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 | ||
| Adult/adult ICU |
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| Children’s hospital |
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| General acute care |
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| Home health care |
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| Outpatient neuro |
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| Outpatient ortho |
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| Pediatrics/PICU |
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| Psychiatric hospital |
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| Rehabilitation hospital |
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| School setting |
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| Early intervention |
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| Skilled care facility |
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| Subacute |
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| Orthopedics | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Upper extremities |
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| Arthritis programs |
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| Back syndrome |
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| Cervical injuries |
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| Chronic fatigue syndrome |
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| Fibromyalgia |
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| Halo traction |
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| Hand injury |
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| Hip fracture |
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| Kyphoplasty |
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| Orthopedics - cont. | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Manual therapy |
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| Mobilization techniques |
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| Pelvic fracture |
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| Postpolio syndrome |
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| Shoulder injuries |
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| TMJ dysfunction |
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| Total hip/total knee |
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| Total joint replacement |
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| Total shoulder/CPM |
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| Neurologic | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| ALS |
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| Brain tumors |
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| Cerebral palsy |
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| Multiple sclerosis |
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| Muscular dystrophy |
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| Polio/post polio syndrome |
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| Spinal cord injury |
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| Adaptive equipment |
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| Functional splinting |
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| Neurodevelopmental testing (NDT) |
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| Head trauma |
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| Glasgow coma scale |
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| Stroke rehabilitation |
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| Wheelchair prescription |
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| Pediatrics | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Activities of daily living |
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| Adaptive |
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| Developmental disability |
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| Equipment assessment |
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| Individualized education programs |
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| Neurodevelopmental testing (NDT) |
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| Orthotics |
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| Sequencing testing |
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| Sports Medicine | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Biodex |
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| Bracing/joint |
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| Cybex |
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| Immobilization |
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| Lido |
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| Medical expenses (Norwegian) |
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| Nautilus/eagle |
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| Orthotron/kinetron |
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| Stabilization techniques |
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| Swiss ball |
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| Taping/strapping |
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| Prosthetics/Orthotics | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Dynamic splints |
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| LE prosthetics |
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| Protonics |
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| Removeable rigid dressings |
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| Serial casting |
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| Static splints |
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| UE prosthetics |
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| Modalities | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Anodyne |
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| Biofeedback |
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| Edema massage |
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| Fluidotherapy |
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| Iontophoresis |
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| JOBST compression pump |
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| Muscle stimulation |
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| Paraffin bath |
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| Phonophoresis |
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| TENS |
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| Therapeutic pool |
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| Ultrasound |
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| Other | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Burn management |
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| Cardiac rehabilitation |
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| Chest physical therapy |
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| DME ordering |
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| FIM scoring |
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| Job task analysis |
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| Lymphedema management |
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| OASIS assessment for home care |
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| Obstetrics in physical therapy |
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| Tone management/spasticity |
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| Wheelchair ordering for SCI patients |
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| Work capacity evaluation |
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| Work hardening |
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| Wound care |
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| Medicare |
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| Medicaid |
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| MDS |
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| General Skills | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Patient/family teaching |
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| Patients in isolation |
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| Patients in restraints |
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| Initial evaluation |
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| Lift/transfer devices |
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| Specialty beds |
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| End of life care/palliative care |
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| Cerner |
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| EPIC |
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| McKesson |
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| Meditech |
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| Accurate patient identification |
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| Effective communication |
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| General Skills - cont. | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Pain assessment & management |
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| Infection control |
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| Universal precautions |
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| Care of patients in isolation |
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| Minimize risk of falls |
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| Prevention of pressure ulcers |
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| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Infant (birth to 1 year) |
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| Toddler (ages 1-3 years) |
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| Preschooler (ages 3-5 years) |
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| Childhood (ages 6-12 years) |
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| Adolescents (ages 12-21 years) |
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| Young Adults (ages 21-39 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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