info@usnurselink.com    866.945.4888
 
 Extended Care Skills Checklist Back to  
This checklist will be used to assess your suitability for placement.
 
Experience Guide
1 - Not Applicable - minimal or no exposure to clinical aspect or care.
2 - Beginner - sufficient knowledge to understand the contextual nature of the function, able to perform routine functions independently, requires assistance when setting priorities in complex situations, needs to gain speed and flexibility to be competent.
3 - Competent - perceives situations and functions as a whole, has knowledge of the typical events to expect in a given situation and the appropriate responses, flexible in decision making.
4 - Proficient - considerable background and experience, can grasp situations intuitively, mastery in performance, incorporates elements of innovation and creativity in clinical experience.
 

 System Assessment
 General System Assessment Skills   Experience
  1    2    3    4
  Cardiovascular     
  Gastrointestinal     
  Genitourinary     
  Integumentary     
  Neurological     
  Respiratory     
  Skin Care     
 
 Medical Conditions
 General Medical Conditions   Experience
  1    2    3    4
  Active Rehabilitation Patients     
  Acute Renal Failure     
  Asthma     
  Bowel Obstruction     
  Cerebral Vascular Accident     
  Cervical Fracture/Surgery     
  Chronic Mechanical Ventilator Dependence     
  Chronic Obstructive Pulmonary Disease     
  Chronic Renal Failure     
  Cirrhosis     
  Colostomy     
  Complicated Fractures     
  Decubitus     
  Decubitus Ulcers     
  Diabetes Mellitus     
  Enteral Feedings     
  Esophageal Varices     
  Fractures     
  Gastroenteritis     
  Gastro Intestinal Bleed     
  Halo Traction     
  Hematological Disorders     
  Hemiplegia     
  Hepatitis     
  Oxygen Dependence     
  PE/DVT     
  PEG     
  Pneumothorax     
  Post TURP     
  Psychological Disorders     
  Quadriplegia     
  Seizure Activity     
  Skeletal Traction     
  Spinal Patients     
  Tracheostomy     
 
 Skilled Nursing
 Skilled Nursing Skills   Experience
  1    2    3    4
  Access Circulation     
  ADLs Assessment and Teaching     
  Airway Management     
  Aseptic Dressing Changes     
  Assessment/Management of Pain     
  Assist With Lumbar Puncture     
  BiPap/CPap     
  Blood Glucose Monitoring     
  Calculate Medication Dosages by Weight     
  Calculate Total Intake and Output by Weight     
  Cardiovascular/Neuro Checks     
  Care of Central and PICC lines     
  Care of Isolation Patient     
  Chest Percussion     
  Coaching Family Needs: Physical Emotional Comfort     
  Colostomy Care     
  Comatose Patients     
  CPR Adult     
  CPR Infant     
  CPR Pediatric     
  Decubitus Care     
  Dressing Changes     
  Electrolyte Balance/Replacement     
  End of Life Care     
  Fluid and Electrolyte Management     
  Gastric Tube Care     
  Hemovac Care     
  Heparin Lock and Saline Flush     
  Hickman Broviac     
  Ileostomy Care     
  Immunization Requirements     
  Incentive Spirometry     
  Insulin Scales and Delivery     
  Intramuscular Injections (Adult and Pediatric)     
  Intravenous Infusions Buretrol Soluset     
  Isolation Techniques     
  JP Tube Care     
  Knowledge Of Normal Lab Values     
  Latex Allergy Precautions     
  Lift and Transfer Devices     
  NG Tube Insertion     
  Oral and Nasotracheal Suctioning     
  Organ Donation Procedures     
  Oxygen Delivery     
  Patient and Family Teaching     
  Patient Transfers     
  PCA     
  Peripheral IV and Blood Draws     
  Portacatheter and Vascular Devices     
  Post Mortem Care     
  Pressure Stockings     
  Pulse Oximetry     
  Restrained Patients: Care, Documentation, Legal Issues     
  Scalp Veins     
  Seizure Precaution     
  Skeletal Pin Site Care     
  Sterile Technique     
  Stump Dressings and Post Surgical Care     
  Suctioning     
  Swallowing Assessment     
  TPN Lipids     
  Tracheostomy Care     
  Universal Precautions     
  Urinary Catheter Insertion & Care     
  Urostomy Care     
  Use of Doppler     
  Use of Infusion Pumps IV Monitoring     
  Use of Specialty Beds     
  Wound Care     
 
 Medication Administration
 General   Experience
  1    2    3    4
  Cardiac Medications     
  Endotracheal Medications     
  Enemas     
  Insulin     
  Intramuscular     
  Narcotics     
  Oral Medication     
  Psychotropics     
  Rectal Medication Administration     
  Subcutaneous     
 
 Intravenous Medication   Experience
  1    2    3    4
  Central Lines     
  Infusions     
  IV Push     
  IV Sedation     
  Peripheral Line Insertion     
  Piggyback     
 
Age Specific Practice Criteria
Please check the boxes below for each age group for which you have expertise in providing age-appropriate nursing care.
 
A. New Born/Neonate (Birth - 30 days)
B. Infant (30 days - 1 Year)
C. Toddler (1 - 3 Years)
D. Preschooler (3 - 5 Years)
E. School age children (5 - 12 Years)
 
F. Adolescents (12 - 18 Years)
G. Young Adults (18 - 39 Years)
H. Middle Adults (39 - 64 Years)
I. Older Adults ( +64 Years)
 

 Experience With Age Groups
  Able to adapt care to incorporate normal growth and development
A B C D E F G H I 
  Able to adapt method and terminology of patient information to their age, comprehension and maturity level.
A B C D E F G H I 
  Can ensure a safe environment reflecting specific needs of varying age groups.
A B C D E F G H I 
 
By submitting this checklist you agree to the following:

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a per diem nurse with those facilities.
 
 
 
 
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