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.
| WORK SETTINGS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Level I Trauma Center |
 |
||||||
| Level II Trauma Center |
|
||||||
| Non-Trauma Center Emergency Department |
|
||||||
| Pediatric Emergency Department |
|
||||||
| Emergency Department - Combined Adult/Pediatric |
|
||||||
| Critical Care Transport |
|
||||||
| CARDIAC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Acute Coronary Syndrome |
|
||||||
| Congestive Heart Failure/Pulmonary Edema |
|
||||||
| Aneurysm |
|
||||||
| Cardioversion |
|
||||||
| Transcutaneous Pacemaker |
|
||||||
| Heart Sound |
|
||||||
| PULMONARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Respiratory Failure |
|
||||||
| COPD/Asthma |
|
||||||
| Aspiration |
|
||||||
| Pneumonia |
|
||||||
| Pneumo/Hemothorax |
|
||||||
| Chest Tube Insertion/Management |
|
||||||
| Pulmonary Embolism |
|
||||||
| Tuberculosis |
|
||||||
| External CPAP/BiPAP |
|
||||||
| Intubation |
|
||||||
| Ventilated Patients |
|
||||||
| ABG Interpretation |
|
||||||
| NEUROLOGICAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| CVA |
|
||||||
| Stroke Scale |
|
||||||
| Brain Injury |
|
||||||
| Glascow Coma Scale |
|
||||||
| Spinal Cord Injury |
|
||||||
| Meningitis |
|
||||||
| Seizures |
|
||||||
| ORTHOPEDICS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Fractures/Casting |
|
||||||
| Open/Complex Fractures |
|
||||||
| Apply/Manage Splints |
|
||||||
| Circulation Checks |
|
||||||
| GASTROINTESTINAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| GI Bleeding |
|
||||||
| Liver Disease |
|
||||||
| GI Obstruction |
|
||||||
| Abdominal Pain/Distress |
|
||||||
| Gastric Tubes |
|
||||||
| RENAL/GU | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Acute Renal Failure |
|
||||||
| Renal Calculi |
|
||||||
| Renal Trauma |
|
||||||
| Testicular Torsion |
|
||||||
| ENDOCRINE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Hypoglycemia |
|
||||||
| Hyperglycemia |
|
||||||
| DKA |
|
||||||
| WOUND MANAGEMENT | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Skin Integrity Assessment |
|
||||||
| Wound Repair |
|
||||||
| SHOCK/TRAUMA | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Some items are covered in system specific areas. |
|
||||||
| Injury Severity Score |
|
||||||
| Trauma Code |
|
||||||
| Trauma Team Member |
|
||||||
| Major Trauma |
|
||||||
| Traumatic Amputation |
|
||||||
| Peritoneal Lavage |
|
||||||
| Hypovolemic Shock |
|
||||||
| Neurogenic Shock |
|
||||||
| Anaphylactic Shock |
|
||||||
| Septic Shock |
|
||||||
| Cardiogenic Shock |
|
||||||
| Burns - 2nd Degree |
|
||||||
| Burns - 3rd Degree |
|
||||||
| INFECTIOUS DISEASE/IMMUNOSUPPRESSED PATIENTS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Contagious/Infectious Patients |
|
||||||
| Isolation |
|
||||||
| Neutropenia/Reverse Isolation |
|
||||||
| WOMEN'S HEALTH | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Placenta Abruptio/Previa |
|
||||||
| Precipitous Delivery |
|
||||||
| Pregnancy Induced Hypertension |
|
||||||
| Fetal Heart Tones |
|
||||||
| Sexual Assault |
|
||||||
| Reporting Acts of Violence |
|
||||||
| PEDIATRICS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Management of Pediatric Emergency Patients |
|
||||||
| Identification/Reporting Abuse |
|
||||||
| Abdominal Pain |
|
||||||
| Epiglottitis |
|
||||||
| Asthma/Reactive Airway Disease |
|
||||||
| Fractures |
|
||||||
| Head/Spinal Injury |
|
||||||
| Poison Ingestion |
|
||||||
| Seizures |
|
||||||
| Sickle Cell Crisis |
|
||||||
| PSYCHIATRIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Acute Psychotic Patient |
|
||||||
| Managing Violent Behavior |
|
||||||
| Drug /ETOH Overdose/Withdrawal |
|
||||||
| Psychiatric Hold |
|
||||||
| Suicidal Patient |
|
||||||
| MISCELLANEOUS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Bites- Animal/Snake/Human |
|
||||||
| Hazardous Material Exposure |
|
||||||
| Heat Exhaustion/Stroke |
|
||||||
| Drowning |
|
||||||
| IV THERAPY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Starting IVs |
|
||||||
| Central Line Placement |
|
||||||
| Intraosseous Infusion |
|
||||||
| Blood Product Administration |
|
||||||
| MEDICATIONS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Anti-Arrhythmics |
|
||||||
| Anticoagulants (IV, oral, & injection) |
|
||||||
| Anti-Hypertensives |
|
||||||
| Anti-Psychotics |
|
||||||
| Anti-Seizure Medications |
|
||||||
| Benzodiazepines |
|
||||||
| Continuous IV Paralytics |
|
||||||
| Continuous IV Sedation |
|
||||||
| Procedural Sedation - Administration |
|
||||||
| Emergency Medications |
|
||||||
| Inhaled Medications |
|
||||||
| Insulin |
|
||||||
| IV Vasopressors |
|
||||||
| Narcotics/Opioid Analgesics (IV, oral, & injection) |
|
||||||
| Nitrates (Oral & Topical) |
|
||||||
| Non-Opioid Analgesics (IV, Oral, & Injection) |
|
||||||
| Reversal Agents |
|
||||||
| Thrombolytic Therapy |
|
||||||
| Steroids (IV, Oral, Inhaled) |
|
||||||
| Automated Medication Dispensing (i.e. Pyxis, Omnicell) |
|
||||||
| CARDIAC MONITORING & EMERG. RESPONSE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Dysrhythmia Interpretation |
|
||||||
| Dysrhythmia Management |
|
||||||
| Obtain 12 Lead EKG |
|
||||||
| Interpret 12 Lead EKG |
|
||||||
| Management of Cardiac Arrest |
|
||||||
| PROFESSIONAL KNOWLEDGE AND SKILLS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Triage |
|
||||||
| Ambulance/Paramedic Radio |
|
||||||
| Charge Experience |
|
||||||
| AMA procedures |
|
||||||
| EMTALA |
|
||||||
| National Patient Safety Goals/Core Measures |
|
||||||
| Fall Risk Assessment/Prevention |
|
||||||
| Pressure Ulcer Risk Assessment/Prevention |
|
||||||
| Restraints/Use of Least Restrictive Device |
|
||||||
| Patient/Family Teaching |
|
||||||
| Age Specific/Population-Based Care |
|
||||||
| Isolation Precautions |
|
||||||
| Infection Prevention |
|
||||||
| Pain Assessment & Management |
|
||||||
| Interpretation and Communication of Lab Values |
|
||||||
| 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) |
|
||||||
| EMR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Epic |
|
||||||
| Cerner |
|
||||||
| Eclipsys |
|
||||||
| McKesson |
|
||||||
| Meditech |
|
||||||
| Allscripts |
|
||||||
| Other Computerized System |
|
||||||
| Computerized Physician Order Entry |
|
||||||
| Bar Coding for Medication Administration |
|
||||||