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
Pacemaker-Permanent & Temporary
Abnormal Heart Sounds/Murmurs
Pulses/Circulation Checks
Thoracotomy/Lobectomy/Pneumonectomy
Anterior/Posterior Spinal Fusion
Hypo/Hyperthermia Blanket
Pancreas/Liver Transplant
Arteriovenous Fistula/Shunt
Diabetes - Hypo/Hyperglycemic Crisis
Open Reduction/Internal Fixation
General Orthopedic Surgeries
Surgical Wound Assessment
Skin Assessment for Breakdown
Narcotics/Opioid Analgesics
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
Central Line/Implanted Line Care
Blood Product Administration
CARDIAC MONITORING & EMERG. RESPONSE
Dysrhythmia Interpretation
PROFESSIONAL KNOWLEDGE AND SKILLS
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
Pressure Ulcer Risk Assessment/Prevention
Age Specific/Population-Based Care
Pain Assessment & Management
Interpretation and Communication of Lab Values
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
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)