROFESSIONAL KNOWLEDGE AND SKILLS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
National Patient Safety Goals/Core Measures |
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Fall Risk Assessment/Prevention |
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Pressure Ulcer Risk Assessment/Prevention |
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Age Specific/Population-Based Care |
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Pain Assessment & Management |
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Charge Experience |
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Interpretation and Communication of Lab Values |
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Specialty Beds |
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EMR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Epic |
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Cerner |
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Eclipsys |
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McKesson |
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Meditech |
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Other Computerized System |
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Computerized Physician Order Entry |
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Bar Coding for Medication Administration |
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PULMONARY |
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Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Infant (Birth - 1 year) |
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Preschooler (ages 2-5 years) |
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Childhood (ages 6-12 years) |
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Adolescents (ages 13-21 years) |
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Young Adults (ages 22-39 years) |
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Adults (ages 40-64 years) |
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Older Adults (ages 65-79 years) |
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Elderly (ages 80+ years) |
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