PCT 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

Patient Rights Rating Stars (Click) 1 2 3 4  
Communicates and obtains information while respecting the rights and privacy and confidentiality of information in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) 
Involves the patient and family and respects their role in determining the nature of care to be provided, including Advance Directives. 
Complies with nursing staff responsibility included in the hospital policy related to Organ Donation. 
Meets patient and families needs regarding communication, including interpreter services 
Provides accurate information to patient and families in a timely manner. 
Vital Signs and Weights Rating Stars (Click) 1 2 3 4  
BP, including Orthostatic 
Pulse, Radia 
Temperature, Oral 
Temperature, Rectal 
Temperature, Axillary 
Temperature, Tympanic 
Weight, Pounds and Kilograms 
Recognizing Cardiac Arrest 
Activating Code Team 
Bringing Emergency Equipment to Room 
Providing Appropriate Code Support 
Automatic BP machine (Dynamap) 
Electronic Thermometer 
Applying Oximeter 
Report Abnormal Findings 
Bowel Function 
Bladder Function 
Tap Water 
Return Flow 
Vital Signs and Weights Rating Stars (Click) 1 2 3 4  
Placing and Removing Bed Pan 
Clamping Catheter 
Emptying Foley Bag 
Placing Condom Catheter 
Emptying and Replacing Ostomy Bag (Established Ostomy) 
Nutrition Rating Stars (Click) 1 2 3 4  
Estimating Intake 
Setting up for Meals 
Feeding Patients 
Aspiration Precautions 
Counting Calories 
Fluid Restriction 
Specimens Rating Stars (Click) 1 2 3 4  
Collecting Stool 
Collecting Sputum 
Labeling Specimens and Preparing for Transport 
Clean Catch 
24 Hour 
Hygiene /Skin Rating Stars (Click) 1 2 3 4  
Risk Factorsfor Skin Breakdown 
Observing Pressure Points for Redness or Breakdown 
Bathing (Shower /Tub /Arjo) 
Oral Care, Including Patients who are NPO,Comatose, Patients with 
Pen Care 
Foot Care for Patients with Impaired Circulation or Sensation 
Incontinence Care 
Shaving and Precautions 
Reducing Pressure and Friction 
Special Beds/Mattresses 
Heels and Elbow Protection 
Foot Cradles 
Use of Shower Chair 
Use of Bath/Shower Boat 
Infection Control Rating Stars (Click) 1 2 3 4  
Reverse Isolation 
Body Substance isolation 
TB Precautions 
MRSA Precautions 
Hand Washing 
Infectious/Hazardous Waste Disposal 
Supply/Equipment Disposal 
Use of Disposable Therrnomete 
Use of CPR Mask/Bag 
Mask / Goggles 
Safety and Activity Rating Stars (Click) 1 2 3 4  
Determining Patient ID 
Identifying Safety Hazards 
Determining Need for Additional Help 
Assessing Safety and ADL Needs 
Assessing Safety and ADL Needs 
Recognizing Abuse: Substance, Physical, Emotional, etc 
MaintainingClean, Orderly Work Area 
Disposing of Sharps 
Handling Hazardous Materials 
Proper Body Mechanics 
ROM Exercises 
Transferring to Bed,WC, Commode, etc 
Turning and Positioning 
Patient Safety Module 
Reporting Broken Equipment 
Responding to Safety Hazards 
Use of HoyerLift (Dextra /Maxi) 
Bed Operation 
Use of Wheel Locks 
Use of Alarms: Bed, Patient, Unit 
Use of CaIl Light 
Documenting Use of Restraints 
Use of Transfer Belt 
Use of Gait Belt for Ambulation 
Use of Seizure Pads 
Belt Including Seat Belt 
Care Routines Rating Stars (Click) 1 2 3 4  
Inventory andDispositionof Belongings, Useof Checklist 
Room Orientation, Call Bell 
Transferring into Bed 
Call Bell 
Assist with Turns 
ROM Exercises 
Replacing Mask or Nasal Caunula if Needed 
Notifying Nurse of Problems 
Basic Comfort Measures 
Early Bath 
Preparing Belongings 
Preparingfor and Explaining Routinesto Patient 
Post Mortem Care 
Use ofIncentive Spirometer 
Antiembolic Stockings 
Sequential Stockings 
Communication Rating Stars (Click) 1 2 3 4  
Using Appropriate Abbreviations 
Identifying UnusuaI Patient Incidents that Require Reporting 
Reinforcing RN Teaching With Patient 
Selecting and Using Forms Appropriately 
Using Alternate Communication Tools /Devices 
Changes in Patient Condition 
Patient Needs, Complaints and Concerns 
Unusual Incidents 
Vital Signs 
Bathing /Hygiene 
Turning and Repositioning 
Ambulation and Activity 
Diet intake, Calorie Count 
Bowel Movements 
Shift Volumes and Totals 
Marking and /or Measuring Amount of Urine, Gastric Fluid, NG Drainage, Emesis, Diarrhea 
Unit Activity Rating Stars (Click) 1 2 3 4  
Identifying Unusual Incidents on the Unit that Require Reporting 
Locating and Using Appropriate Reference Materials: Hospital, Patient Care and 
Charging for Patient Care Items 
Completing Risk Management Reports as Needed 
Obtaining Needed Supplies and Equipment 
Reporting and Following up on Faulty Equipment and Supplies 
Using Telephone System 
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)