Skills Checklist

Skilled Nursing Checklist

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GENERAL SKILLS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Advanced directives
Awareness of HCAHPS
Patient/family teaching
Discharge planning
UR/medicare review
Lift/transfer devices
Specialty beds
Restrictive devices (restraints)
End of life care/palliative care
Automated Medication Dispensing System, Pyxis, Omnicell, or other
National Patient Safety Goals
Accurate patient identification
Effective communication
Awareness of patient rights
Interpretation & communication of lab values
Medication administration
Labeling (medications & specimens)
Medication reconciliation
Anticoagulation therapy
Pain assessment & management
Infection control
Universal precautions
Isolation
Minimize risk for falls
Prevention of pressure ulcers

CARDIAC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Assessment of heart sounds
Identification of arrhythmias (rate/rhythm)
Pacemakers/AID’s
Cardiac arrest/CPR

CARE OF PATIENT WITH:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Hypertension
Pre/post MI
CHF
Post cardiac surgery
Fluid & electrolyte imbalances
Pneumonia
Asthma
COPD
Emphysema
TBI (Traumatic Brain Injury: history of)
Seizure activity
Spinal cord injury
Stroke (CVA)
Multiple sclerosis
Alzheimer’s disease
Parkinson’s disease
ALS (Amyotrophic Lateral Sclerosis)
Colostomy/ileostomy
GI bleed
Feeding devices/adaptive equipment
Dietary restrictions
GT/PEG feedings
Shunts and fistulas
Straight catheterizations
Incontinence/bladder training
Chronic renal failure/dialysis
Peritoneal dialysis
Amputation
Stump wrapping
Laminectomy
Assistive devices
CPM machines

MEDICATION ADMINISTRATION:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Anticoagulants
Antiarrhythmics
Beta blockers
Nitroglycerin
Diuretics

RESPIRATORY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Assessment/auscultation of lung sounds
Establishing an airway
Chest PT
Incentive spirometry
Supplemental oxygen (cannula, facemask)
Tracheostomy care
Suctioning (tracheostomy & nasotracheal)
Nebulizer use

USE & ADMINISTRATION OF:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Bronchodilators
Expectorants
Corticosteroids
Antiseizure medications
Antiemetics
Laxatives
Enemas
Bowel prep
Antiemetics
Laxatives
Enemas
Bowel prep

NEUROLOGY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Assessment of neuro signs
Seizure precautions

GASTROINTESTINAL EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

NG tube (insertion/removal)
Long term feeding tubes (dobhoff/keofeed)
Gastrostomy tube
Tube feedings
Monitoring input/output

GENITOURINARY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Foley catheter insertion/removal
GU irrigations
Nephrostomy tube
Suprapubic catheter
Ileo conduit
Use of bladder scan equipment

ORTHOPEDIC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Total joint replacement
Arthroscopic surgery
Cast care
Pulse/CMS checks
Suture/staple removal
Prosthesis application
Standard extremity braces

IV THERAPY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Start & maintain IVs
Blood draw: venous
Central line care (PICC)
Blood draw: central line PICC
Care & management of ports
Infusion pumps
Administration of blood/blood products

SKIN EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Wound care/surgical
Wound care/medical
Dressing changes
Skin assessment
Wound vac

AGE-SPECIFIC COMPETENCIES EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *

Newborn / neonate (birth-30 days)
Infant (31 days-1 year)
Toddler (ages 2-3 years)
Preschool (ages 4-5 years)
School age (ages 6-12 years)
Adolescent (ages 13-21 years)
Young adult (ages 22-39 years)
Adult (ages 40-64 years)
Elderly (ages 80+ years)