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 | ||
Defibrillation/Cardioversion |
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Assisting with Insertion of Central Lines |
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Pacemakers?External |
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Permanent or Temporary Pacemaker |
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Cardiac Arrest/CPR |
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A?Line (Transducer setup?D/C) |
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Swan Ganz (Transducer setup?D/C) |
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Balloon Pump (IABP) |
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SVO2 Monitoring |
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Automatic Internal Cardioverter Defib |
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Care of patient with | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Aneurysm |
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Acute MI/Unstable Angina |
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Cardiogenic/Hypovolemic Shock |
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Pre/Post Cardiac Surgery |
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Heart Transplant |
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PTCA |
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COPD |
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ARDS |
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Pulmonary Embolism |
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Pulmonary Edema |
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Pneumonia |
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Inhalation Injuries |
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CVA |
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Seizure Disorder |
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Overdose |
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Neuro Injury/Trauma |
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Pre/Post Neuro Surgery |
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Cranial Hemorrhage |
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Aphasia |
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Multiple Sclerosis |
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Pancreatitis |
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GI Bleed |
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Esophageal Bleeding |
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Bowel Obstruction |
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Liver Transplant |
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Paralitic Ileus |
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TURP |
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Shunts and Fistulas |
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Nephrectomy |
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Renal Transplant |
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Renal Trauma |
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Use and Administration of the following | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Atropine |
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Bretylol |
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Bumex |
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Digoxin |
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Dopamine |
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Dobutrex |
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Inderal |
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Inocor |
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Isuprel |
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Lidocaine |
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Neosynephrine/Nipride |
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NTG |
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Pronestyl |
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Titrate Morphine |
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Verapamil |
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Thrombolitic Agents |
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Prep/Titration of Emergency Drugs |
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Aminophylline |
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Corticosteroids |
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Bronkosol |
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Ventolin |
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Alupent |
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Decadron |
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Dilantin |
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Magnesium Sulfate |
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Phenobarbital |
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Steroids |
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Valium |
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Versed |
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Respiratory | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Lung Transplant |
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Establishing an Airway |
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Pulse Oximetry |
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Interpretation of ABG |
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Drawing ABG Blood Sample from A?Line |
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Incentive Spirometer |
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Neurology | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment of Neuro Signs |
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Use of Glascow Coma Scale |
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Seizure Precautions |
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Assist with Lumbar Puncture |
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ICP Monitoring |
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Crutchfield Tongs |
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Halo Traction |
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Stryker Frame |
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Assessment of Sensory?Motor Function |
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Cervical Traction |
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Cranial Nerve Assessment |
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LOC Assessment |
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Pre/Post Neuro Surgical Care |
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Visual Acuity Measurement |
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Vascular | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Peripheral Pulses |
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Fluid Overload |
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Starting IV's |
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Subcutaneous Central Line |
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Hickman/Broviac/Groshong Catheters |
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Mainenance of Heparin Lock |
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TPN/Hyperalimentation |
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Air Occlusive Dressing |
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Infusion Pump |
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Peritoneal Dialysis |
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Hemodialysis |
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Heparin Drip ? Precautions and Maintenance |
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Gastrointestinal | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
NG Tube Insertion |
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Gastronomy Tube |
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Jejunoostomy Tube |
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Enterostomal Care |
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Genito Urinary/Renal | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Foley Catheter Insertion |
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GU Irrigations |
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Nephrostomy Tube |
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Suprapubic Tube |
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Electrolyte Imbalance/Replacement |
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Other | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Oncology |
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Chemotherapy |
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Isolation Techniques |
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Hyperbaric Oxygenation |
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Fingerstick Blood Glucose monitoring |
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Equipment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Bear I |
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Bear II |
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Bear V |
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Bennett 7200 |
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CPAP |
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Emerson |
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EMV |
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MA?I |
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MA?II |
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Monihan |
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Ohio 560 |
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PEEP |
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Pressure Pre?Set |
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Servo 900b |
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Servo 900c |
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Servo 900e |
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Siemens |
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Hewlett?Packard |
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Spacelab |
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Marquette |
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Mennen |
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Lifecare |
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Nihon?Koder |
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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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