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.
| Skills | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Activities of daily living |
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| Admission of patient |
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| Administration of medication |
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| Ambulation |
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| Application of heat and cold |
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| Aseptic Technique |
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| Assist with medical examination |
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| Bathing: Sitz, tub, bed, shower |
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| Bandaging |
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| Binders |
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| Body Alignment |
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| Body Systems Review (Head to Toe data collection) |
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| Cast care |
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| Catheterization / Foley catheter care |
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| Charting |
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| Colostomy Care and irrigation |
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| CPR |
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| Crutch walking |
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| Decubitus Care |
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| Diabetic tests and preparation forms |
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| Diabetic blood glucose testing |
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| Discharge patients |
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| Dosage computation |
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| Draping |
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| Dressing (sterile) |
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| Ear drops |
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| Elimination needs |
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| Enemas, cleansing, retention, Harris flush |
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| Restraints |
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| Infection Control: Standard Universal Precautions |
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| Infection Control: Reverse Isolation |
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| Infection Control: TB/ Airborne Precautions |
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| Infections Control: MRSA/ VRE Precautions |
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| Isolation procedure for specimen collection |
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| IVs: Monitor rate and infusion site |
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| Medications: Oral, IM, SQ |
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| Mouth care |
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| Nail Care |
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| Neurological Check |
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| Nutritional check |
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| Observations: Response to treatments/ meds |
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| Observations: Signs of significant body system changes |
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| Observations: Signs of shock |
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| Observations: Signs of pain |
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| Observes safety procedures |
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| O2 administration |
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| Pain assessment |
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| Patient care plans (revise and update) |
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| Patient safety standards/ precautions |
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| Positioning patient |
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| Postural drainage |
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| Pre-op and post-op care |
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| Provide comfort, safety and privacy |
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| Pulse oxymetry |
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| Range of motion |
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| Report observations/ changes |
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| Hand hygiene |
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| Skin care |
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| Specimen collection: routine urine |
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| Specimen collection: clean catch |
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| Specimen collection: 12 & 24 hour specimen |
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| Specimen collection: stool |
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| Specimen collection: culture |
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| Specimen collection: sputum |
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| Specimen collection: from foley catheter |
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| Suppositories |
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| Suction-oral |
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| Surgical Preps |
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| Computerized charting |
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| Trach care/suctioning |
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| Telephone manners |
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| Topical Medication Application |
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| Traction |
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| Transfer/ transport patients: wheelchair |
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| Transfer/ transport patients: gurney |
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| Transfer/ transport patients: to chair |
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| Urine test for glucose/ acetone |
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| Vital Signs |
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| Weight: Bed scales and standing scales |
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| IV therapy certified |
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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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