Skills Checklist - LTC RN - Origin Travel Nurses

GENERAL SKILLS*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Standard Precautions
Isolation Precautions
Pediatric Respiratory/ Cardiac Arrest
Adult Respiratory/ Cardiac Arrest
Crash Carts
Defibrillators
Care of Patients in Restraints
Pain Management
Care Planning & Discharge Planning
Patient/ Family Education
Patient Head to Toe Assessment
Automated Med Dispensing System
Electronic Documentation

MEDICATION-KNOWLEDGE AND USE OF*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Pouring from Stock Medications
Narcotic Administration
IV Push/ Drip Medications
Antibiotics
Oral
Topical
Otic
Rectal
Vaginal
Ophthalmic
Continuous Subcutaneous Infusion Pumps
Total Parenteral Nutrition (TPN)
Peripheral Parenteral Nutrition
Patient Controlled Analgesia (PCA)

PHLEBOTOMY/ IV THERAPY*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Blood Draw- Peripheral
Blood Draw- Central Line/ Port
Insertion, Care and Maintenance of Peripheral IV
Care and Maintenance of Central Lines
Care and Maintenance of Implanted Port- A- Cath
Mixing IVs
Regulating IVs
IV Infusion Pumps
Blood/ Blood Product Administration

CARDIAC*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Recognizing Basic & Life- Threatening Dysrhythmia
Congestive Heart Failure
Pulse Checks
Use of Doppler Cardiac Monitors
Taking EKGs- 12 Lead
Use of Automatic BP Cuff (ie Dinamap)

RESPIRATORY*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
COPD
Asthma Exacerbation
Tracheostomy
Pneumonia
Emphysema
Pre/ Post Thoracic Surgery
Chest Tubes
Collection of Sputum Specimen
O2 Cannulas/ Masks
Non- rebreather Mask
Nebulizer Set- up/ Use
Incentive Spirometry
Chest PT
Suctioning (Oral/ Nasotracheal)
Suctioning (Tracheostomy Tube)
Ventilator Patient (Mouth Care, Suctioning, Ambu bag)

RESPIRATORY - Knowledge and Use of:*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Bronchodilators (Oral, IV, Inhaler)
Steroids

NEURO*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Spinal Cord Injury- Acute
Spinal Cord Injury- Long Term
CVA/Stroke
Neuromuscular Disease
Alzheimer's Disease
Wandering
Hallucinations
Anxiety
Reality Orientation
Assessing Levels of Consciousness
Pupil Checks
Seizure Precautions
Stroke Precautions
Swallow Precautions
Assisting with Lumbar Puncture
Use of Hyper/ Hypothermia Blanket

NEURO - Knowledge and Use of:*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Anticonvulsant
Sedative
SENSORY DEFICITS-CARE OF PATIENTS WITH:*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Dentures
Hearing Aids
Hearing Loss
Prosthetic eye
Contact Lens Care
Blindness
Macular Degeneration

GASTROINTESTINAL- CARE OF PATIENTS WITH:*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Nasogastric tubes (i.e. Salem Sump, Levine)
Nasointestinal Tubes (i.e. Cantor, Miller- Abbott)
Jejunostomy, Gastrostomy, Cecostomy Tubes
Colostomy, Ileostomy
Bronchoscopy Lung/ Wedge Resection

GI GENERAL*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Collection of Stool Specimens
Bowel Preparation and Cleansing Procedures
Administration of Tube Feedings via Flexible Tubes
Bowel Disimpaction
Bowel Retraining
Sitz Bath Treatments
Insertion and Checking Placement/ Patency NG Tubes

ENDOCRINE- CARE OF PATIENTS WITH:*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Diabetes
Hyper/ hypoglycemia
ENDOCRINE GENERAL*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Blood Glucose Monitoring
Performing Fingersticks
Use of Blood Glucose Meter Device
Use of Visual Blood Glucose Strips
ENDOCRINE GENERAL - Knowledge and Use of:*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Single Type Insulin
Mixed Insulins
Insulin Infusion

RENAL/ GU- CARE OF PATIENTS WITH:*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Incontinence
Urinary Retention
UTI
Insertion of Foley Catheter- Female
Insertion of Foley Catheter- Male
Straight Catheterization- Male
Straight Catheterization- Female
Insertion of Suprapubic Catheter
Application of Condom Catheter
Bladder Retraining
Urinary Diversion
Bladder Irrigation (Continuous and Intermittent)

RENAL/ GU- Peritoneal Dialysis*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Manual
Automatic Cycler Machine
ORTHOPEDIC- CARE OF PATIENTS WITH:*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Total Joint Replacement
Rheumatic/ Arthritic Disease
Amputation
Fracture

ORTHOPEDIC GENERAL*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Cast Care
CMS Checks
Traction- Skin
Traction- Skeletal
Range of Motion
Use of Assistive Devices
Application of Splints of Extremities
Continuous Passive Motion Machine (CPM)
Transfer Techniques
Use of Sliding Board
Gait Training/ Retraining
Application of Prosthetic Devices
Application of Orthotic Devices

WOUND/ SKIN- CARE OF PATIENTS WITH:*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Pressure Sores
Leg Ulcers
Burns

WOUND/ SKIN GENERAL*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Acute Dressing Changes
Wound Care
Irrigations
Identifying Common Skin Problems
Recognizing Normal Skin Changes
Use of Special Pressure Relief Devices
Pressure Relief Mattress/ Seat Cushion

Age Group Experience*

Do you speak any languages other than English?*
- No
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Confirmation*
- I attest that the information I have given is both true and, to the best of my knowledge, represents an accurate self assessment of my professional skills and/or education.
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Origin Travel Nurses has earned the Joint Commission's Gold Seal of Approval