Skills Checklist

Wound Care Checklist

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WORK SETTING 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 *

Inpatient Acute Care Facility
Trauma Center
Academic/Teaching Facility
Outpatient Care Facility
Long term care/Skilled Nursing
Clinic/Ambulatory
Home Health Setting

PRESSURE ULCER:

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 - Ulcer Characteristics
Prevention - Risk Assessment Tool (Braden, Norton)

PRESSURE ULCER STAGING:

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 *

Reactive Hyperemia
Stage One
Stage Two
Stage Three
Stage Four
Deep Tissue Injury

PRESSURE ULCER SUPPORT SURFACES:

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 *

Static Air
Alternating Air
Foam
Gel
Water
Combination
Low Airloss
Dynamic (Kinetic) Air
Air Fluidized
Continuous Lateral Rotation

NEUROPATHIC (DIABETIC FOOT) ULCER TREATMENT:

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 *

Offloading
Serial Debridement
Prevention/Diabetic Teaching
Ulcer Assessment Characteristics

VENOUS STASIS ULCER TREATMENT:

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 *

Compression Therapy
Ulcer Assessment Characteristics
Skin Signs of Venous Stasis

PERIPHERAL ARTERIAL ULCER (PAD):

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 *

Ankle Brachial Index
Ulcer Assessment Characteristics
Skin Signs of Diminished Circulation

OTHER WOUNDS:

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 *

Fistulae - Pouching, Skin Care
Drains - Management of
G/J Tubes - Anchoring, Skin Care

WOUND CARE TREATMENT:

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 *

Debridement
Autolytic
Enzymatic
Mechanical
Sharp
Surgical
Dressings/Treatments
Hydrogels
Hydrocolloids
Silver Products
Foams
Alginates
VAC (Vacuum Assisted Closure)
Growth Factors
Skin Substitutes
Hyperbaric Oxygen Therapy
Culturing of Wounds
Electrical Stimulation
Enzymatic Debriding Agents
Debriding Ointments
Mist Therapy

COLOSTOMY:

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 *

Loop w/Rod Stoma
End Stoma
Mucous Fistula
Double Barrel Stoma
Irrigation Procedure
Stoma Within Incision
Related Conditions/Surgeries
Abdominoperineal Resection
Rectal Cancer/Colon Cancer
Diverticulitis
Colitis/Crohn’s Disease
Pelvic Exenteration Anterior
Pelvic Exenteration Posterior

ILEOSTOMY:

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 *

Loop w/Rod Stoma
End Stoma
Ileal Lavage
Related Conditions
Crohn’s Disease
Ulcerative Colitis
Familial Polyposis
Short Bowel Syndrome

CONTINENT ILEOSTOMY:

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 *

Kock Pouch
Pelvic Pouch

CONTINENT UROSTOMY:

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 *

Kock Pouch
Indiana Pouch
Neobladder

STOMAL, PERISTOMAL SKIN CONDITIONS:

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 *

Flush or Recessed Stoma
Stomal Necrosis
Stomal Prolapse
Peristomal Hernia
Denuded Skin/Ulcerations
Skin Infections/Fungal Infections
Mucocutaneous Separation
Hyperplasia
Pyoderma Gangrenosum
Stoma Plane Dynamics

OSTOMY EQUIPMENT:

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 *

One-Piece/Two-Piece Appliance
Open End, Closed End, Clip or Velcro Closure for Pouches
Convex/Flexible Pouching Systems
Skin Barriers/Sealants
Barrier Pastes/Strips/Rings/Discs/Washers
Wound Pouches
Molding Kit for Custom Appliances
Irrigation Procedure
Single/Double Lumen Catheters for Culture
Reusable Ostomy Equipment
Measure for Ostomy Belts/Peristomal Hernia Support Belt
One-Pi

CONTINENCE EVALUATION/ASSESSMENT:

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 *

Urodynamics
Manometry
Electromyography
Leak Point Pressures
Cystometrogram
Uroflometry
Biofeedback - Diagnostic/Treatment
PNTML (Pudendal Nerve Terminal Motor Latency)
PNTML (Pudendal Nerve Terminal Motor Latency)
Ultrasound

CONTINENCE SKIN CARE/CONTAINMENT:

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 *

Skin Sealants
Moisture Barriers
Absorbent Garments
Skin Care

CONTINENCE THERAPEUTIC DEVICES:

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 *

Vaginal Cones
Penile Clamps
Male Urinals
Male External Catheters
Internal Urethral Inserts (Female)
Catheters - Indwelling
Catheters - Intermittent Self Cath and Teaching for
Magnetic Therapy
Urinary Incontinence/Bladder Programs
Fecal Incontinence/Bowel Programs

PEDIATRIC RELATED CONDITIONS:

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 *

Necrotizing Enterocolitis
Inflammatory Bowel Disease
Irritable Bowel Syndrome
Meckel Diverticulum
Familial Adenomatous Polyposis
Distal Ureter or Bladder Defects
Hirschsprung’s Disease
Megacolon
Malabsorption Syndromes
Obstructive Disorders
Spinal Cord Injury
Neurogenic Bladder
Diaper Dermatitis
Stoma Care - Loop Stoma
Dehydration Risks in Pediatric Patients
High Output Stoma - Skin Barrier Issues

G/J TUBES:

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 *

Anchoring Devices
Skin Protection for Leakage of Gastric Contents
Long Term Tubes/Skin Level Devices for Feeding
Procedures for Flushing/Treatment for Clogging

OTHER:

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 *

IV Infiltration Wounds
Incision Care
Burns
Bariatric Patients
Self-Catheterization/Teaching
Indwelling Catheter Care
Medications
Bowel and Bladder Training Programs

INTERPRETATION OF LAB RESULTS:

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 *

Albumin/Total Protein
Obtaining Wound Cultures
Urine Cultures
Tumor Staging
Pathology Reports

AGE-SPECIFIC 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)
Older adult (ages 65-79 years)
Elderly (ages 80+ years)