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
Assessment of heart sounds
Care of patients with CHF
Care of patients with Diabetes
NG tube care and feedings
Gastrostomy tube care and feedings
Assessment of Bowel Sounds
IV Medication Administration
Assessment of Neurological Status
Care of a patient with a CVA
Care of a patient with Alzheimer’s
Care of patients with Spinal Cord Injury
Phenobarbital Administration
Wound Care and Treatments
Use of special pressure relief devices
Care of pts with a total hip replacement
Care of pts with a total knee replacement
Oxygen Administration via nasal cannuia
Oxygen Administration via face mask
Principles of chest percussion
Care of patients with ventilator
Care of patients with COPD
Care of patients with ARDS
Care of patient with a Tracheotomy
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)