• Wound Care Skills Checklist

  • Answer Key:

    1. No Experience

    2. Limited Experience

    3. Experienced

    4. Very Experienced

  • Pressure Ulcer
    Rows
  • Pressure Ulcer Staging
    Rows
  • Pressure Ulcer Support Surfaces
    Rows
  • Neuropathic (Diabetic Foot) Ulcer Treatment
    Rows
  • Venous Stasis Ulcer Treatment
    Rows
  • Peripheral Arterial Ulcer (PAD)
    Rows
  • Other Wounds
    Rows
  • Wound Care Treatment
    Rows
  • Colostomy
    Rows
  • Ileostomy
    Rows
  • Continent Ileostomy
    Rows
  • Continent Urostomy
    Rows
  • Stomal, Peristomal Skin Conditions
    Rows
  • Ostomy Equipment
    Rows
  • Continence Evaluation/Assessment
    Rows
  • Continence Skin Care/Containment
    Rows
  • Continence Therapeutic Devices
    Rows
  • Pediatric Related Conditions
    Rows
  • G/J Tubes
    Rows
  • Other
    Rows
  • Interpretation of Lab Results
    Rows
  • Age Specific
    Rows
  • 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.  

  •  -
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: