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LTC RN Skills Checklist

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1 – 2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

AGE OF PATIENTS CARED FOR

Young Adults (18 years to 39 years)(Required)
Middle Adults (39 years to 64 years)(Required)
Older Adults (64+ years)(Required)

CLINICAL SETTINGS

Hospital within Hospital(Required)
Free-Standing LTAC(Required)

GENERAL SKILLS

Admission(Required)
Advance Directives(Required)
Collect Appropriate Data(Required)
Organ/Tissue Donation(Required)
Patient and Family Teaching(Required)
Electronic Medical Records(Required)

CARDIOVASCULAR

Assess
Abnormal Heart Sounds/Murmurs(Required)
Capillary Refill(Required)
Patient Experience
Acute MI(Required)
Angina(Required)
Cardiac Arrest/CPR(Required)
Cardiomyopathy(Required)
Congestive Heart Failure(Required)
Pacemaker(Required)
AICD (Automatic Implanted Cardioverter/Defibrillator)(Required)
Post Cardio-Thoracic Surgery(Required)
Monitoring
CVP Monitoring(Required)
Arterial Line(Required)
Cardiac Monitoring(Required)
Labs
BNP (Brain Natriuretic Peptide)(Required)
Cardiac Enzymes and Isoenzymes(Required)
Coagulation Studies(Required)
Troponin(Required)

PULMONARY

Assess
Adventitious Breath Sounds(Required)
Oxygenation Status(Required)
Rate and Work of Breathing(Required)
Patient Experience
Acute Pneumonia(Required)
Chest Tube(Required)
COPD(Required)
Pulmonary Edema(Required)
Pulmonary Embolism(Required)
Tracheostomy(Required)
Tuberculosis(Required)
Monitoring
Pulse Oximetry(Required)
End Tidal CO2(Required)
Labs
ABGs(Required)

NEUROLOGY

Assess
Level of Consciousness(Required)
Neuro Assessment(Required)
Reflex/Motor Deficits(Required)
Visual/Communication Deficits(Required)
Patient Experience
Alzheimer's Disease(Required)
Coma(Required)
CVA/Stroke(Required)
Neuromuscular Disease(Required)
Seizure Disorder(Required)
Spinal Cord Injury(Required)
Traumatic Brain Injury(Required)
Halo Traction/Cervical Tongs(Required)

GASTROINTESTINAL

Patient Experience
Nutritional Status(Required)
Bowel Sounds(Required)
GI Assessment(Required)
Patient Experience
Abdominal Wounds(Required)
Bowel Obstruction(Required)
Colostomy(Required)
GI/Esophageal Bleeding(Required)
Hepatitis(Required)
Pancreatitis(Required)
Liver Failure(Required)
Cancer(Required)
Labs
Serum Amylase(Required)
Serum Ammonia(Required)
Liver Function Tests(Required)

RENAL/GENITOURINARY

Assess
Fluid Status(Required)
Patient Experiences
Acute Renal Failure(Required)
End Stage Renal Failure(Required)
Hemodialysis(Required)
Nephrostomy(Required)
Urinary Tract Infection(Required)
Suprapubic Cath(Required)
Fistula/Shunt(Required)
Monitoring
I &O Measurment(Required)
Fluid Balance(Required)
Labs
Serum Electrolytes(Required)
BUN and Creatinine(Required)

ENDOCRINE/METABOLIC

Patient Experience
Diabetes(Required)
Blood Glucose(Required)

MUSCULOSKELETAL

Assess
Pulse/Circulation Checks(Required)
Patient Experience
Amputation(Required)
Joint Replacement(Required)
Skeletal/Skin Traction(Required)
Cast Care(Required)

IMMUNOLOGY/HEMATOLOGY/ONCOLOGY

Patient Experience
Cancer(Required)
HIV/AIDS(Required)
Treatment Side Effects - Chemo/Radiation(Required)
Sepsis(Required)

WOUNDS/INTEGUMENT

Assess
S/S Infection(Required)
Staging of PRessure Ulcers(Required)
Skin Assessment(Required)
Patient Experience
Burns(Required)
Pressure Ulcers(Required)
Surgical Wounds and Drains(Required)
Statis Ulcers(Required)
Wounds(Required)
Monitoring
Skin Breakdown(Required)

MEDICATION/THERAPEUTIC INTERVENTIONS

Medication Administration
Administer IM and SQ Meds(Required)
Administer PO Medications(Required)
Administer IVP Medications(Required)
Administer IV Drips and Titration(Required)
Administer Meds per Feeding Tubes(Required)
IV Therapy
Assess/Maintain IV(Required)
Heparin Lock(Required)
Vascular Access Device - Care/Maintenance(Required)
Peripheral IV Insertion(Required)
Blood
Administer Blood/Blood Products(Required)
Nutrition Therapy
Enteral Feeding Administration(Required)
TPN/Procalamine(Required)
Tube Feeding Pumps(Required)
Bolus Tube Feedings(Required)
NGT/SBFT Insertion(Required)
PEG/G-Tube(Required)
Oxygen Administration
Nasal Cannula(Required)
Venti Mask(Required)
Non-Rebreather Mask(Required)
Ambu-Bag(Required)
Trach Collar(Required)
Portable Oxygen Ventilator (IMV, AC, PEEP)(Required)
Pain Management
Assess Pain Level Tolerance(Required)
Functional Pain Goal(Required)
Epidural Analgesia(Required)
Patient Controlled Analgesia(Required)

PROCEDURES/EQUIPMENT

Perform/Maintain
Chest Tube Drainage Systems(Required)
Doppler(Required)
Dressing Changes(Required)
Drains (JP-Hemovac-Penrose)(Required)
Suctioning (Oral-Naso-Pharnyx)(Required)
Tracheostomy Care/Suctioning(Required)
Indwelling Urinary Catheter(Required)
Isolation(Required)
Wound Vac(Required)
Wound Care/Irrigations(Required)
Specimen Collections
Finger Stick(Required)
Butterfly Stick(Required)
Central-Line Blood Draw(Required)
Clean Catch Urine(Required)
Urine Catheter Culture Collection(Required)
Blood Cultures(Required)
Venipuncture(Required)
24 Hour Urine(Required)
Assist
Bedside Invasive Procedures(Required)
Bronchoscopy(Required)
Central Line Insertion(Required)
Chest Tube Insertion(Required)
Endotracheal Intubation(Required)
Procedure/Moderate Sedation(Required)

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