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Acute Rehab CheckList

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

Work Settings Rating Stars (Click) 1 2 3 4  
General Acute Care 
 
Home Health 
 
Nursing Home 
 
Outpatient Clinic 
 
Pediatric Rehab 
 
Acute Rehab Hospital 
 
Rehab Unit in Hospital 
 
Neuro Rating Stars (Click) 1 2 3 4  
Cerebral Vascular Accident 
 
Coma Patients 
 
Head Trauma 
 
Spinal Cord Injury 
 
Parkinsonís Disease 
 
Traumatic Brain Injury 
 
Neuromuscular Disease 
 
Post Craniotomy 
 
Bowl/Bladder Programs 
 
Ortho Rating Stars (Click) 1 2 3 4  
Arthritis Programs 
 
Back Syndrome 
 
Cervical Traction 
 
Continuous Passive Motion Machine N/A 
 
Gait Training 
 
Hand Injury 
 
Hip Fractures 
 
Care of Patient with Halo 
 
Hot/Cold Packs 
 
Mobilization Techniques 
 
Neck Injuries 
 
TMJ Dysfunction 
 
Total Hip Replacement 
 
Total Knee Replacement 
 
Pulmonary Rating Stars (Click) 1 2 3 4  
Assessment of breath sounds 
 
Chest Physiotherapy 
 
Oximetry 
 
Nasal cannula 
 
Face Mask 
 
Portable O2 tank 
 
Nasotracheal Suctioning 
 
Tracheal Suctioning 
 
Care of patient w/Mechanical Vent 
 
COPD 
 
Pediatrics Rating Stars (Click) 1 2 3 4  
Cerebral Palsy 
 
Activities of Daily Living 
 
Learning Disabilities 
 
Orthotics 
 
Spina Bifida 
 
Autism 
 
AK Prosthetics 
 
Amputees 
 
BK Prosthetics 
 
Bracing/Joint Immobilization 
 
Resting Splints 
 
Casts/Check for Circulation 
 
Upper Extremity Prosthetics 
 
Nutritional Requirements Rating Stars (Click) 1 2 3 4  
Thickened Liquids 
 
Minimal 
 
Thick 
 
Extra Thick 
 
Pudding Thick 
 
NG Tubes 
 
Peg Tubes 
 
Restraints Rating Stars (Click) 1 2 3 4  
4pt 
 
Shoulder Strap 
 
Hand Mitts 
 
Wrist 
 
Ankle 
 
Pelvic Strap 
 
EMR Rating Stars (Click) 1 2 3 4  
Epic 
 
Cerner 
 
Eclipsys 
 
McKesson 
 
Meditech 
 
Other Computerized System 
 
Computerized Physician Order Entry 
 
Bar Coding for Medication Administration 
 
Other Rating Stars (Click) 1 2 3 4  
Ability to evaluate and assign Functional Independence Score 
 
AIDS Patients 
 
Burn Management 
 
Cardiac Rehabilitation 
 
Function Capacity Evaluation 
 
Geriatrics 
 
Manual Therapy 
 
Massage Therapy 
 
Muscle Stimulation 
 
Pain Management/Giving Meds 
 
Physical Capacity 
 
Pulmonary Rehab 
 
Sterilization Technique 
 
TENS 
 
Wound Debridement/Dressing Change 
 
Age Specific Competencies Rating Stars (Click) 1 2 3 4  
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)