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 Care of Patient with | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Acute MI |
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CHF |
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Angina Hypertension |
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Cardiomyopathy Cardiopulmonary Arrest |
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Abdominal Aortic Aneurysm |
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Carotid Endarterectomy |
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Femoral Popliteal Bypass |
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Pre & Post Cardiac Surgery |
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Pre & Post Cardiac Cath |
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Pre & Post PTCA |
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Permanent Pacemaker Temporary PacemakerExternal Pacemaker |
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Cardiac Lab Interpretation |
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Cardiac Patient/Family Teaching |
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RESPIRATORY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Respiratory assessment |
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Assess Lung sounds |
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Chest percussion |
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Establish/Protect Airway |
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Chest tubes/Pleurevac |
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Oxygen therapy |
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Drawing ABGs |
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Interpretation of ABGs |
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Incentive Spirometry |
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Suctioning: oral nasotracheal endotracheal tube tracheostomy tube |
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Oxygen Equipment Set Up and Maintenance: nasal canula non-rebreather mask venti-mask ET |
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Inturbation/extubationambu bag pulse oximetry |
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Care of patient with: COPD tracheostomy pulmonary edema ARDS ventilator (A/C, IMV, PEEP) pre/post-op thoracis surgery pneumonia chest tubes asthma emphysema |
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NEUROLOGY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Neurological assessment |
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Seizure precautions |
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Assessment and Management of Seizure Activity |
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Assisting with lumbar puncture |
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Signs/Symptoms of increasing ICP |
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Glascow Coma Scale |
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Crutchfield tongs |
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Circo-electric bed Halo traction |
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Stryker frame |
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Care of patient with: seizures CNS infection overdose DTs spinal cord injury acute head injury CVA/TIA neuromuscular disease pre/post neuro surgery |
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GASTROINTESTINAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
G.I. assessment |
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Bowel sounds |
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Inserting N-G tubes |
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Colostomy care |
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Measurement of I & O |
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Administration of tube feedings |
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Care of patients with: GI bleed NG tube G-tube J-tube abdominal wounds/surgeries inflammatory bowel disease bowel obstruction |
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RENAL/GENITOURINARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Insertion and care of: straight cath Indwelling urinary cath: male female 3-way |
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Care of Patient with: Bladder Irrigation Suprapubic Tube Nephrostomy Tube Renal Transplant Nephrectomy Renal Transplant BPH Pre/post Turp |
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ORTHOPEDIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Total Knee Replacement |
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Bucks Extension |
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Cast Care |
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Crutch Walking |
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K-Wires |
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Spica Casts |
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Balanced Suspension Traction |
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Circulation Checks |
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Care of Patient with: Amputation Rheumatic/Arthritic Disease Multiple Trauma Paraplegia External Fixation Post Arthroplasty |
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GENERAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Blood Glucose Monitoring |
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Dressing Changes |
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Universal Precautions |
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Isolation |
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Discharge Planning |
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Care of Patient with: Diabetes Pressure Sores Sickle Cell Anemia Cancer Alzheimer's Disease HIV/AIDS |
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MEDICATIONS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Unit Dose |
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Dosage Calculation |
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Pouring from stock medication |
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Administration of Code Cart Emergency Drugs |
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Aminophylline |
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Ativan |
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Atropine |
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Chemotherapy Agents |
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Corticosteroids |
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Decadron |
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Digoxin |
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Dilantin |
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Dobutamine |
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Dopamine |
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Heparin Inhalers |
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Lidocaine |
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Lopressor |
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Magenesium Sulfate |
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Nipride Nitroglycerin |
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Phenobarbital |
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Thrombolytic Agents |
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Valium |
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Verapamil |
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IV THERAPY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Inserting IVs Mixing IV solutions |
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Heparin locks |
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TPN/Hyperalimentation |
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IV push IV drip Infusion pumps Syringe pumps |
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Continuous Subcutaneous Infusion Pumps |
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PCA Pumps |
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Ultrasonic Doppler |
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CVP lines/measurement of CVP |
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Central line dressing change |
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Blood/Blood products administration ordering/obtaining from blood bank identification/intercession for adverse reaction |
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Multi-lumen central venous catheters Implanted CVC (port-a-cath) |
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Assessment of IV insertion site |
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Assist with insertion of central line |
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X-ray/assessment after insertion |
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Care of patient with Central Line |
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Charge Nurse Experience? |
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CPR certified? |
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BCLS certified? |
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ACLS certified? |
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Knowledge of normal values? |
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Have you had a dysrhythmia course? |
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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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