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
Communicates and obtains information while respecting the rights and privacy and confidentiality of information in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Involves the patient and family and respects their role in determining the nature of care to be provided, including Advance Directives.
Complies with nursing staff responsibility included in the hospital policy related to Organ Donation.
Meets patient and families needs regarding communication, including interpreter services
Provides accurate information to patient and families in a timely manner.
BP, including Orthostatic
Weight, Pounds and Kilograms
Recognizing Cardiac Arrest
Bringing Emergency Equipment to Room
Providing Appropriate Code Support
Automatic BP machine (Dynamap)
Placing and Removing Bed Pan
Emptying and Replacing Ostomy Bag (Established Ostomy)
Labeling Specimens and Preparing for Transport
Risk Factors for Skin Breakdown
Observing Pressure Points for Redness or Breakdown
Bathing (Shower /Tub /Arjo)
Oral Care, Including Patients who are NPO, Comatose, Patients with
Foot Care for Patients with Impaired Circulation or Sensation
Reducing Pressure and Friction
Heels and Elbow Protection
Infectious/Hazardous Waste Disposal
Supply/Equipment Disposal
Use of Disposable Thermometer
Identifying Safety Hazards
Determining Need for Additional Help
Assessing Safety and ADL Needs
Recognizing Abuse: Substance, Physical, Emotional, etc
Maintaining Clean, Orderly Work Area
Handling Hazardous Materials
Transferring to Bed, WC, Commode, etc
Reporting Broken Equipment
Responding to Safety Hazards
Use of Hoyer Lift (Dextra /Maxi)
Use of Alarms: Bed, Patient, Unit
Documenting Use of Restraints
Use of Gait Belt for Ambulation
Inventory and Disposition of Belongings, Use of Checklist
Room Orientation, Call Bell
Replacing Mask or Nasal Cannula if Needed
Notifying Nurse of Problems
Preparing for and Explaining Routines to Patient
Use of Incentive Spirometer
Using Appropriate Abbreviations
Identifying Unusual Patient Incidents that Require Reporting
Reinforcing RN Teaching With Patient
Selecting and Using Forms Appropriately
Using Alternate Communication Tools /Devices
Changes in Patient Condition
Patient Needs, Complaints and Concerns
Turning and Repositioning
Diet intake, Calorie Count
Marking and /or Measuring Amount of Urine, Gastric Fluid, NG Drainage, Emesis, Diarrhea
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)
Identifying Unusual Incidents on the Unit that Require Reporting
Locating and Using Appropriate Reference Materials: Hospital, Patient Care and
Charging for Patient Care Items
Completing Risk Management Reports as Needed
Obtaining Needed Supplies and Equipment
Reporting and Following up on Faulty Equipment and Supplies