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.
CARDIOVASCULAR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
ACS/Post MI |
|
||||||
Heart Failure |
|
||||||
Post Cardiac Surgery |
|
||||||
Cardiac Auscultation (Rate/Rhythm) |
|
||||||
Peripheral Pulse/Circulation Checks |
|
||||||
PULMONARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Asthma |
|
||||||
COPD |
|
||||||
Pneumonia |
|
||||||
Lung Cancer |
|
||||||
Pulmonary Emboli |
|
||||||
Auscultate Lung Sounds |
|
||||||
Oxygen Administration |
|
||||||
Oxygen Safety |
|
||||||
Oro/Nasotracheal Suctioning |
|
||||||
CPAP/BiPAP |
|
||||||
Ventilator Management (Specify): |
|
||||||
NEUROLOGICAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
CVA |
|
||||||
Alzheimer's Disease/Dementia |
|
||||||
Parkinson's |
|
||||||
Degenerative Neurologic Disorders (ALS, MS, etc.) |
|
||||||
Brain Tumor |
|
||||||
Brain Injury |
|
||||||
Para/Quadriplegia |
|
||||||
Seizure Disorder |
|
||||||
Level of Consciousness/Neuro Changes |
|
||||||
ORTHOPEDICS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Joint Replacement |
|
||||||
DVT Prophylaxis/Recognition |
|
||||||
Incision Checks |
|
||||||
Staple Removal |
|
||||||
Fractures |
|
||||||
Cast/Brace |
|
||||||
Amputation |
|
||||||
Arthritis |
|
||||||
Assistive Equipment/Lift Devices |
|
||||||
In Home PT/INR (Specify): |
|
||||||
GASTROINTESTINAL | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Nutritional Assessment |
|
||||||
Colostomy/Ileostomy Management |
|
||||||
Fecal Incontinence/Diarrhea |
|
||||||
Bowel Obstruction |
|
||||||
GI Bleed |
|
||||||
Post GI Surgery |
|
||||||
Hepatitis Liver Failure |
|
||||||
NG Tubes |
|
||||||
Feeding Tubes |
|
||||||
Feeding Pumps (Specify): |
|
||||||
Drainage Devices |
|
||||||
RENAL/GENITOURINARY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Hemodialysis |
|
||||||
AV Fistula/Shunt |
|
||||||
Peritoneal Dialysis |
|
||||||
Post Bladder Surgery |
|
||||||
Post Prostate Surgery |
|
||||||
Urostomy |
|
||||||
Urinary Incontinence |
|
||||||
Bladder Catheter Insertion/Maintenance |
|
||||||
Suprapubic Catheter Insertion/Maintenance |
|
||||||
ENDOCRINE/METABOLIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Diabetes |
|
||||||
Hyper/Hypoglycemia |
|
||||||
Diabetic Skin Assessment |
|
||||||
Cushing's / Addison's Disease |
|
||||||
Thyroid Disease |
|
||||||
Insulin Pumps |
|
||||||
Glucometers |
|
||||||
WOUND/SKIN CARE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Braden Scale |
|
||||||
Pressure Ulcer Prevention |
|
||||||
Pressure Ulcer Staging |
|
||||||
Pressure Ulcer Management |
|
||||||
Burns |
|
||||||
Wound Care |
|
||||||
Wound Cultures |
|
||||||
Wound Vac |
|
||||||
ONCOLOGY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Risk for Infection |
|
||||||
Symptom Management |
|
||||||
Side Effects of Treatment |
|
||||||
Terminal Disease |
|
||||||
INFECTIOUS DISEASE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
MRSA |
|
||||||
VRE |
|
||||||
C. Difficile |
|
||||||
HIV |
|
||||||
Tuberculosis |
|
||||||
Isolation Precautions |
|
||||||
PHLEBOTOMY/IV THERAPY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Peripheral Venipuncture for Labs |
|
||||||
Start Ivs |
|
||||||
Peripheral Ivs |
|
||||||
PICC/CVP Lines |
|
||||||
Venous Access Ports |
|
||||||
Infusion Pump Set up and Management |
|
||||||
Specify Infusion Pump Type: |
|
||||||
PSYCHIATRIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Cognitive Disorders |
|
||||||
Mood Disorders |
|
||||||
Schizophrenia/Psychotic Disorders |
|
||||||
Medication Compliance |
|
||||||
WOMENS HEALTH/MATERNAL-INFANT CARE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Pregnancy Related Complications |
|
||||||
Fetal Heart Tones |
|
||||||
Contractions |
|
||||||
Post Partum Mother/Baby Visit |
|
||||||
Newborn Care |
|
||||||
Phototherapy |
|
||||||
Breast Feeding Support |
|
||||||
PEDIATRICS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Growth and Development |
|
||||||
Respiratory Distress Syndrome |
|
||||||
Bronchopulmonary Dysplasia |
|
||||||
Cystic Fibrosis |
|
||||||
Muscular Dystrophy |
|
||||||
Spina Bifida |
|
||||||
Spinal Surgery |
|
||||||
Sickle Cell Disease |
|
||||||
Trach Care/Suctioning |
|
||||||
Ventilator Management |
|
||||||
Ventilator Type (Specify): |
|
||||||
PAIN MANAGEMENT | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Verbal/Nonverbal Pain Scales |
|
||||||
Response to Pain Management Interventions |
|
||||||
PCA Pump |
|
||||||
Epidural Cath/Site Monitoring/Pump |
|
||||||
Non-Pharmacologic Pain Measures |
|
||||||
PALLIATIVE AND END OF LIFE CARE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Palliative Symptom Management |
|
||||||
Pain Management/Response |
|
||||||
Family Support/Teaching |
|
||||||
After Death Protocols |
|
||||||
MEDICATIONS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Alzheimer's Medications |
|
||||||
Antiarrhythmics |
|
||||||
Antibiotics/Antivirals |
|
||||||
Anti-Depressants |
|
||||||
Anti-Hypertensives |
|
||||||
Anti-Psychotics |
|
||||||
Anti-Seizure Medications |
|
||||||
Benzodiazepines |
|
||||||
Calculation of Pediatric Dosages |
|
||||||
Coumadin |
|
||||||
Diuretics |
|
||||||
Enoxaparin |
|
||||||
Inhaled Medications |
|
||||||
Nebulizer Medications |
|
||||||
Insulin |
|
||||||
Opioid and Non-Opioid Analgesics |
|
||||||
Oral Chemotherapy |
|
||||||
Oral Hypoglycemics |
|
||||||
Oral & Topics Nitrates |
|
||||||
Rivaroxaban |
|
||||||
Sedative/Hypnotics |
|
||||||
Steroids |
|
||||||
HOME HEALTH | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Intake/Admissions |
|
||||||
Case Manager |
|
||||||
Case Load - Pts/Day(specify) |
|
||||||
Supervise LVNs/HHAs |
|
||||||
Medicare/Medicaid |
|
||||||
Long/Short Term Disability |
|
||||||
Private Insurance |
|
||||||
Telephonic Assessments |
|
||||||
Management of Complaints |
|
||||||
APS Reports |
|
||||||
OASIS |
|
||||||
Diagnosis Coding |
|
||||||
Document Plan of Care |
|
||||||
Clinical Assessment Documentation |
|
||||||
PROFESSIONAL KNOWLEDGE AND SKILLS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
National Patient Safety Goals/Core Measures |
|
||||||
Safety Assessment |
|
||||||
Fall Assessment and Prevention |
|
||||||
Patient/Family Teaching |
|
||||||
Age Specific/Population Based Care |
|
||||||
EMR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Allscripts |
|
||||||
Cerner |
|
||||||
Epic |
|
||||||
HomeCare Home Base |
|
||||||
McKesson |
|
||||||
Meditech |
|
||||||
Other Computerized Documentation System |
|
||||||
EMR Conversion |
|
||||||
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 |
|