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.
| CARDIAC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Use of cardiac monitors |
 |
||||||
| Assessment of heart sounds |
|
||||||
| Cardiac Arrest |
|
||||||
| CPR |
|
||||||
| Care of patients with CHF |
|
||||||
| Atropine administration |
|
||||||
| Digoxin administration |
|
||||||
| Dopamine administration |
|
||||||
| Inderal administration |
|
||||||
| Lidocaine administration |
|
||||||
| GENITOURINARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Fluid Balance |
|
||||||
| Foley Catheter Insertion |
|
||||||
| Ileostomy |
|
||||||
| GU Irrigations |
|
||||||
| Nephrostomy Tube |
|
||||||
| ENDOCRINE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Blood Glucose Checks |
|
||||||
| Insulin Administration |
|
||||||
| Care of patients with Diabetes |
|
||||||
| GASTROINTESTINAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| NG tube care and feedings |
|
||||||
| Gastrostomy tube care and feedings |
|
||||||
| Colostomy Care |
|
||||||
| Assessment of Bowel Sounds |
|
||||||
| LEADERSHIP/PATIENT CARE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Taking Charge |
|
||||||
| Admission Procedures |
|
||||||
| Discharge Procedures |
|
||||||
| Patient Education |
|
||||||
| Patient Care Plans |
|
||||||
| MEDICATIONS/IV THERAPY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Medication Calculation |
|
||||||
| Reconstitution |
|
||||||
| Oral Administration |
|
||||||
| Eye Administration |
|
||||||
| IM Administration |
|
||||||
| SQ Administration |
|
||||||
| Rectal Administration |
|
||||||
| Starting IV’s |
|
||||||
| IV Medication Administration |
|
||||||
| Central Line Care |
|
||||||
| NEUROLOGY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Assessment of Neurological Status |
|
||||||
| Seizure Precautions |
|
||||||
| Care of a patient with a CVA |
|
||||||
| Care of a patient with Alzheimer’s |
|
||||||
| Care of patients with Spinal Cord Injury |
|
||||||
| Decadron Administration |
|
||||||
| Dilantin Administration |
|
||||||
| Phenobarbital Administration |
|
||||||
| Valium Administration |
|
||||||
| ORTHO/SKIN | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Assessment of skin |
|
||||||
| Wound Care and Treatments |
|
||||||
| Use of special pressure relief devices |
|
||||||
| Care of pts with a total hip replacement |
|
||||||
| Care of pts with a total knee replacement |
|
||||||
| Crutch Walking |
|
||||||
| RESPIRATORY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Pulse Oximetry |
|
||||||
| Oxygen Administration via nasal cannuia |
|
||||||
| Oxygen Administration via face mask |
|
||||||
| Principles of chest percussion |
|
||||||
| Care of patients with ventilator |
|
||||||
| Care of patients with COPD |
|
||||||
| Care of patients with ARDS |
|
||||||
| Care of patient with a Tracheotomy |
|
||||||
| 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) |
|
||||||