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.
General Patient Care | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Admit and Assess Patients |
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Advance Directives |
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Collect Appropriate Data |
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Discharge Teaching |
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Preoperative Teaching |
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Patient Prep |
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Computerized Documentation |
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Cardiovascular | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assess Heart Tones |
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Bedside Tele Monitoring |
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Interpretation of Coagulation Studies |
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Perform Pulses/Circulation Checks |
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Pre/Post Op Care Pacemaker |
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Pulmonary | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assess Breath Sounds |
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Apply Oxygen |
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Interpret ABGs |
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Thoracentesis |
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Oximetry |
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Neurology | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assess Neurological Signs |
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Epidurals |
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Selective Nerve Root Blocks |
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Level of Consciousness |
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GI | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Insertion/Monitoring NG Tubes |
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Assessment/Patient Care Continued |
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Flexible Sigmoidoscopy |
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Hemorrhoid Banding |
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Liver Biopsy |
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Paracentesis |
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Lap Band Surgery |
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GU | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Bladder Biopsy |
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Cystoscopy |
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Urethral Dilation |
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Nephrostomy |
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Kidney Biopsy |
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Suprapubic Catheter |
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Prostate Biopsy |
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Endocrine | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Care of Diabetic Patient |
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Diabetic Teaching |
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ENT and Mouth | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Prosthondontics – Restorative Dentistry |
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Mouth Biopsy |
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Myringotomy |
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Maxillofacial Prosthetics |
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Nose Biopsy |
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Thyroid Aspirate Biopsy |
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Fiberoptic Laryngoscopy |
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Tonsilectomy |
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Rhinoplasty |
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Wounds/Integument | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Application of Burn Dressings |
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Application of Dressing |
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Debridement of Wound |
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Wound Care |
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OB/GYN | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Electrodesiccation and Curettage (ED&C) |
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Nipple Reconstruction |
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Musculoskeletal | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Arthrocentesis |
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External Hardware and Pin Care |
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Arthroscopy |
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Open Reduction and Internal Fixation |
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Closed Reduction and Internal Fixation |
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Plastics | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Liposuction |
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Plastic Surgery |
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Cosmetic |
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General Medications/Therapeutic Interventions | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Administer IM and SQ Meds |
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Administer Inhalation Medications |
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Administer PO Medications |
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Bladder Irrigation and Instillation |
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Needleless Systems |
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Chemotherapy |
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IV Therapy | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Infusion Pumps |
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Peipheral IV Insertion |
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Syringe Pumps |
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Vascular Access Devices Care/Maintenance |
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Administer IV Medications |
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Oxygen Administration | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Ambu-Bug |
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Nasal Cannula |
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Non-ReBreather Mask |
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Pulse Oximetry |
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Venti Mask |
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Face Mask |
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Nutritional Therapy | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Lipids |
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TPN |
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Procalamine |
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Enteral Administration |
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Pain Management/Anesthesia | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Inplantable Narcotic Pump Re ll |
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Moderate Sedation |
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Epidural |
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Spinal |
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Local |
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General |
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Axillary Block |
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Bier Block |
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Blood | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Blood and Blood Products |
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Albumin |
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General Procedures/Equipment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Apply Immobilizers (clavicle, knee, etc.) |
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Assist with Code Resuscitation |
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Assist with Lumbar Puncture |
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Laser |
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Dermabrasion |
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Drain Removal |
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Incision and Drainage |
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NGT Insertion |
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Patch Test |
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Punch Biopsy |
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Procedure Set Up |
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Procedures/Equipment Continued |
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Remove External Fixators With Pin |
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Scissor Biopsy |
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Scrub |
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Screw-Hardware Removal |
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Set-up Assist Suturing |
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Staple Removal |
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Straight/Foley Cath Female |
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Straight/Foley Cath Male |
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Suture Removal |
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TENS (Transcutaneous Elec. Nerve Stimulator) |
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Use of Doppler |
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Specimen Collections | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Venipuncture |
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Clean Catch Urine |
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Sterile Urine Collection |
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Stool |
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Sputum |
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Butter y Stick |
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Central Line Draw |
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Clinical Settings | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Surgi-Center |
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Out Patient Clinic |
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Age Group Experience Continued |
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Physician O ce |
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Ambulatory Surgery Clinic |
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Joint Commission | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
National Safety Goals |
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“Do Not Use” Abbreviations and Terms |
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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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