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
Medication Administration
Knowledge of drug actions/interactions
Verification of narcotic wastage
Intramuscular medications
Inventory and storage control
Decubitus/Wound care (Contaminated)
Linen -Transporting, storing, & Handling
Proper disposal of sharpes and waste
Documentation and assessment of site, character, & frequency of pain
Assessment of pain levels
Documentation of response to pain medications
I.V. certified (Check "4")
Administration of I.V. antibiotics
Administration of I.V. fluids
Administration of I.V. pain medications
Administration of I.V. cardiac meds
Blood draws - central line
Blood draws - implanted catheter
Care of I.V. site - peripheral
Care of I.V. site - central line
Care of I.V. site - implanted catheter
I.V. insertion - peripheral
Diabetic patient teaching
Regular, long-acting insulin
Assessment and documentation of behavioral problems (target behaviors)
Assessment and documentation of s/s of depression
Assessment and documentation of patient response to psychotropic medications
Parameters for use of restraints in long-term care settings
Assessment and documentation of effectiveness of preventive medicine medications
Assessment of circulation
Assessment of range of motion
Rheumatic/Arthritic disease
Continuous passive motion
Auscultation of rate/rythym
Post-abdominal aortic bypass
Post carotic endarterectomy
Administration of post-op cardiac meds
Gastrointestinal Problems
Administration of tube feedings
Administration of medications via tube
Inflammatory bowel disease
NG tube placement and care
Assessment of bowel tones
Assessment of bowel incontinence
Signs and symptoms of fecal impaction
Post-Op anticonvulsant medications
Assessing levels of consciousness
Dementias (Re-direction/Validation)
Administration of anticonvulsant Medications
Spinal cord injuries - long term
Assessment and care of AV shunt
Assessment of urinary incontinence
Assessment of I and O data
Signs and symptoms of UTI
Indwelling catheter insertion
Straight catheter insertion
Screening for UTI via urine dipstick
Wounds, Pressure Sores, and Skin Impairments
Assessment and care of post-surgical wounds
Assessment, prevention, and care of pressure ulcers
Assessment and documentation of skin conditions/wounds
Dressing changes - aseptic
Dressing changes - sterile
Application of wound care products
Use of air fluidized, low air-loss beds
Use of pressure-relieving seat cushions
Staple and suture removal
Use of 24-hour written and verbal reporting systems
Use of "911" in LTC setting
Regulatory guidelines related to the prevention of abuse and neglect of residents
Regulatory guidelines related to resident rights in LTC setting
Incident and accident reporting
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)