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
(PROFICIENCY)
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
(FREQUENCY)
1 = Never performed observed only
2 = Less than 6 times per year
3 = 1-2 times per month
4 = Daily or Weekly
PROFICIENCY / FREQUENCY
PROFICIENCY
FREQUENCY
Admit and Assess Patients
Computerized Documentation
Interpretation of Coagulation Studies
Perform Pulses/Circulation Checks
Pre/Post Op Care Pacemaker
Assess Neurological Signs
Selective Nerve Root Blocks
Insertion/Monitoring NG Tubes
Assessment/Patient Care Continued
Prosthodontics – Restorative Dentistry
Maxillofacial Prosthetics
Application of Burn Dressings
Electrodesiccation and Curettage (ED&C)
External Hardware and Pin Care
Open Reduction and Internal Fixation
Closed Reduction and Internal Fixation
General Medications/Therapeutic Interventions
Administer IM and SQ Meds
Administer Inhalation Medications
Administer PO Medications
Bladder Irrigation and Instillation
Vascular Access Devices Care/Maintenance
Administer IV Medications
Pain Management/Anesthesia
Implantable Narcotic Pump Refill
General Procedures/Equipment
Apply Immobilizers (clavicle, knee, etc.)
Assist with Code Resuscitation
Assist with Lumbar Puncture
Procedures/Equipment Continued
Remove External Fixators With Pin
Straight/Foley Cath Female
TENS (Transcutaneous Elec. Nerve Stimulator)
Age Group Experience Continued
Ambulatory Surgery Clinic
“Do Not Use” Abbreviations and Terms
Age Specific Competencies
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)