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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| 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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| 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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| 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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