Home Health

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
Skill Level
1
2
3
4
1
2
3
4
CARDIOVASCULAR
ACS/Post MI
Heart Failure
Post Cardiac Surgery
Cardiac Auscultation (Rate/Rhythm)
Peripheral Pulse/Circulation Checks
PULMONARY
Asthma
COPD
Pneumonia
Lung Cancer
Pulmonary Emboli
Auscultate Lung Sounds
Oxygen Administration
Oxygen Safety
Oro/Nasotracheal Suctioning
CPAP/BiPAP
Ventilator Management (Specify)
NEUROLOGICAL
CVA
Alzheimer's Disease/Dementia
Parkinson's
Degenerative Neurologic Disorders (ALS, MS, etc.)
Brain Tumor
Brain Injury
Para/Quadriplegia
Seizure Disorder
Level of Consciousness/Neuro Changes
ORTHOPEDICS
Joint Replacement
DVT Prophylaxis/Recognition
Incision Checks
Staple Removal
Fractures
Cast/Brace
Amputation
Arthritis
Assistive Equipment/Lift Devices
In Home PT/INR (Specify)
GASTROINTESTINAL
Nutritional Assessment
Colostomy/Ileostomy Management
Fecal Incontinence/Diarrhea
Bowel Obstruction
GI Bleed
Post GI Surgery
Hepatitis Liver Failure
NG Tubes
Feeding Tubes
Feeding Pumps (Specify)
Drainage Devices
RENAL/GENITOURINARY
Hemodialysis
AV Fistula/Shunt
Peritoneal Dialysis
Post Bladder Surgery
Post Prostate Surgery
Urostomy
Urinary Incontinence
Bladder Catheter Insertion/Maintenance
Suprapubic Catheter Insertion/Maintenance
ENDOCRINE/METABOLIC
Diabetes
Hyper/Hypoglycemia
Diabetic Skin Assessment
Cushing's / Addison's Disease
Thyroid Disease
Insulin Pumps
Glucometers
WOUND/SKIN CARE
Braden Scale
Pressure Ulcer Prevention
Pressure Ulcer Staging
Pressure Ulcer Management
Burns
Wound Care
Wound Cultures
Wound Vac
ONCOLOGY
Risk for Infection
Symptom Management
Side Effects of Treatment
Terminal Disease
INFECTIOUS DISEASE
MRSA
VRE
C. Difficile
HIV
Tuberculosis
Isolation Precautions
PHLEBOTOMY/IV THERAPY
Peripheral Venipuncture for Labs
Start Ivs
Peripheral Ivs
PICC/CVP Lines
Venous Access Ports
Infusion Pump Set up and Management
Specify Infusion Pump Type
PSYCHIATRIC
Cognitive Disorders
Mood Disorders
Schizophrenia/Psychotic Disorders
Medication Compliance
WOMEN'S HEALTH/MATERNAL-INFANT CARE
Pregnancy Related Complications
Fetal Heart Tones
Contractions
Post Partum Mother/Baby Visit
Newborn Care
Phototherapy
Breast Feeding Support
PEDIATRICS
Growth and Development
Respiratory Distress Syndrome
Bronchopulmonary Dysplasia
Cystic Fibrosis
Muscular Dystrophy
Spina Bifida
Spinal Surgery
Sickle Cell Disease
Trach Care/Suctioning
Ventilator Management
Ventilator Type (Specify)
PAIN MANAGEMENT
Verbal/Nonverbal Pain Scales
Response to Pain Management Interventions
PCA Pump
Epidural Cath/Site Monitoring/Pump
Non-Pharmacologic Pain Measures
PALLIATIVE AND END OF LIFE CARE
Palliative Symptom Management
Pain Management/Response
Family Support/Teaching
After Death Protocols
MEDICATIONS
Alzheimer's Medications
Antiarrhythmics
Antibiotics/Antivirals
Anti-Depressants
Anti-Hypertensives
Anti-Psychotics
Anti-Seizure Medications
Benzodiazepines
Calculation of Pediatric Dosages
Coumadin
Diuretics
Enoxaparin
Inhaled Medications
Nebulizer Medications
Insulin
Opioid and Non-Opioid Analgesics
Oral Chemotherapy
Oral Hypoglycemics
Oral & Topics Nitrates
Rivaroxaban
Sedative/Hypnotics
Steroids
HOME HEALTH
Intake/Admissions
Case Manager
Case Load - Pts/Day (Specify)
Supervise LVNs/HHAs
Medicare/Medicaid
Long/Short Term Disability
Private Insurance
Telephonic Assessments
Management of Complaints
APS Reports
OASIS
Diagnosis Coding
Document Plan of Care
Clinical Assessment Documentation
PROFESSIONAL KNOWLEDGE AND SKILLS
National Patient Safety Goals/Core Measures
Safety Assessment
Fall Assessment and Prevention
Patient/Family Teaching
Age Specific/Population Based Care
EMR
Allscripts
Cerner
Epic
HomeCare Home Base
McKesson
Meditech
Other Computerized Documentation System
EMR Conversion
AGE SPECIFIC COMPETENCIES
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)