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 Assessment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Auscultation (Rate/Rhythm) |
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| Blood Pressure/Non-Invasive |
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| Doppler |
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| Heart Sounds/Murmurs |
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| Pulses/Circulation Checks |
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| Cardiovascular Equipment & Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Basic 12 Lead Interpretation |
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| Basic Arrhythmia Interpretation |
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| Lead Placement |
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| Permanent Pacemaker |
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| Temporary Pacemaker |
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| Care of Patient with Cardiovascular Disease | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Abdominal Aortic Bypass |
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| Aneurysm |
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| Angina |
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| Cardiac Arrest |
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| Cardiomyopathy |
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| Carotid Endarterectomy |
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| Congestive Heart Failure (CHF) |
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| Femoral-Popliteal Bypass |
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| Myocarditis |
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| Post-Acute Myocardial Infarction (24-48 Hours) |
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| Pre/Post Angioplasty |
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| Pre/Post Cardiac Catheter |
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| Post Cardiac Surgery |
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| Thrombophlebitis |
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| Drug Overdose/Delirium Tremens (DTs) |
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| Heart Transplant |
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| Cardiovascular Medications | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Heparin Drip |
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| Oral Anticoagulants |
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| Oral and IVP Antihypertensives |
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| Oral and Topical Nitrates |
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| Pulmonary Assessment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Breath Sounds |
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| Rate and Work of Breathing |
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| Interpretation of Pulmonary Laboratory Results | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Blood Chemistry |
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| Arterial Blood Gases |
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| Pulmonary Equipment & Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Endotracheal Tube/Suctioning |
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| Nasal Airway/Suctioning |
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| Oropharyngeal/Suctioning |
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| Tracheostomy/Suctioning |
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| Sputum Specimen Collection |
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| Assist with Intubation |
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| Assist with Thoracentesis |
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| Assist with Set Up and Insertion of Chest Tube |
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| Measuring and Emptying Chest Tube |
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| Removal of Chest Tube |
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| Chest Physiotherapy |
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| Incentive Spirometry |
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| Ambu Bag and Mask |
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| External CPAP |
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| Assist with Extubation |
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| Care of Patients with Pulmonary Disease | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Acute Pneumonia |
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| Acute Respiratory Distress Syndrome (ARDS) |
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| Chronic Obstructive Pulmonary Disease (COPD) |
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| Patient with Mechanical Ventilator |
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| Pulmonary Edema/Hypertension |
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| Pulmonary Embolism |
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| Status Asthmaticus |
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| Tuberculosis |
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| Pulmonary Medications | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Alupent (Metaproterenol) |
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| Aminophylline (Theophylline) |
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| Bronkosol (Isoetharine Hydrochloride) |
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| Corticosteroids |
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| Ventolin (Albuterol) |
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| Neurological Assessment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Cranial Nerves |
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| Glasgow Coma Scale |
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| Level of Consciousness |
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| Reflex/Motor Deficits |
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| Visual/Communication Deficits |
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| Neurological Equipment & Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Assist with Lumbar Puncture |
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| Intracranial Pressure Monitoring |
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| Seizure Precautions |
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| Spinal Precautions |
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| Use of Hyper/Hypothermia Blanket |
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| Care of Patients with Neurological Disease | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Aneurysm Precautions |
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| Basal Skull Fracture |
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| Closed Head Injury |
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| Coma |
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| Cerebrovascular Accident (CVA) |
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| Delirium Tremens (DTs) |
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| Encephalitis |
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| Increased ICP |
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| Meningitis |
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| Post Craniotomy |
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| Spinal Cord Injury |
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| Neurological Medications | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Barbiturate |
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| Decadron (Dexamethasone) |
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| Dilantin (Phenytoin) |
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| Phenobarbital |
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| Valium (Diazepam) |
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| Gastrointestinal Assessments | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Abdominal/Bowel Sounds |
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| Nutritional |
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| Fluid Balance |
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| Interpretation of Gastrointestinal Laboratory Results | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Serum Ammonia |
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| Serum Amylase |
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| Liver Function Tests (LFTs) |
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| Gastrointestinal Equipment & Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Administration of Tube Feeding |
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| Feeding Pump |
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| Management of Gastrostomy Tube |
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| Management of Jejunostomy Tube |
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| T-Tube |
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| TPN and Lipids Administration |
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| Peripheral Parenteral Nutrition (PPN) |
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| Placement of Nasogastric Tube |
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| Salem Sump to Suction |
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| Care of Patients with Gastrointestinal Disease | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Bowel Obstruction |
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| Colostomy/Ileostomy |
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| GI Bleeding |
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| GI Surgery |
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| Hepatitis |
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| Inflammatory Bowel Diseases |
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| Liver Failure |
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| Parlytic Ileus |
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| Gastrointestinal Medications | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Inderal (Propranolol) |
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| Kayexelate |
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| Lactulose (Cephulac) |
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| Pitressin (Vasopressin) |
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| Renal/Genitourinary Assessments | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Arteriovenous Fistula/Shunt |
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| Fluid and Electrolyte Imbalance |
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| Interpretation of Renal/Genitourinary Laboratory Results | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| BUN and Creatinine |
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| Serum Electrolytes |
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| Renal/Genitourinary Equipment and Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Bladder Irrigation |
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| Insertion and Care of 3-Way Foley - Female |
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| Insertion and Care of 3-Way Foley - Male |
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| Routine Specimen Collection |
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| 24-Hour Specimen Collection |
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| Care of Patients with Renal/Genitourinary Disease | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Hemodialysis |
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| Nephrectomy |
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| Peritoneal Dialysis |
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| Renal Failure |
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| Transurethral Resection of the Prostate (TURP) |
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| Urinary Tract Infection |
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| Endocrine/Metabolic Assessment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| S/S Diabetic Coma |
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| S/S Insulin Reaction |
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| Endocrine/Metabolic Equipment and Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Blood Glucose Measuring |
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| Performing Finger Stick |
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| Care of Patients with Endocrine/Metabolic Disease | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Diabetes Mellitus |
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| Diabetic Ketoacidosis |
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| Disorders of Adrenal Gland (e.g., Addisons Disease) |
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| Disorders of Pituitary Gland (e.g., Diabetes Insipidus) |
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| Drug Overdose |
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| Hyperthyroidism (Graves Disease) |
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| Hypothyroidism |
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| Insulin Shock |
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| Orthopedic Assessment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Circulation Checks |
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| Gait |
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| Range in Motion |
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| Skin |
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| Orthopedic Equipment and Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Continuous Passive Motion Devices |
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| Cane |
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| Cervical Collar |
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| Gait Belt |
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| Prosthetic |
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| Transfer Boards |
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| Walker |
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| Wound Assessment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Skin for Impending Breakdown |
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| Stasis Ulcers |
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| Surgical Wound Healing |
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| Wound Equipment and Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Application of Steristrips |
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| Air Fluidized, Low Air Loss Beds |
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| Sterile Dressing Changes |
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| Wound Care/Irrigations |
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| Care of Patient with Wound | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Pressure Sores |
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| Staged Decubitus Ulcers |
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| Surgical Wounds with Drain(s) |
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| Traumatic Wounds |
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| Interpretation of Infectious Diseases Laboratory Results | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| CBC |
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| SMA7 |
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| Infectious Diseases Equipment and Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Fever Management |
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| Isolation |
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| Care of Patient with Infectious Diseases | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| HIV/AIDS |
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| Phlebotomy/IV Therapy Equipment and Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Auto Transfusion |
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| Administration of Cryoprecipitate |
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| Administration of Packed Red Blood Cells |
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| Administration of Plasma/Albumin |
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| Administration of Whole Blood |
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| Drawing Venous Blood |
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| Starting Angiocath IVs |
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| Starting Butterfly IVs |
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| Starting Heparin Lock |
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| Care of Patient with IVs | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Angiography |
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| Broviac/Hickman |
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| Groshong |
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| PICC |
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| Pericardiocentesis |
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| Pain Assessment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Pain Level/Tolerance |
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| Care of Patient with Pain | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Epidural Anesthesia/Analgesia |
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| IV Conscious Sedation |
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| Patient Controlled Analgesia (PCA pump) |
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| Care of Patient with Trauma/Shock | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Suicide Precautions |
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| Disaster Protocols |
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| Charge Experience |
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| Dehydration |
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| Electrocution |
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| Gun Shot/Stab Wounds |
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| Hazardous Material Exposure |
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| Radiation Exposure |
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| Anaphylactic Shock |
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| Cardiogenic Shock |
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| Hypovolemic Shock |
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| Neurogenic Shock |
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| Septic Shock |
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| Burns: Rule of Nines |
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| First Degree Burns |
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| Second Degree Burns |
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| Third Degree Burns |
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| Automated Medication Dispensing Systems | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Accudose |
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| Metro |
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| Omnicell |
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| Promanager Rx |
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| Pyxis |
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| eMAR |
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| Electronic Documentation | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| AllScripts |
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| Care360 |
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| Cerner |
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| CPSI |
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| eClinicalWorks |
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| Eclipsys |
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| EPIC |
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| MACLAB |
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| McKesson/Paragon |
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| Meditech |
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| PACS |
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| Quadramed |
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| Soarian |
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| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Newborn/Neonate (birth to 30 days) |
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| Infant (30 days - 1 year) |
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| Toddler (1 year to 3 years) |
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| Preschooler (3 years to 5 years) |
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| School age children (5years to 12 years) |
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| Adolescents (12 years to 18 years) |
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| Young Adults (18 years to 39 years) |
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| Middle Adults (39 years to 64 years) |
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| Older Adults (64 years to 79 years) |
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| Elderly Adults (over 79+ years) |
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