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 OF PATIENTS CARED FOR

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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 to 79 years)
Elderly Adults (over 79+ years)

GENERAL SKILLS

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Isolation Precautions
Pediatric Respiratory/Cardiac Arrest
Adult Respiratory/Cardiac Arrest
Crash Carts
Defibrillators
Care of Patient in Restraints
Pain Management
Automated Med Dispensing Systems
Care Planning & Discharge Planning
Patient/Family Education
Electronic Documentation
Patient Head to Toe Assessment
Peripheral IV Insertion, Care and Maintenance
Triage Procedures
Lab Values
Procedure for Patient Signing AMA
Consent for Treatment of Minor
Disaster Protocols
Crisis Intervention
Upholding Patient’s Rights
Reporting Procedures for Acts of Violence
Care of Patients with Infectious Diseases
Care of Patient with Central Line

IMMUNOCOMPROMISED

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Care of Patients with Cancer
Care of Patients with HIV/ AIDS
Care of Patients with Hepatitis
Care of Patients with TB

HEENT DISORDERS- CARE OF PATIENT WITH:

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Set-up for Lamp Exam
Use of Morgan Lens Irrigation
Ear Irrigations
Eye Irrigations
Eye Patch Application
Epistaxis/Nasal Packing
Visual Acuity

PULMONARY- CARE OF PATIENT WITH:

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Pulmonary Edema
Pulmonary Embolism
ARDS
Trach
C.O.P.D
Aspiration
Tuberculosis
Pneumothorax
Intubation/Extubation
T-Piece
Obtaining Arterial Blood Gases
Setting Up of Arterial Line
Ventilator
O2 Mask and Cannula
O2 Cylinders
Nebulizer Set-Up
Oropharyngeal Suction
Nasotracheal Suction
Endotracheal Suction
Assisting with Chest Tube Insertion
Use of Pleuravac Drainage System
Use of Emerson Drainage System

KNOWLEDGE AND USE OF

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Bronchodilators
Racemic Epinephrine
Steroids (IV/PO/INHALED)

CARDIOVASCULAR- CARE OF PATIENT WITH:

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Acute MI, Angina
CHF
Abdominal Aortic Aneurysm
Cardiac Monitoring
Recognizing Arrhythmias
Obtaining 12 Lead EKG’s
Cardioversion
Open Chest Heart Massage
Assist with Insertion of Pacemakers (Temp/Perm)
Set-up & Use of CVP
Interpretation of CVP Readings
Interpretation of Swan-Ganz Readings
Thrombolytic Therapy
Anaphylactic Shock
Cardiogenic Shock
Septic Shock
Hypovolemic Shock
Administration of Blood and Blood Products

KNOWLEDGE AND USE OF

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Heparin
Sodium Bicarbonate
Lidocaine
Bretylium
Nipride
Dopamine
Isuprel
Digitalis
Sodium Bicarbonate
Atropine
Epinephrine
Dobutrex
Tridil/Nitroglycerine

NEUROLOGICAL- CARE OF PATIENT WITH:

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Spinal Precautions
Neuro Assessment
Use of Glascow Coma Scale
Acute Head Injury
Acute T.I.A./C.V.A
Acute Spinal Cord Injury
Seizure Precautions
Observing for Increased Intracranial Pressure
Assist with Lumbar Puncture

KNOWLEDGE AND USE OF

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Narcan
Dilantin
Phenobarbital
Decadron
Mannitol
Solu-Medrol

GASTROINTENSTINAL- CARE OF PATIENT WITH:

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G.I. Bleed
Abdominal Wounds
Acute Abdominal Disorders
Insertion of Nasogastric Tube
Gastric Lavage

RENAL- CARE OF PATIENT WITH:

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Renal Failure
Peritoneal Dialysis
Renal Calculi
Pyelonephritis/UTI

OBSTETRICS/GYNECOLOGY- CARE OF PATIENT WITH:

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HELLP Syndrome
Spontaneous Abortion
Hemorrhage
Placenta Previa
Placental Abruption
Pre-eclampsia/Eclampsia
Emergency Delivery
Fetal Heart Tones
Sexually Transmitted Disease

KNOWLEDGE AND USE OF

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Pitocin
Magnesium Sulfate

PSYCHIATRIC- CARE OF PATIENT WITH:

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Suicidal Patient
Overdose
Emergency Police Hold
ETOH Abuse/ DTs
Seclusion

SEXUAL ASSULT/CHILD ABUSE- CARE OF PATIENT WITH:

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Sexual Assault
Signs of Abuse

ORTHOPEDIC - CARE OF PATIENT WITH:

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Traction
Cast Application
Checking C/M/S
OCL Splinting
Pins/Wires
Closed Fracture/Dislocation Reduction
Application of Orthopedic Appliances

LACERATIONS - CARE OF PATIENT WITH:

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Setting up Suture Tray
Assist with Sutures/Staples
Steri Strips

TRAUMA - CARE OF PATIENT WITH:

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Air Transport of Trauma Patient
Major Trauma
Minor Trauma
M.A.S.T. Suit

BURNS - CARE OF PATIENT WITH:

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First Degree
Second Degree
Third Degree
Electrocution
Hazardous Materials Exposure
Radiation Exposure

PEDIATRIC GENERAL SKILLS

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Abuse Reporting
Vital Sign Parameters for Pediatric Patients
Calculating Pediatric Medication Dosages
Knowledge of Normal Serum Lab Values

PEDIATRIC- CARE OF PATIENT WITH:

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Febrile Seizure
Epiglottitis
Overdose/Poison Ingestion
Asthma
Near Drowning

ENVIRONMENTAL - CARE OF PATIENT WITH:

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Hypothermia
Heat Stroke/Exhaustion
Snake Bite
Administration of Antivenim
Animal Bite
Poison Index

KNOWLEDGE AND USE OF

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Antibiotics
Analgesics
Antiemetics
Sedatives
Medication Titration and Calculations
Reversal Agents
Charcoal

MISCELLANEOUS INSTRUMENTS/TRAYS

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Pelvic Tray
Cut Down Tray
Procto Tray
CVP Tray
Trach Tray
Culdocentesis Tray
Thoracentesis Tray

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 - ER RN