Registered Nurse Skills Checklist
   LAST 4 OF SSN      
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) Medication Administration 1 2 3 4  
Documentation on M.A.R.  
Dose calculation  
Generic equivalents  
Usage of PDR  
Knowledge of drug actions/interactions  
Verification of narcotic wastage  
Oral medications  
Sublingual medications  
Intradermal medications  
Parenteral medications  
Subcutaneous medications  
Intramuscular medications  
Topical medications  
Eye drops  
Ear drops  
Swallowing precautions  
Inventory and storage control  
Rating Stars (Click) Infectious Control 1 2 3 4  
AIDS/HIV interaction  
Hepatitis interaction  
Fever management  
Interpretation of labs  
Decubitus/Wound care (Contaminated)  
Linen -Transporting, storing, & Handling  
Personal clothing  
Proper disposal of sharpes and waste  
Standard precautions  
Rating Stars (Click) Pain Management 1 2 3 4  
Documentation and assessment of site, character, & frequency of pain  
Assessment of pain levels  
Documentation of response to pain medications  
Rating Stars (Click) Intraveneous Therapy 1 2 3 4  
I.V. certified (Check "4")  
Administration of I.V. antibiotics  
Administration of I.V. fluids  
Administration of I.V. pain medications  
Administration of I.V. cardiac meds  
Blood draws - peripheral  
Blood draws - central line  
Blood draws - implanted catheter  
Care of I.V. site - peripheral  
Care of I.V. site - central line  
Care of I.V. site - implanted catheter  
I.V. dose calculations  
I.V. insertion - peripheral  
Use of infusion pumps  
Rating Stars (Click) Diabetic Care 1 2 3 4  
Diabetic monitoring  
S/S hyper/hypoglycemia  
Diabetic patient teaching  
Performing fingersticks  
Use of glucometers  
Insulin infusions  
Regular, long-acting insulin  
Mixed insulin  
Rating Stars (Click) Psychosocial Problems 1 2 3 4  
Assessment and documentation of behavioral problems (target behaviors)  
Assessment and documentation of s/s of depression  
Assessment and documentation of patient response to psychotropic medications  
Parameters for use of restraints in long-term care settings  
Assessment and documentation of effectiveness of preventive medicine medications  
Rating Stars (Click) Orthopedics 1 2 3 4  
Assessment of circulation  
Assessment of gait  
Assessment of range of motion  
Amputation care  
Post-arthroscopy care  
Casts and related care  
Pinned fractures  
Total hip replacement  
Total knee replacement  
Rheumatic/Arthritic disease  
Continuous passive motion  
Cervical collars  
Gait belts  
Transfer board  
Rating Stars (Click) Cardiovascular Problems 1 2 3 4  
Auscultation of rate/rythym  
Blood pressure  
Circulation checks  
Post-abdominal aortic bypass  
Post carotic endarterectomy  
Fem-pop bypass  
Permanent pacemaker  
Post acute M.I.  
Post cardiac surgery  
Congestive heart failure  
Administration of post-op cardiac meds  
Rating Stars (Click) Gastrointestinal Problems 1 2 3 4  
Administration of tube feedings  
Administration of medications via tube  
Inflammatory bowel disease  
Bowel prep  
G.I. bleeding  
Nutritional status  
Colostomy care  
Post abdominal surgery  
NG tube placement and care  
Nasointestinal tube care  
Assessment of bowel tones  
Assessment of abdomen  
Enema administration  
Assessment of bowel incontinence  
Signs and symptoms of fecal impaction  
Rating Stars (Click) Neurological Problems 1 2 3 4  
Post-Op anticonvulsant medications  
Assessing levels of consciousness  
Dementias (Re-direction/Validation)  
Neuromuscular disease  
Pupil check  
Seizure precautions  
Administration of anticonvulsant  
Aneurysm precautions  
Spinal cord injuries - long term  
Rating Stars (Click) Urinary Problems 1 2 3 4  
Assessment and care of AV shunt  
Post renal surgery  
Renal failure  
Assessment of urinary incontinence  
Assessment of I and O data  
Use of bladder scanne  
Signs and symptoms of UTI  
Indwelling catheter insertion  
Indwelling catheter care  
Straight catheter insertion  
Suprapubic catheter care  
Screening for UTI via urine dipstick  
Rating Stars (Click) Wounds, Pressure Sores, and Skin Impairments 1 2 3 4  
Assessment and care of post-surgical wounds  
Assessment, prevention, and care of pressure ulcers  
Assessment and documentation of skin conditions/wounds  
Dressing changes - asceptic  
Dressing changes - sterile  
Wound irrigation  
Application of wound care products  
Use of air fluidized, low air-loss beds  
Use of pressure-relieving seat cushions  
Staple and suture removal  
Rating Stars (Click) Other Skills 1 2 3 4  
Alert charting system  
Use of 24-hour written and verbal reporting systems  
Use of "911" in LTC setting  
Regulatory guidelines related to the prevention of abuse and neglect of residents  
Regulatory guidelines related to resident rights in LTC setting  
Discerning code status  
Incident and accident reporting  
Rating Stars (Click) Age Specific Competencies 1 2 3 4  
Infant (Birth - 1 year)  
Preschooler (ages 2-5 years)  
Childhood (ages 6-12 years)  
Adolescents (ages 13-21 years)  
Young Adults (ages 22-39 years)  
Adults (ages 40-64 years)  
Older Adults (ages 65-79 years)  
Elderly (ages 80+ years)