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 Skills | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Advanced directives |
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Awareness of HCAHPS |
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Patient/family teaching |
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Discharge planning |
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UR/medicare review |
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Lift/transfer devices |
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Specialty beds |
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Restrictive devices (restraints) |
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End of life care/palliative care |
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Automated Medication Dispensing System, Pyxis, Omnicell, or other |
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National Patient Safety Goals |
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Accurate patient identification |
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Effective communication |
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Awareness of patient rights |
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Interpretation & communication of lab values |
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Medication administration |
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Labeling (medications & specimens) |
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Medication reconciliation |
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Anticoagulation therapy |
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Pain assessment & management |
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Infection control |
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Universal precautions |
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Isolation |
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Minimize risk for falls |
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Prevention of pressure ulcers |
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Cardiac | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment of heart sounds |
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Identification of arrhythmias (rate/rhythm) |
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Pacemakers/AID’s |
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Cardiac arrest/CPR |
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Hypertension |
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Pre/post MI |
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CHF |
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Post cardiac surgery |
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Fluid & electrolyte imbalances |
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Anticoagulants |
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Antiarrhythmics |
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Beta blockers |
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Nitroglycerin |
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Diuretics |
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Respiratory | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment/auscultation of lung sounds |
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Establishing an airway |
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Chest PT |
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Incentive spirometry |
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Supplemental oxygen (cannula, facemask) |
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Tracheostomy care |
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Suctioning (tracheostomy & nasotracheal) |
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Nebulizer use |
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Pneumonia |
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Asthma |
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COPD |
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Emphysema |
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Bronchodilators |
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Expectorants |
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Corticosteroids |
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Neurology | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment of neuro signs |
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Seizure precautions |
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TBI (Traumatic Brain Injury: history of) |
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Seizure activity |
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Spinal cord injury |
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Stroke (CVA) |
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Multiple sclerosis |
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Alzheimer’s disease |
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Parkinson’s disease |
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ALS (Amyotrophic Lateral Sclerosis) |
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Antiseizure medications |
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Antiemetics |
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Laxatives |
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Enemas |
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Bowel prep |
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Gastrointestinal | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
NG tube (insertion/removal) |
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Long term feeding tubes (dobhoff/keofeed) |
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Gastrostomy tube |
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Tube feedings |
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Monitoring input/output |
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Colostomy/ileostomy |
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GI bleed |
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Feeding devices/adaptive equipment |
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Dietary restrictions |
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GT/PEG feedings |
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Antiemetics |
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Laxatives |
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Enemas |
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Bowel prep |
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Gastrointestinal | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Foley catheter insertion/removal |
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GU irrigations |
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Nephrostomy tube |
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Suprapubic catheter |
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Ileo conduit |
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Use of bladder scan equipment |
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Shunts and fistulas |
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Straight catheterizations |
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Incontinence/bladder training |
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Chronic renal failure/dialysis |
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Peritoneal dialysis |
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Orthopedic | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Total joint replacement |
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Arthroscopic surgery |
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Cast care |
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Pulse/CMS checks |
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Suture/staple removal |
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Prosthesis application |
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Standard extremity braces |
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Amputation |
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Stump wrapping |
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Laminectomy |
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Assistive devices |
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CPM machines |
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IV Therapy | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Start & maintain Ivs |
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Blood draw: venous |
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Central line care (PICC) |
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Blood draw: central line PICC |
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Care & management of ports |
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Infusion pumps |
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Administration of blood/blood products |
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Skin | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Wound care/surgical |
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Wound care/medical |
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Dressing changes |
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Skin assessment |
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Wound vac |
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Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Newborn/neonate (birth-30 days) |
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Infant (31 days-1 year) |
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Toddler (2-3 years) |
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Preschool (ages 4-5 years) |
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School age (ages 6-12 years) |
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Adolescents (ages 13-21 years) |
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Young adult (ages 22-39 years) |
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Adults (ages 40-64 years) |
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Older adult (ages 65-79 years) |
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Elderly (ages 80+ years) |
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