Skills Checklist - Infection Prevention RN

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)

WORK SETTING

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Home Hospice
Inpatient Hospice
Pediatric Hospice
Home Health/Hospice Setting

ASSESSMENT

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Intake Assessment
Assessment Interview
Physical Exam
Coping Status
Environmental Status

PLAN OF CARE

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Set Goals with Patient/Family
Collaborate with Other Team Members
Collaborate with Other Team Members

SYMPTOM MANAGEMENT

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Urgent Assessment of Symptoms
Reduce Symptoms to Level Acceptable to Patient
Report Symptoms/Management to Provider
Treat Underlying Cause
Severity Scale
Management of Nausea
Management of Constipation
Management of Fatigue
Anorexia/Cachexia
Restlessness
Educate Family of Symptom Management

PAIN MANAGEMENT

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Identify Source of Pain
Pain Severity
PAINAD Scale for Non-verbal Patient
Reduce Pain to Level Acceptable to Patient
WHO 3-Step Ladder
Non-Pharmacological Management of Pain
Pharmacological Management of Pain
Effects of Pharmacological Treatment
Nociceptive/Neuropathic/Mixed Pain
Management of Nociceptive Pain
Management of Neuropathic Pain
Educate Family on Pain Management

WOUND CARE

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Positioning Techniques
Bed/Support Surface Selection
Pressure Ulcer Staging/Management
Response to Treatment
Evaluate Factors that Impede Healing
Educate Family on Positioning/Shearing

PEDIATRICS

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Developmentally Appropriate Assessment
Parental/Sibling Support
Pediatric Support Team Collaboration

MEDICATION ADMINISTRATION

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Equianalgesic Conversion Formula
Titration of Opioids
IV Pump Management
Evaluate Effectiveness of Medications
Family Management of Medications
Disposal of Medications

AFTER DEATH

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Family/Cultural Rituals/Rites
Patient Care after Death
Coordinate Mortuary Services
Bereavement Services

COMPLIANCE

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Scope and Frequency of Services
Medicare/State Regulations for Hospice
Document Progression of Decline
DME Authorization & Documentation of Need/Order
OASIS-C

PROFESSIONAL KNOWLEDGE AND SKILLS

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Identify Source of Suffering
Palliative Care Philosophy
Patient/Family Directs Goals of Care
Maximize Quality of Life
Cultural Diversity
Supervision of Ancillary Staff
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
Infection Prevention
Isolation Precautions
Interpretation and Communication of Lab Values
Electronic Documentation
Automated Medication Dispensing Systems

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 - Hospice LPN