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.
Medication Administration | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Documentation on M.A.R. |
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Dose calculation |
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Generic equivalents |
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Usage of PDR |
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Knowledge of drug actions/interactions |
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Verification of narcotic wastage |
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Oral medications |
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Sublingual medications |
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Intradermal medications |
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Parenteral medications |
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Subcutaneous medications |
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Intramuscular medications |
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Topical medications |
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Eye drops |
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Ear drops |
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Swallowing precautions |
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Inventory and storage control |
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Infectious Control | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
AIDS/HIV interaction |
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Hepatitis interaction |
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Hospice |
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MRSA |
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VRE |
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Fever management |
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Interpretation of labs |
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Decubitus/Wound care (Contaminated) |
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Linen -Transporting, storing, & Handling |
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Cleaned |
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Soiled |
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Personal clothing |
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Proper disposal of sharpes and waste |
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Standard precautions |
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Pain Management | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Documentation and assessment of site, character, & frequency of pain |
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Assessment of pain levels |
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Documentation of response to pain medications |
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Intraveneous Therapy | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
I.V. certified (Check '4') |
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Administration of I.V. antibiotics |
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Administration of I.V. fluids |
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Administration of I.V. pain medications |
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Administration of I.V. cardiac meds |
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Blood draws - peripheral |
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Blood draws - central line |
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Blood draws - implanted catheter |
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Care of I.V. site - peripheral |
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Care of I.V. site - central line |
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Care of I.V. site - implanted catheter |
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I.V. dose calculations |
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I.V. insertion - peripheral |
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Use of infusion pumps |
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Diabetic Care | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Diabetic monitoring |
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S/S hyper/hypoglycemia |
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Diabetic patient teaching |
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Performing fingersticks |
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Use of glucometers |
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Insulin infusions |
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Regular, long-acting insulin |
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Mixed insulin |
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Psychosocial Problems | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment and documentation of behavioral problems (target behaviors) |
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Assessment and documentation of s/s of depression |
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Assessment and documentation of patient response to psychotropic medications |
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Parameters for use of restraints in long-term care settings |
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Assessment and documentation of effectiveness of preventive medicine medications |
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Orthopedics | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment of circulation |
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Assessment of gait |
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Assessment of range of motion |
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Amputation care |
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Post-arthroscopy care |
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Casts and related care |
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Osteoporosis |
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Pinned fractures |
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Total hip replacement |
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Total knee replacement |
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Rheumatic/Arthritic disease |
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Continuous passive motion |
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Canes |
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Cervical collars |
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Gait belts |
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Prostheses |
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Slings |
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Transfer board |
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Walker |
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Wheelchair |
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Cardiovascular Problems | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Auscultation of rate/rythym |
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Blood pressure |
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Doppler |
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Pulses |
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Circulation checks |
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CPR |
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Post-abdominal aortic bypass |
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Aneurysm |
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Angina |
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Post carotic endarterectomy |
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Fem-pop bypass |
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Permanent pacemaker |
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Post acute M.I. |
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Post cardiac surgery |
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Thrombophlebitis |
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DVT |
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Congestive heart failure |
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Administration of post-op cardiac meds |
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Gastrointestinal Problems | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Administration of tube feedings |
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Administration of medications via tube |
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Inflammatory bowel disease |
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Bowel prep |
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G.I. bleeding |
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Gualac |
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Nutritional status |
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Colostomy care |
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Post abdominal surgery |
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NG tube placement and care |
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Nasointestinal tube care |
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Assessment of bowel tones |
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Assessment of abdomen |
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Enema administration |
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Assessment of bowel incontinence |
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Signs and symptoms of fecal impaction |
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Neurological Problems | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Post-Op anticonvulsant medications |
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Assessing levels of consciousness |
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Dementias (Re-direction/Validation) |
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Neuromuscular disease |
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CVA |
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Pupil check |
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A.I.M.S. |
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Seizure precautions |
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Administration of anticonvulsant |
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Medications |
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Aneurysm precautions |
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Spinal cord injuries - long term |
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Urinary Problems | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment and care of AV shunt |
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Post renal surgery |
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Renal failure |
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Assessment of urinary incontinence |
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Assessment of I and O data |
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Use of bladder scanne |
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Signs and symptoms of UTI |
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Indwelling catheter insertion |
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Indwelling catheter care |
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Straight catheter insertion |
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Suprapubic catheter care |
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Screening for UTI via urine dipstick |
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Wounds, Pressure Sores, and Skin Impairments | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment and care of post-surgical wounds |
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Assessment, prevention, and care of pressure ulcers |
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Assessment and documentation of skin conditions/wounds |
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Dressing changes - asceptic |
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Dressing changes - sterile |
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Wound irrigation |
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Application of wound care products |
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Use of air fluidized, low air-loss beds |
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Use of pressure-relieving seat cushions |
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Staple and suture removal |
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Other Skills | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Alert charting system |
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Use of 24-hour written and verbal reporting systems |
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Use of '911' in LTC setting |
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Regulatory guidelines related to the prevention of abuse and neglect of residents |
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Regulatory guidelines related to resident rights in LTC setting |
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Discerning code status |
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Incident and accident reporting |
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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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