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
Rating Stars (Click)
OBTAINING AND RECORDING:
1
2
3
4
BP, including Orthostatic
VITAL SIGNS AND WEIGHTS
Administering an Enema
Applying Ted Hose
Asssessing Respirations
Assisting with Ambulation
Assist with Dressing
Colostomy Care
Denture Care
EKG
Incentive Spirometer
Isolation Techniques
Making an Unoccupied Bed
Making an Occupied Bed
Massaging
Measuring Height
Measuring Intake and
Output
Moving the Patient
Mouth Care
Perineal Care
Phlebotomy
Placing Restraints
Positioning the Patient
Postmortem Care
Range of Motion
Sterile Technique
Transferring the Client
Universal Precautions
Using a Mechanical Lift
Recognizing Cardiac Arrest
Activating Code Team
Bringing Emergency
Equipment to Room
Providing Appropriate Code
Support
GI/GU
Report Abnormal Findings
Bowel Function
Bladder Function
Placing and Removing Bed
Pan
Clamping Catheter
Emptying Foley Bag
Placing Condom Catheter
Emptying and Replacing
Ostomy Bag (Established Ostomy)
Rating Stars
(Click)
Assessing Pulse
1
2
3
4
Apical
Radial
Rating Stars
(Click)
Assessing Temperature
1
2
3
4
Axillary
Oral
Rectal
Tympanic
Rating Stars
(Click)
Medication Administration
1
2
3
4
Buccal
Oral
Rectal
Topical
Vaginal
Rating Stars
(Click)
Weighing the Client
1
2
3
4
Chair
Bed
Sliding Scale
Rating Stars
(Click)
Use of Electronic VS
Equipment:
1
2
3
4
Automatic BP machine
(Dynamap)
Electronic Thermometer
Applying Oximeter
Rating Stars
(Click)
Administering Edemas:
1
2
3
4
Tap Water
Fleets
Return Flow
Rating Stars
(Click)
Nutrition:
1
2
3
4
Estimating Intake
Setting up for Meals
Feeding Patients
Aspiration Precautions
Nourishments
Counting Calories
Fluid Restriction
NPO
Rating Stars
(Click)
Specimens:
1
2
3
4
Collecting Stool
Collecting Sputum
Labeling Specimens and
Preparing for Transport
Rating Stars
(Click)
Collecting Urine:
1
2
3
4
Clean catch
24 hour
Rating Stars
(Click)
Hygiene/Skin:
1
2
3
4
Risk Factors for Skin
Breakdown
Observing Pressure Points
for Redness or Breakdown
Rating Stars
(Click)
Bathing/Daisy Hygiene:
1
2
3
4
Bathing (Shower/Tub/Arjo)
Oral Care, including
Patients who are NPO, Comatose
Pen Care
Foot Care for Patients
with Impaired Circulation or Sensation