Long Term Care

Long Term Care Skills Checklist

Answer Key:

1. No Experience

2. Limited Experience

3. Experienced

4. Very Experienced

Type of Facility Experience

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Nursing Home
Assisted Living
Skilled Nursing Facility (SNF)
Continuing Care Retirement Community

General Skills

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Standard Precautions
Isolation Precautions
Pain Management
Care of Patient in Restraints
Peripheral IV Insertion, Care and Maintenance
Access/Management of Implanted Ports
Access/Management of Central Lines (CVL, Hickman, Broviac, etc.)
Patient/Family Education
Knowledge of "Do Not Use Abbreviations"
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores

Medication Use

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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

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Blood Draw-Peripheral
Mixing IVs
Regulating IVs
IV Infusion Pumps
Blood/Blood Product Administration

Cardiac

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Recognizing Basic & Life-Threatening Dysrhythmias
Congestive Heart Failure
Pulse Checks
Use of Doppler
Cardiac Monitors
Obtaining EKGs - 12 Lead
Use of Automatic BP Cuff (ie Dinamap)
Nitrates (Oral, Topical)
Antiarrythmics (Oral)
Antihypertensives (Oral)

Respiratory

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Emphysema
COPD
Asthma Exacerbation
Tracheostomy
Pneumonia
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)
Bronchodilators (Oral, IV, Inhaler)
Steroids

Neuro

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Spinal Cord Injury - Acute
Spinal Cord Injury - Long Term
CVA Stroke
Neuromuscular Disease
Alzheimer Disease
Wandering
Hallucinations
Anxiousness
Agitation
Reality Orientation
Assessing Levels of Consciousness
Pupil Checks
Seizure Precautions
Stroke Precautions
Swallow Precautions
Assisting with Lumbar Puncture
Use of Hyper/Hypothermia Blanket
Dentures
Hearing Aid Devices
Care of Patients with Hearing Loss
Prosthetic Eye
Contact Lens Care
Cataracts
Blindness
Macular Degeneration
Anticonvulsant
Sedative

Gastrointestinal

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Nasogastric Tubes (i.e. Salem Sump, Levine)
Nasointestinal Tubes (i.e. Cantor, Miller-Abbot)
Jejunostomy, Gastrostomy, Cecostomy Tubes
Colostomy, Ileostomy
Administration of Tube Feedings via Flexible Tubes
By Gravity Infusion
By Feeding Pump
Collection of Stool Specimens
Bowel Preparation and Cleansing Procedures
Bowel Disimpaction
Bowel Retraining
Sitz Bath Treatments
Inserting and Checking Placement/Patency NG Tubes

Endocrine

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Diabetes
Hyper/hypoglycemia
Blood Glucose Monitoring
Performing Fingersticks
Use of Blood Glucose Meter Device
Use of Visual Blood Glucose Strips
Insulin
Single Type
Mixed Insulins
Insulin Infusion

Renal/GU

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Incontinence
Urinary Retention
UTI
Insertion of Catheter-Female
Insertion of Catheter - Male
Insertion of Suprapubic Catheter
Applications of Condom Catheter
Bladder Retraining
Urinary Diversion
Bladder Irrigation (Continuous and Intermittent)
Peritoneal Dialysis
Manual
Automatic Cycler Machine

Orthopedic

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Total Joint Replacement
Rheumatic/Arthritic Disease
Amputation
Fracture
Cast Care
CMS Checks
Traction - Skin
Traction - Skeletal
Range of Motion
Use of Assistive Devices
Applications of Splints of Extremities
Continuous Passive Motion Machine (CPM)
Transfer Techniques
Use of a Sliding Board
Gait Training/Retraining
Application of Prosthetic Devices
Application of Orthotic Devices
Pressure Sores
Leg Ulcers
Burns

Wound / Skin Care

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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
Hemovacs
Jackson-Pratt Tubes
enrose Drains
T-Tubes

Age Specific

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Newborn/Neonatal (up to 30 days)
Infant (30 days to 1 year)
Toddler (1 to 3 years)
Preschooler (3 to 5 years)
School Age (5 to 12 years)
Adolescents (12 to 18 years)
Young Adults (18 to 39 years)
Middle Adults (40 to 64 years)
Older Adults (65 & up)

I attest that this checklist represents a true reflection of my experience to the best of my knowledge. By electronically signing this form I give my permission for it to be shared with facilities as a way to assess my skill level and be considered for employment opportunities.

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