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LPN Skills Checklist | ||||||
| NAME | |||||||
| LAST 4 OF SSN | |||||||
| DATE | |||||||
| I hereby certify that ALL information I have provided to FILL IN THE BLANK 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) | Skills | 1 | 2 | 3 | 4 | ||
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Activities of daily living | ||||||
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Admission of patient | ||||||
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Administration of medication | ||||||
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Ambulation | ||||||
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Application of heat and cold | ||||||
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Aseptic Technique | ||||||
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Assist with medical examination | ||||||
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Bathing: Sitz, tub, bed, shower | ||||||
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Bandaging | ||||||
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Binders | ||||||
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Body Alignment | ||||||
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Body Systems Review (Head to Toe data collection) | ||||||
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Cast care | ||||||
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Catheterization / Foley catheter care | ||||||
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Charting | ||||||
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Colostomy Care and irrigation | ||||||
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CPR | ||||||
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Crutch walking | ||||||
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Decubitus Care | ||||||
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Diabetic tests and preparation forms | ||||||
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Diabetic blood glucose testing | ||||||
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Discharge patients | ||||||
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Dosage computation | ||||||
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Draping | ||||||
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Dressing (sterile) | ||||||
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Ear drops | ||||||
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Elimination needs | ||||||
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Enemas, cleansing, retention, Harris flush | ||||||
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Restraints | ||||||
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Infection Control: Standard Universal Precautions | ||||||
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Infection Control: Reverse Isolation | ||||||
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Infection Control: TB/ Airborne Precautions | ||||||
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Infections Control: MRSA/ VRE Precautions | ||||||
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Isolation procedure for specimen collection | ||||||
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IVs: Monitor rate and infusion site | ||||||
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Medications: Oral, IM, SQ | ||||||
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Mouth care | ||||||
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Nail Care | ||||||
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Neurological Check | ||||||
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Nutritional check | ||||||
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Observations: Response to treatments/ meds | ||||||
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Observations: Signs of significant body system changes | ||||||
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Observations: Signs of shock | ||||||
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Observations: Signs of pain | ||||||
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Observes safety procedures | ||||||
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O2 administration | ||||||
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Pain assessment | ||||||
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Patient care plans (revise and update) | ||||||
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Patient safety standards/ precautions | ||||||
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Positioning patient | ||||||
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Postural drainage | ||||||
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Pre-op and post-op care | ||||||
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Provide comfort, safety and privacy | ||||||
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Pulse oxymetry | ||||||
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Range of motion | ||||||
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Report observations/ changes | ||||||
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Hand hygiene | ||||||
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Skin care | ||||||
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Specimen collection: routine urine | ||||||
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Specimen collection: clean catch | ||||||
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Specimen collection: 12 & 24 hour specimen | ||||||
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Specimen collection: stool | ||||||
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Specimen collection: culture | ||||||
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Specimen collection: sputum | ||||||
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Specimen collection: from foley catheter | ||||||
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Suppositories | ||||||
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Suction-oral | ||||||
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Surgical Preps | ||||||
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Computerized charting | ||||||
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Trach care/suctioning | ||||||
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Telephone manners | ||||||
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Topical Medication Application | ||||||
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Traction | ||||||
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Transfer/ transport patients: wheelchair | ||||||
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Transfer/ transport patients: gurney | ||||||
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Transfer/ transport patients: to chair | ||||||
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Urine test for glucose/ acetone | ||||||
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Vital Signs | ||||||
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Weight: Bed scales and standing scales | ||||||
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IV therapy certified | ||||||
| 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) | ||||||