Medical/Surgical 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)

Full Name(Required)

Email(Required)

Date(Required)

Send to(Required)

AGE OF PATIENTS CARED FOR

Newborn/Neonate (birth to 30 days)(Required)

Infant (31 days to 12 months)(Required)

Toddler/Preschool (13 months to 5 years)(Required)

School Age Child/adolescent (6 years to 12 years)(Required)

Adolescent (12 - 18 years)(Required)

Young Adults (18 - 39 years)(Required)

Middle Adult (39 - 64 years)(Required)

Older Adults (64+ years)(Required)

GENERAL SKILLS

Standard Precautions(Required)

Isolation Precautions(Required)

Discontinue PIV(Required)

Initiate Peripheral IV(Required)

Lift/ Transfer Devices(Required)

Pediatric Respiratory/Cardiac Arrest(Required)

Adult Respiratory/Cardiac Arrest(Required)

Crash Carts(Required)

Defibrillators(Required)

Care of Patients in Restraints(Required)

Pain Management(Required)

Automated Med Dispensing Systems(Required)

Care Planning & Discharge Planning(Required)

Patient/Family Education(Required)

Electronic Documentation(Required)

Patient Head to Toe Assessment(Required)

Knowledge of Normal Serum Lab Values(Required)

Obtaining Cultures (Blood, Sputum, Swab, Urine)(Required)

Calculate mcg/min and mcg/Kg/min(Required)

Titrating Medications(Required)

Electronic Documentation(Required)

PSYCHOLOGICAL

Overdose/ Withdrawl(Required)

Suicidal Precautions(Required)

Manic Disorder/ Behavior(Required)

Depression(Required)

Knowledge and Use of :

Anti-depressants(Required)

Anti-anxiety Medications(Required)

Psych Medications(Required)

MEDICATIONS

Anticoagulants(Required)

Narcotics(Required)

PCA for Pain Control(Required)

Epidural for Pain Control(Required)

Non-narcotic Analgesics(Required)

Topical Medications(Required)

IM Medications(Required)

SQ Medications(Required)

Oral Medications(Required)

IV Push Medications(Required)

IV Drip Medications(Required)

Antibiotics(Required)

Chemotherapy(Required)

NEURO GENERAL SKILLS

Assessing Levels of Consciousness(Required)

Pupil Checks(Required)

Seizure Precautions(Required)

Aneurysm Precautions(Required)

Assisting with Lumbar Puncture(Required)

Use of Hyper/Hypothermia Blanket(Required)

NEURO- CARE OF PATIENTS WITH:

Stroke(Required)

Spinal Cord Injury - Acute(Required)

Spinal Cord Injury – Long Term(Required)

Neuromuscular Disease(Required)

Alzheimer's Disease(Required)

Knowledge and Use of :

Anticonvulsants(Required)

IV Drip Steroids(Required)

CARDIAC GENERAL SKILLS

Angina(Required)

CHF(Required)

Chest Pain(Required)

Post MI(Required)

Knowledge and Use of:

Nitrates (Oral, Topical)(Required)

Antiarrhythmics (Oral)(Required)

Antihypertensives (Oral)(Required)

Heparin Drip(Required)

RESPIRATORY GENERAL SKILLS

O2 Cannulas/Masks(Required)

Nebulizer Set-up/Use(Required)

Incentive Spirometry(Required)

Chest PT(Required)

Suctioning:(Required)

ENDOCRINE

Oral(Required)

Tracheostomy Tube(Required)

RESPIRATORY- CARE OF PATIENT WITH:

SOB(Required)

Pulmonary Embolism(Required)

COPD(Required)

Asthma Exacerbation(Required)

Pneumonia(Required)

Pre/Post Thoracic Surgery(Required)

Chest Tubes(Required)

Tuberculosis(Required)

Knowledge and Use of:

O2 Therapy(Required)

Bronchodilators(Required)

Oral Steroids(Required)

IV Steroids(Required)

Inhaler(Required)

GASTROINTESTINAL GENERAL SKILLS

Insertion, Care & Maintenance of Nasogastric Tubes (ie Salem Pump, Levine)(Required)

Nasointestinal Tubes (ie Cantor, Miller-Abbot)(Required)

Jejunostomy, Gastrostomy, Cecostomy Tubes(Required)

Tube Feedings via Flexible Tubes:

by Gravity Infusion(Required)

by Feeding Pump(Required)

Collection of Stool Specimens(Required)

Bowel Preparation & Cleansing Procedures(Required)

GASTROINTESTINAL- CARE OF PATIENTS WITH:

Stoma(Required)

Bowel Obstruction(Required)

Pancreatitis(Required)

Post Abdominal Surgery(Required)

Ileostomy(Required)

Colostomy(Required)

Inflammatory Bowel Disease(Required)

Obstruction(Required)

Hepatitis(Required)

Total Parenteral Nutrition (TPN)(Required)

Peripheral Parenteral Nutrition (PPN)(Required)

Antiemetics(Required)

Proton Pump Inhibitors(Required)

RENAL/GU PROBLEMS GENERAL SKILLS

Insertion of Catheter Straight(Required)

Insertion of Catheter Foley(Required)

Bladder Irrigation Intermittent(Required)

Peritoneal Dialysis(Required)

Automatic Cycler Machine(Required)

Collection of Urine Specimens(Required)

Hemodialysis(Required)

A-V Fistula/Shunt Care(Required)

Pre- & Post- Dialysis Care(Required)

Suprapubic Catheter(Required)

Nephrostomy Tube(Required)

RENAL/GU- CARE OF PATIENT WITH:

Urinary Tract Infection(Required)

Pyelonephritis(Required)

Renal Calculi(Required)

Urinary Retention/Incontinence(Required)

ENDOCRINE GENERAL SKILLS

Performing Fingersticks(Required)

Use of Blood Glucose Meter Device(Required)

Use of Visual Blood Glucose Strips(Required)

Endocrine- Care of Patient With:

Hyper/Hypoglycemia(Required)

DKA(Required)

Thyroid Disorders(Required)

Knowledge and Use of Insulin:

Single Type(Required)

Dextrose(Required)

Mixed Insulins(Required)

Insulin Infusion(Required)

ORTHOPEDIC GENERAL SKILLS

Cast Care(Required)

C.M.S. Checks(Required)

Traction – Skin(Required)

Traction – Skeletal(Required)

Range of Motion(Required)

Use of Assistive Devices(Required)

Applications of Splints Extremities(Required)

Continuous Passive Motion Machine (CPM)(Required)

ORTHOPEDIC- CARE OF PATIENTS WITH:

Total Joint Replacement(Required)

Rheumatic/Arthritic Disease(Required)

Amputation(Required)

WOUND/SKIN CARE

Dressing Changes(Required)

Air Fluidized, Low Airloss Beds(Required)

Pressure Relief Mattress/Seat Cushion(Required)

Pressure Sores(Required)

Leg Ulcers(Required)

Burns(Required)

WOUND VACS

Hemovacs(Required)

Jackson-Pratt Tubes(Required)

Penrose Drains(Required)

T-Tubes(Required)

Surgical Wound Irrigations & Dressings(Required)

VASCULAR

Discontinue PICC(Required)

Care of Patient with DVT(Required)

Draw Blood from Arterial Line(Required)

Draw Blood from Central Line(Required)

Peripheral IV Insertion, Care & Maintenance(Required)

Discontinue Peripheral IV(Required)

IV Infusion Pumps(Required)

CVP Lines – Measurement of CVP(Required)

Central Line Care & Maintenance (including dressing changes)(Required)

Blood/Blood Product Administration(Required)

Port-A-Caths (Infusa-Ports)(Required)

Continuous Subcutaneous Infusion Pumps(Required)

OTHER SKILLS