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Emergency Department 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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Level I Trauma Center | ||||||
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Level II Trauma Center | ||||||
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Non-Trauma Center Emergency Department | ||||||
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Pediatric Emergency Department | ||||||
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Emergency Department - Combined Adult/Pediatric | ||||||
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Critical Care Transport | ||||||
| Rating Stars (Click) | CARDIAC | 1 | 2 | 3 | 4 | ||
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Acute Coronary Syndrome | ||||||
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Congestive Heart Failure/Pulmonary Edema | ||||||
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Aneurysm | ||||||
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Cardioversion | ||||||
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Transcutaneous Pacemaker | ||||||
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Heart Sound | ||||||
| Rating Stars (Click) | PULMONARY | 1 | 2 | 3 | 4 | ||
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Respiratory Failure | ||||||
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COPD/Asthma | ||||||
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Aspiration | ||||||
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Pneumonia | ||||||
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Pneumo/Hemothorax | ||||||
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Chest Tube Insertion/Management | ||||||
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Pulmonary Embolism | ||||||
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Tuberculosis | ||||||
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External CPAP/BiPAP | ||||||
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Intubation | ||||||
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Ventilated Patients | ||||||
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ABG Interpretation | ||||||
| Rating Stars (Click) | NEUROLOGICAL | 1 | 2 | 3 | 4 | ||
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CVA | ||||||
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Stroke Scale | ||||||
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Brain Injury | ||||||
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Glascow Coma Scale | ||||||
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Spinal Cord Injury | ||||||
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Meningitis | ||||||
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Seizures | ||||||
| Rating Stars (Click) | ORTHOPEDICS | 1 | 2 | 3 | 4 | ||
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Fractures/Casting | ||||||
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Open/Complex Fractures | ||||||
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Apply/Manage Splints | ||||||
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Circulation Checks | ||||||
| Rating Stars (Click) | GASTROINTESTINAL | 1 | 2 | 3 | 4 | ||
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GI Bleeding | ||||||
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Liver Disease | ||||||
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GI Obstruction | ||||||
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Abdominal Pain/Distress | ||||||
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Gastric Tubes | ||||||
| Rating Stars (Click) | RENAL/GU | 1 | 2 | 3 | 4 | ||
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Acute Renal Failure | ||||||
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Renal Calculi | ||||||
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Renal Trauma | ||||||
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Testicular Torsion | ||||||
| Rating Stars (Click) | ENDOCRINE | 1 | 2 | 3 | 4 | ||
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Hypoglycemia | ||||||
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Hyperglycemia | ||||||
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DKA | ||||||
| Rating Stars (Click) | WOUND MANAGEMENT | 1 | 2 | 3 | 4 | ||
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Skin Integrity Assessment | ||||||
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Wound Repair | ||||||
| Rating Stars (Click) | SHOCK/TRAUMA | 1 | 2 | 3 | 4 | ||
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Some items are covered in system specific areas. | ||||||
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Injury Severity Score | ||||||
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Trauma Code | ||||||
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Trauma Team Member | ||||||
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Major Trauma | ||||||
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Traumatic Amputation | ||||||
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Peritoneal Lavage | ||||||
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Hypovolemic Shock | ||||||
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Neurogenic Shock | ||||||
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Anaphylactic Shock | ||||||
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Septic Shock | ||||||
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Cardiogenic Shock | ||||||
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Burns - 2nd Degree | ||||||
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Burns - 3rd Degree | ||||||
| Rating Stars (Click) | INFECTIOUS DISEASE/IMMUNOSUPPRESSED PATIENTS | 1 | 2 | 3 | 4 | ||
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Contagious/Infectious Patients | ||||||
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Isolation | ||||||
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Neutropenia/Reverse Isolation | ||||||
| Rating Stars (Click) | WOMEN'S HEALTH | 1 | 2 | 3 | 4 | ||
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Placenta Abruptio/Previa | ||||||
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Precipitous Delivery | ||||||
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Pregnancy Induced Hypertension | ||||||
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Fetal Heart Tones | ||||||
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Sexual Assault | ||||||
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Reporting Acts of Violence | ||||||
| Rating Stars (Click) | PEDIATRICS | 1 | 2 | 3 | 4 | ||
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Management of Pediatric Emergency Patients | ||||||
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Identification/Reporting Abuse | ||||||
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Abdominal Pain | ||||||
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Epiglottitis | ||||||
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Asthma/Reactive Airway Disease | ||||||
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Fractures | ||||||
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Head/Spinal Injury | ||||||
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Poison Ingestion | ||||||
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Seizures | ||||||
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Sickle Cell Crisis | ||||||
| Rating Stars (Click) | PSYCHIATRIC | 1 | 2 | 3 | 4 | ||
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Acute Psychotic Patient | ||||||
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Managing Violent Behavior | ||||||
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Drug /ETOH Overdose/Withdrawal | ||||||
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Psychiatric Hold | ||||||
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Suicidal Patient | ||||||
| Rating Stars (Click) | MISCELLANEOUS | 1 | 2 | 3 | 4 | ||
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Bites- Animal/Snake/Human | ||||||
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Hazardous Material Exposure | ||||||
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Heat Exhaustion/Stroke | ||||||
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Drowning | ||||||
| Rating Stars (Click) | IV THERAPY | 1 | 2 | 3 | 4 | ||
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Starting IVs | ||||||
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Central Line Placement | ||||||
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Intraosseous Infusion | ||||||
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Blood Product Administration | ||||||
| Rating Stars (Click) | MEDICATIONS | 1 | 2 | 3 | 4 | ||
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Anti-Arrhythmics | ||||||
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Anticoagulants (IV, oral, & injection) | ||||||
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Anti-Hypertensives | ||||||
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Anti-Psychotics | ||||||
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Anti-Seizure Medications | ||||||
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Benzodiazepines | ||||||
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Continuous IV Paralytics | ||||||
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Continuous IV Sedation | ||||||
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Procedural Sedation - Administration | ||||||
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Emergency Medications | ||||||
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Inhaled Medications | ||||||
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Insulin | ||||||
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IV Vasopressors | ||||||
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Narcotics/Opioid Analgesics (IV, oral, & injection) | ||||||
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Nitrates (Oral & Topical) | ||||||
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Non-Opioid Analgesics (IV, Oral, & Injection) | ||||||
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Reversal Agents | ||||||
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Thrombolytic Therapy | ||||||
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Steroids (IV, Oral, Inhaled) | ||||||
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Automated Medication Dispensing (i.e. Pyxis, Omnicell) | ||||||
| Rating Stars (Click) | CARDIAC MONITORING & EMERG. RESPONSE | 1 | 2 | 3 | 4 | ||
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Dysrhythmia Interpretation | ||||||
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Dysrhythmia Management | ||||||
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Obtain 12 Lead EKG | ||||||
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Interpret 12 Lead EKG | ||||||
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Management of Cardiac Arrest | ||||||
| Rating Stars (Click) | PROFESSIONAL KNOWLEDGE AND SKILLS | 1 | 2 | 3 | 4 | ||
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Triage | ||||||
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Ambulance/Paramedic Radio | ||||||
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Charge Experience | ||||||
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AMA procedures | ||||||
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EMTALA | ||||||
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National Patient Safety Goals/Core Measures | ||||||
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Fall Risk Assessment/Prevention | ||||||
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Pressure Ulcer Risk Assessment/Prevention | ||||||
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Restraints/Use of Least Restrictive Device | ||||||
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Patient/Family Teaching | ||||||
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Age Specific/Population-Based Care | ||||||
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Isolation Precautions | ||||||
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Infection Prevention | ||||||
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Pain Assessment & Management | ||||||
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Interpretation and Communication of Lab Values | ||||||
| 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) | ||||||
| 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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Allscripts | ||||||
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Other Computerized System | ||||||
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Computerized Physician Order Entry | ||||||
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Bar Coding for Medication Administration | ||||||
| EMR Conversion | |||||||
| CERTIFICATIONS | Expiry Date : | ||||||
| BLS | |||||||
| ACLS | |||||||
| PALS | |||||||
| PEARS | |||||||
| TNCC | |||||||
| ENPC | |||||||
| CEN | |||||||
| Other: Specify | |||||||
| Other: Specify | |||||||