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Skilled Nursing Checklist

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Skilled Nursing Checklist

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 below to describe your experience/expertise in each area listed below.

General Skills

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Advanced directives
Awareness of HCAHPS
Patient/family teaching
Discharge planning
UR/medicare review
Lift/transfer devices
Specialty beds
Restrictive devices (restraints)
End of life care/palliative care
Automated Medication Dispensing System, Pyxis, Omnicell, or other
National Patient Safety Goals
Accurate patient identification
Effective communication
Awareness of patient rights
Interpretation & communication of lab values
Medication administration
Labeling (medications & specimens)
Medication reconciliation
Anticoagulation therapy
Pain assessment & management
Infection control
Universal precautions
Isolation
Minimize risk for falls
Prevention of pressure ulcers
Cardiac

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Assessment of heart sounds
Identification of arrhythmias (rate/rhythm)
Pacemakers/AID’s
Cardiac arrest/CPR
Hypertension
Pre/post MI
CHF
Post cardiac surgery
Fluid & electrolyte imbalances
Anticoagulants (Medication Administration)
Antiarrhythmics (Medication Administration)
Beta blockers (Medication Administration)
Nitroglycerin (Medication Administration)
Diuretics (Medication Administration)
Respiratory

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Assessment/auscultation of lung sounds
Establishing an airway
Chest PT
Incentive spirometry
Supplemental oxygen (cannula, facemask)
Tracheostomy care
Suctioning (tracheostomy & nasotracheal)
Nebulizer use
Pneumonia(Care of Patient with: )
Asthma(Care of Patient with: )
COPD(Care of Patient with: )
Emphysema (Care of Patient with: )
Bronchodilators(Use & Administration of: )
Expectorants(Use & Administration of: )
Corticosteroids (Use & Administration of: )
Neurology

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Assessment of neuro signs
Seizure precautions
TBI (Traumatic Brain Injury: history of) (Care of Patient with:)
Seizure activity (Care of Patient with:)
Spinal cord injury (Care of Patient with:)
Stroke (CVA) (Care of Patient with:)
Multiple sclerosis (Care of Patient with:)
Alzheimer’s disease (Care of Patient with:)
Parkinson’s disease (Care of Patient with:)
ALS (Amyotrophic Lateral Sclerosis) (Care of Patient with:)
Antiseizure medications(Use & Administration of: )
Antiemetics(Use & Administration of: )
Laxatives(Use & Administration of: )
Enemas(Use & Administration of: )
Bowel prep(Use & Administration of: )
Gastrointestinal

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
NG tube (insertion/removal)
Long term feeding tubes (dobhoff/keofeed)
Gastrostomy tube
Tube feedings
Monitoring input/output
Colostomy/ileostomy(Care of Patient with:)
GI bleed(Care of Patient with:)
Feeding devices/adaptive equipment(Care of Patient with:)
Dietary restrictions (Care of Patient with:)
GT/PEG feedings(Care of Patient with:)
Antiemetics(Use & Administration of: )
Laxatives(Use & Administration of: )
Enemas(Use & Administration of: )
Bowel prep(Use & Administration of: )
Gastrointestinal

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Foley catheter insertion/removal
GU irrigations
Nephrostomy tube
Suprapubic catheter
Ileo conduit
Use of bladder scan equipment
Shunts and fistulas(Care of Patient with:)
Straight catheterizations(Care of Patient with:)
Incontinence/bladder training(Care of Patient with:)
Chronic renal failure/dialysis(Care of Patient with:)
Peritoneal dialysis(Care of Patient with:)
Orthopedic

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Total joint replacement
Arthroscopic surgery
Cast care
Pulse/CMS checks
Suture/staple removal
Prosthesis application
Standard extremity braces
Amputation(Care of Patient with:)
Stump wrapping(Care of Patient with:)
Laminectomy(Care of Patient with:)
Assistive devices(Care of Patient with:)
CPM machines (Care of Patient with:)
IV Therapy

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Start & maintain Ivs
Blood draw: venous
Central line care (PICC)
Blood draw: central line PICC
Care & management of ports
Infusion pumps
Administration of blood/blood products
Skin

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Wound care/surgical
Wound care/medical
Dressing changes
Skin assessment
Wound vac
Age Specific Competencies

 No Experience Need Traning Able to perform with Supervision Able to perform Independently
Newborn/neonate (birth-30 days)
Infant (31 days-1 year)
Toddler (2-3 years)
Preschool (ages 4-5 years)
School age (ages 6-12 years)
Adolescents (ages 13-21 years)
Young adult (ages 22-39 years)
Adults (ages 40-64 years)
Older adult (ages 65-79 years)
Elderly (ages 80+ years)

Please list any Additional Skills:
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2
3
4

Additional training:
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2
3
4

Additional equipment:
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2
3
4

I hereby certify that ALL information I have provided on this skills checklist, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.