LPN CheckList

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.

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Skills Rating Stars (Click) 1 2 3 4  
Activities of daily living 
Admission of patient 
Administration of medication 
Application of heat and cold  
Aseptic Technique  
Assist with medical examination 
Bathing: Sitz, tub, bed, shower 
Body Alignment 
Body Systems Review (Head to Toe data collection) 
Cast care  
Catheterization / Foley catheter care 
Colostomy Care and irrigation 
Crutch walking 
Decubitus Care  
Diabetic tests and preparation forms  
Diabetic blood glucose testing  
Discharge patients 
Dosage computation  
Dressing (sterile)  
Ear drops 
Elimination needs 
Enemas, cleansing, retention, Harris flush  
Infection Control: Standard Universal Precautions 
Infection Control: Reverse Isolation 
Infection Control: TB/ Airborne Precautions 
Infections Control: MRSA/ VRE Precautions 
Isolation procedure for specimen collection 
IVs: Monitor rate and infusion site 
Medications: Oral, IM, SQ 
Mouth care 
Nail Care 
Neurological Check 
Nutritional check 
Observations: Response to treatments/ meds 
Observations: Signs of significant body system changes 
Observations: Signs of shock 
Observations: Signs of pain 
Observes safety procedures 
O2 administration 
Pain assessment 
Patient care plans (revise and update) 
Patient safety standards/ precautions 
Positioning patient 
Postural drainage 
Pre-op and post-op care 
Provide comfort, safety and privacy 
Pulse oxymetry 
Range of motion 
Report observations/ changes 
Hand hygiene 
Skin care 
Specimen collection: routine urine 
Specimen collection: clean catch  
Specimen collection: 12 & 24 hour specimen  
Specimen collection: stool  
Specimen collection: culture 
Specimen collection: sputum  
Specimen collection: from foley catheter 
Surgical Preps 
Computerized charting  
Trach care/suctioning 
Telephone manners 
Topical Medication Application 
Transfer/ transport patients: wheelchair 
Transfer/ transport patients: gurney 
Transfer/ transport patients: to chair 
Urine test for glucose/ acetone 
Vital Signs 
Weight: Bed scales and standing scales 
IV therapy certified 
Age Specific Competencies Rating Stars (Click) 1 2 3 4  
Infant (Birth - 1 year) 
Preschooler (ages 2-5 years) 
Childhood (ages 6-12 years) 
Adolescents (ages 13-21 years) 
Young Adults (ages 22-39 years) 
Adults (ages 40-64 years) 
Older Adults (ages 65-79 years) 
Elderly (ages 80+ years)