Skills Checklist

This Skills Checklist is a self-evaluation to assess your recent experience in various clinical settings focusing on the past 2 years.

0 = No Experience
1 = Some Experience
2 = Intermittent Experience
3 = Experienced
4 = Very Experienced

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AGE SPECIFIC CARE

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Newborn/Neonate (birth to 30 days)
Infant (1 month to 1 year)
Toddler (1 year to 3 years)
Preschooler (3 years to 5 years)
School Age Child (5 years to 12 years)
Adolescents (12 years to 18 years)
Young Adults (18 years to 39 years)
Middle Adults (39 years to 64 years)
Older Adults (64+ years)

CLINICAL AREAS

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Burn Unit
Cardiac Care
Emergency Department
Intensive Care Unit
Step Down
Gynecology
Labor and Delivery
Medical
Mother/Baby
Neurology
Nursery
Obstetrics
OR
Oncology
Orthopedics
Pediatrics
Post Partum
Psychiatry
Rehabilitation
Renal/Dialysis
Respiratory
Surgical
Telemetry
Doctor’s Office
Health Department
Corrections
Home Health
Long Term Care
Hospice
Respite Care
Outpatient Clinic
Nursing Home

CORE SKILLS

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Admissions of a Patient
Transfer of a Patient
Discharge of a Patient
Assist with Emergency Situations/Codes
Vital Signs
Post Mortem Care
Assist with Defibrillation
Assist with Cardioversion
Documentation
Patient and Family Education
Assessment of Abuse
Restraints
Body Mechanics
Aseptic Technique
Isolation Precautions

CARDIOVASCULAR - CARE OF PATIENT WITH:

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Auscultation (rate, rhythm)
Blood Pressure/Non-invasive
Doppler
Heart Sounds/Murmurs
Abdominal Aortic Aneurysm/Bypass
Angina
Cardiac Arrest
Cardiomyopathy
Carotid Endarterectomy
Congestive Heart Failure
Femoral-Popliteal Bypass
Myocarditis
Status Post MI
Post Angioplasty
Post Cardiac Cath
Thrombophlebitis
Temporary Pacemaker
Permanent Pacemaker
Cardiac Enzymes
Blood Chemistries
Basic Arrhythmia Interpretation
Lead Placement

PULMONARY - CARE OF PATIENT WITH:

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Ventilator/Weaning
Breath Sounds
Rate and Work of Breathing
Arterial Blood Gases (ABG)
Asthma
COPD
Tracheostomy
Lobectomy
Pneumonectomy
Pneumonia
Pulomonary Embolism
Thoracotomy
Tuberculosis
Pulmonary Edema
Pneumothorax
Laryngospasm
Endotracheal Tube/Suctioning
Nasal Airway/Suctioning
Oropharyngeal/Suctioning
Sputum Specimen Collection
Tracheostomy/Suctioning
Assist with Intubation
Assist with Thoracentesis
Chest Tube Management
Chest Physiotherapy
Incentive Spirometry
Pulse Oximetry
Bag and Mask
Face Mask
Nasal Cannula
Portable O2 Tank

NEUROLOGICAL - CARE OF PATIENT WITH:

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Glascow Coma Scale
Level of Consciousness
Assist with Lumbar Puncture
Use of Hypo-Hyperthermia Blanket
Aneurysm Precautions
Basal Skull Fracture
Closed Head Injuries
Coma
CVA
TIA
Delerium Tremens
Encephalitis
Meningitis
Neuromuscular Disorders
Psychiatric Disorders
Seizures
Overdose
Guillain- Barre Syndrome
Externalized VP Shunts
Post Craniotomy
Spinal Cord Injuries

ORTHOPAEDICS - CARE OF PATIENT WITH:

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Circulation checks
Gait
Range of Motion
Skin
Wheelchair Use
Cane/Crutches/Walker Use
Amputation
Arthroscopic Surgery
Cast
Splint
Knee Immobilizer
Osteoporosis
Pinned Fractures
Total Joint Replacements
Continuous Passive Motion Devices
Cervical Collar
Prosthetics
Traction- Bucks/Skeletal
Auto Transfuser

GASTROINTESTINAL - CARE OF PATIENT WITH:

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Abdominal/ bowel sounds
Fluid Balance
Placement of NG tube
Placement of Flexible Feeding Tube
Administration of Tube Feeding
Feeding Pumps
Gravity Feeding
Salem Sump to Suction
Care of Gastrostomy Tube
Colostomy Care
Bowel Obstruction
GI Bleeding
GI Surgery
Hepatitis
Inflammatory Bowel Disease
Liver Failure
Liver Transplant
Paralytic Ileus
Colostomy/Ileostomy
Abdominal Trauma

RENAL/GENITOURINARY - CARE OF PATIENT WITH:

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Fluid Balance
Urinary Output
BUN &Creatinine
Catheter Care
Specimen Collection- Routine
Specimen Collection- 24 Hours
Specimen Collection- Clean Catch
Insertion & Care of Straight and Foley Catheters- Female
Insertion & Care of Straight and Foley Catheters- Male
Hemodialysis
Nephrectomy
Peritoneal Dialysis
Renal Failure
Renal Transplant
TURP
Ileal Conduit
Bladder Irrigations
Urinary Tract Infections
Gyn Surgery
Renal trauma

ENDOCRINE/ METABOLIC - CARE OF PATIENT WITH:

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S/S Diabetic Coma
S/S Insulin Coma
Blood Glucose Monitoring
Performing Finger/Heel Stick
Sliding Scale Insulin Protocols
Adrenal Disorders (Addison’s)
Diabetes Mellitus
Diabetes Insipidus (Pituitary Disorder)
Diabetic Ketoacidosis
Hyperthyroidism
Hypothyroidism
Thyroidectomy

WOUND MANAGEMENT

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Assess Skin for Impending Breakdown
Surgical Wound Healing
Sterile Dressing Change
Wound Vac
Wet to Dry Dressings
First Degree Burns
Second Degree Burns
Third Degree Burns
Decubitus Ulcers
Surgical Wounds with Drains
Traumatic Wounds
Wound Care Irrigations
Multiple Abdominal Wounds and Drains
Gunshot Wound
Stab Wound
Lacerations
Abrasions

ONCOLOGY - CARE OF PATIENT WITH:

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Bone Marrow Transplant
Inpatient Chemotherapy
Leukemia
Radiation Implant
Lymphoma
Depressed Immune System
Radiation Therapy
Fresh Oncology Surgery

INFECTIOUS DISEASE - CARE OF PATIENT WITH:

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HIV
MRSA
C. Difficile
VRE
Hepatitis
Influenza
Isolation Precautions

INTRAVENOUS THERAPY

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Site Assessment
Administration of Blood & Blood Products
Drawing Blood from a Central Line
IV Insertion
Heplock Flushes
Administration of IV Fluid
Administration of IV Piggy Back
Administration of IV Push Medications
Access VAD
Central Line
Peripheral Line
Administration TPN/Lipids

PAIN MANAGEMENT

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Assessment of Pain Level/Tolerance
Administration of Narcotic Analgesia
PCA Pumps
IV Conscious Sedation
Epidural Anesthesia

MISCELLANEOUS

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Computerized Charting
Automated Med. Dispensing Systems
Safe Needle Devices
PO Medications
IM Injections
SQ Injections
Z- Track Injections
Rectal Suppositories
Nasal Sprays
Eye Drops
Inhalers
Assist with Emergency Drugs/Code Cart

Position Category

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Total Years of Experience

First Name

Last Name

Social Security #

Date of Birth

Email

Phone

Attestation

I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified, particularly within the last 2 years. I hereby authorize Alliant Personnel Resources (The Company) to collect, store, and release any information that I have provided in this Skills Checklist and/or any other documentation and information they have collected or that I have submitted in any form to its parent company(s), its subsidiaries, or other subcontractors/its service providers as it deems necessary in its business operations as well as to individuals and companies in relation to consideration of employment as a Healthcare Professional with those companies and individuals. I acknowledge that The Company will take precaution and care to protect my personal information that is collected/stored/shared but cannot guarantee permanent data security and I release The Company from all related liability for damages or punitive liability.

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Skills Checklist - LPN