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 | ||
Acute Coronary Syndrome |
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Congestive Heart Failure |
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Post Open Heart (12-24 hours) |
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Carotid Endarterectomy |
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Post Vascular Surgery |
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Heart Transplant |
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Pacemaker - Temporary/Permanent |
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Pacemaker - Epicardial |
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Sheath Removal |
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Heart Sounds |
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PULMONARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Pneumonia |
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Respiratory Distress |
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COPD |
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Breath Sounds |
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Post Thoracic Surgery |
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Chest Tube Placement & Management |
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Trach Management |
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Modes of Ventilation (AC/PC/SIMV/CPAP) |
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Intubation/Extubation |
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External CPAP/BiPAP |
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Interpretation of Arterial Blood Gases |
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NEUROLOGIC & PSYCHIATRIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Stroke Scale Assessment |
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CVA |
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Brain Injury |
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Post Craniotomy |
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Spinal Cord Injury |
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Seizure Disorders |
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ETOH/Drug Withdrawal |
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GASTROINTESTINAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
GI Bleeding |
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GI Surgery |
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Liver Failure |
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Pancreatitis |
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Liver Transplant |
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Pancreas Transplant |
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RENAL/GENITOURINARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Renal Failure |
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Renal Surgery |
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Renal Transplant |
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Arteriovenous Fistula/Shunt |
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Nephrostomy Tubes |
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Peritoneal Dialysis |
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ENDOCRINE METABOLIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Diabetes - Hypo/Hyperglycemic Crisis |
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Pituitary Disorders |
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IV Insulin Protocols |
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Indwelling Insulin Pumps |
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MEDICATIONS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Anti-Arrhythmics |
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Anticoagulants (IV, oral, & injection) |
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Anti-Hypertensives |
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Anti-Psychotics |
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Anti-Seizure Medications |
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Benzodiazepines |
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Procedural Sedation |
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Diuretics |
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Emergency Medications |
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Inhaled Medications |
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Insulin |
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Titrate Vasoactive Drips |
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Manage Vasoactive Drips - No Titration |
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Narcotics/Opioid Analgesics (IV, oral, & injection) |
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Nitrates (Oral & Topical) |
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Non-Opioid Analgesics (IV, Oral, & Injection) |
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Reversal Agents |
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Steroids (IV, Oral, Inhaled) |
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Automated Medication Dispensing (i.e. Pyxis, Omnicell) |
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IV THERAPY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Starting Ivs |
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Central Line Blood Draws |
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Central Line/Implanted Line Care |
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Arterial Line Management |
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TPN & Lipids |
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Blood Product Administration |
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Administration of Chemotherapy |
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CARDIAC MONITORING & EMERG. RESPONSE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Dysrhythmia Interpretation |
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Dysrhythmia Management |
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Obtain 12 Lead EKG |
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Interpret 12 Lead EKG |
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Cardioversion |
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Defibrillation |
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Malignant Hyperthermia |
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PROFESSIONAL KNOWLEDGE AND SKILLS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
National Patient Safety Goals/Core Measures |
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Fall Risk Assessment/Prevention |
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Pressure Ulcer Risk Assessment/Prevention |
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Restraints/Use of Least Restrictive Device |
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Patient/Family Teaching |
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Age Specific/Population-Based Care |
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Isolation Precautions |
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Infection Prevention |
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Pain Assessment & Management |
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Charge Experience |
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Interpretation and Communication of Lab Values |
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Specialty Beds |
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EMR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Epic |
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Cerner |
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Eclipsys |
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McKesson |
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Meditech |
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Other Computerized System |
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Computerized Physician Order Entry |
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Bar Coding for Medication Administration |
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