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Acute Rehab Skills Checklist | ||||||
| NAME | |||||||
| LAST 4 OF SSN | |||||||
| DATE | |||||||
| I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination. | |||||||
| 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. | |||||||
| Proficiency Scale: |
1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently |
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| Rating Stars (Click) | Work Settings | 1 | 2 | 3 | 4 | ||
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General Acute Care | ||||||
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Home Health | ||||||
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Nursing Home | ||||||
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Outpatient Clinic | ||||||
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Pediatric Rehab | ||||||
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Acute Rehab Hospital | ||||||
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Rehab Unit in Hospital | ||||||
| Rating Stars (Click) | Neuro | 1 | 2 | 3 | 4 | ||
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Cerebral Vascular Accident | ||||||
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Coma Patients | ||||||
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Head Trauma | ||||||
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Spinal Cord Injury | ||||||
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Parkinson’s Disease | ||||||
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Traumatic Brain Injury | ||||||
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Neuromuscular Disease | ||||||
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Post Craniotomy | ||||||
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Bowl/Bladder Programs | ||||||
| Rating Stars (Click) | Ortho | 1 | 2 | 3 | 4 | ||
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Arthritis Programs | ||||||
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Back Syndrome | ||||||
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Cervical Traction | ||||||
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Continuous Passive Motion Machine N/A | ||||||
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Gait Training | ||||||
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Hand Injury | ||||||
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Hip Fractures | ||||||
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Care of Patient with Halo | ||||||
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Hot/Cold Packs | ||||||
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Mobilization Techniques | ||||||
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Neck Injuries | ||||||
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TMJ Dysfunction | ||||||
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Total Hip Replacement | ||||||
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Total Knee Replacement | ||||||
| Rating Stars (Click) | Pulmonary | 1 | 2 | 3 | 4 | ||
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Assessment of breath sounds | ||||||
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Chest Physiotherapy | ||||||
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Oximetry | ||||||
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Nasal cannula | ||||||
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Face Mask | ||||||
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Portable O2 tank | ||||||
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Nasotracheal Suctioning | ||||||
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Tracheal Suctioning | ||||||
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Care of patient w/Mechanical Vent | ||||||
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COPD | ||||||
| Rating Stars (Click) | Pediatrics | 1 | 2 | 3 | 4 | ||
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Cerebral Palsy | ||||||
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Activities of Daily Living | ||||||
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Learning Disabilities | ||||||
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Orthotics | ||||||
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Spina Bifida | ||||||
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Autism | ||||||
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AK Prosthetics | ||||||
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Amputees | ||||||
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BK Prosthetics | ||||||
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Bracing/Joint Immobilization | ||||||
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Resting Splints | ||||||
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Casts/Check for Circulation | ||||||
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Upper Extremity Prosthetics | ||||||
| Rating Stars (Click) | Nutritional Requirements | 1 | 2 | 3 | 4 | ||
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Thickened Liquids | ||||||
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Minimal | ||||||
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Thick | ||||||
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Extra Thick | ||||||
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Pudding Thick | ||||||
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NG Tubes | ||||||
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Peg Tubes | ||||||
| Rating Stars (Click) | Restraints | 1 | 2 | 3 | 4 | ||
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4pt | ||||||
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Shoulder Strap | ||||||
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Hand Mitts | ||||||
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Wrist | ||||||
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Ankle | ||||||
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Pelvic Strap | ||||||
| Rating Stars (Click) | EMR | 1 | 2 | 3 | 4 | ||
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Epic | ||||||
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Cerner | ||||||
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Eclipsys | ||||||
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McKesson | ||||||
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Meditech | ||||||
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Other Computerized System | ||||||
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Computerized Physician Order Entry | ||||||
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Bar Coding for Medication Administration | ||||||
| Rating Stars (Click) | Other | 1 | 2 | 3 | 4 | ||
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Ability to evaluate and assign Functional Independence Score | ||||||
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AIDS Patients | ||||||
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Burn Management | ||||||
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Cardiac Rehabilitation | ||||||
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Function Capacity Evaluation | ||||||
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Geriatrics | ||||||
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Manual Therapy | ||||||
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Massage Therapy | ||||||
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Muscle Stimulation | ||||||
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Pain Management/Giving Meds | ||||||
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Physical Capacity | ||||||
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Pulmonary Rehab | ||||||
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Sterilization Technique | ||||||
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TENS | ||||||
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Wound Debridement/Dressing Change | ||||||
| Rating Stars (Click) | Age Specific Competencies | 1 | 2 | 3 | 4 | ||
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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) | ||||||