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 | ||
| Angina |
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| Post Acute MI |
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| Congestive Heart Failure |
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| Post Cardiac Cath |
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| Post Cardiac Surgery |
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| Aneurysm |
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| Carotid Endarterectomy |
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| Post Vascular Surgery |
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| Post Cardiac Transplant |
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| PULMONARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Pneumonia |
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| COPD |
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| Tuberculosis |
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| Pulmonary Embolism |
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| Tracheostomy Management |
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| CPAP/BiPAP |
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| Interpretation of Arterial Blood Gases |
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| Post Lung Transplant |
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| NEUROLOGICAL & PSYCHIATRIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Stroke Scale Assessment |
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| Traumatic Brain Injury |
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| CVA |
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| Post Craniotomy |
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| Seizure Disorders |
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| Spinal Cord Injuries |
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| Mood Disorders |
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| Substance Withdrawal |
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| ORTHOPEDICS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Circulation/Skin Checks |
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| Continuous Passive Motion Devices |
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| Ambulation Assistive Devices |
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| Prosthetics |
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| Cast Care |
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| Pin Care |
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| Traction |
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| Total Joint Replacement |
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| Amputation |
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| GASTROINTESTINAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Bariatrics |
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| Feeding Tubes |
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| GI Bleeding |
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| Bowel Obstruction |
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| GI Surgery |
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| Liver Disease |
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| Pancreatitis |
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| Post Liver Transplant |
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| Post Pancreas Transplant |
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| RENAL/GENITOURINARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Arteriovenous Fistula/Shunt |
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| 3 Way Catheter & Bladder Irrigation |
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| Suprapubic Catheter |
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| Renal Failure |
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| Peritoneal Dialysis |
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| GU Surgery |
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| Nephrostomy Tubes |
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| Renal Transplant |
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| Management Pre/Post Hemodialysis |
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| Gyn Surgery |
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| ENDOCRINE METABOLIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Diabetes Type I |
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| Diabetes Type II |
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| Blood Glucose Monitoring |
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| IV Insulin Protocols |
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| Management of Hypoglycemia |
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| Indwelling Insulin Pumps |
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| Pituitary Disorders |
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| ONCOLOGY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Chemotherapy Administration |
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| Radiation Therapy |
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| Medical Oncology |
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| Surgical Oncology |
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| Radiation Implants |
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| Bone Marrow Transplant |
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| MEDICATIONS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Antiarrhythmics |
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| Anticoagulants (IV, oral, & injection) |
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| Anti-Depressants |
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| Anti-Hypertensives |
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| Anti-Psychotics |
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| Benzodiazepines |
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| Emergency Medications |
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| Epidural Analgesia |
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| Inhaled Medications |
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| Insulin |
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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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| Oral Hypoglycemics |
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| Patient Controlled Analgesia |
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| Procedural Sedation Administration |
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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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| TPN & Lipids |
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| Blood Product Administration |
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| Monitoring of Chemotherapy |
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| CARDIAC MONITORING & EMERG. RESPONSE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Placement of Telemetry Leads |
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| Rhythm Interpretation |
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| Dysrhythmia Management |
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| Obtain 12 Lead EKG |
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| Use of Rapid Response Teams |
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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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| Wound Care /Wound Vac |
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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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| EMR Conversion |
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