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
Vital Sign - BLOOD PRESSURE
Vital Sign - PULSE OXIMETRY
Basic Airway - OROPHARYNGEAL AIRWAY (OPA)
Basic Airway - NASOPHARYNGEAL AIRWAY (NPA)
Basic Airway - ORAL SUCTIONING
Basic Airway - BAG VALVE MASK
Basic Airway - OXYGEN ADMINISTRATION
Advanced Airway - MULTI-LUMEN AIRWAY (COMBI-TUBE)
Patient Assessment - TRAUMA
Patient Assessment - MEDICAL
Bleeding Control/Shock Management
PNEUMATIC ANTI SHOCK GARMENT (MAST)
Spinal Immobilization - B/B (SUPINE PT.)
Spinal Immobilization - KED (SEATED PT.)
Helmet Removal - FOOTBALL
Helmet Removal - MOTORCYCLE
Splinting - BIPOLAR TRACTION (HARE)
Splinting - UNIPOLAR TRACTION (SAGER)
BLS/ALS - Cardiac Arrest Management (AED)
BLS/ALS - Nitroglycerin Administration (NTG)
BLS/ALS - Epinephrine Administration (EPI)
CPR - ADULT / CHILD / INFANT
FBAO - ADULT / CHILD / INFANT