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
Chest Tube Placement/Management
Seizures-Febrile/Epileptic
Car Seat Instruction for Casted Patient
Abdominal Trauma/Peritoneal Lavage
Pelvic Inflammatory Disease/STD
Reporting Acts of Violence
Glasgow Coma/Pediatric Trauma Scale
INFECTIOUS DISEASE/IMMUNOSUPPRESSION
Contagious/Infectious Patients
Reporting Communicable Disease
Neutropenia/Reverse Isolation
Drug /ETOH Overdose/Withdrawal
Pediatric Dosage Calculations
Anticoagulants (IV, Oral & Injection)
Procedural Sedation - Administration
Narcotics/Opioid Analgesics (IV, Oral & Injection)
Steroids (IV, Oral & Inhaled)
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
PROFESSIONAL KNOWLEDGE AND SKILLS
Recognizing/Reporting Abuse
Ambulance/Paramedic Radio
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
Pressure Ulcer Risk Assessment/Prevention
Restraints/Use of Least Restrictive Device
Car Seat Specific Standards/Teaching
Age/Developmentally Specific/Population Based Care
Pain Assessment and Management - Verbal/Non-Verbal
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)