Ambulatory 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)

Young Adults Middle Adult (19 years to 64 years)(Required)

GENERAL SKILLS

Standard Precautions(Required)

Isolation Precautions(Required)

Adult Respiratory/ Cardiac Arrest(Required)

Pediatric Respiratory/ Cardiac Arrest(Required)

Crash Carts(Required)

Defibrillators(Required)

Patient/ Family Education(Required)

Admit and Assess Patients(Required)

Automated med Dispensing Systems(Required)

List Types

Electronic Documentation(Required)

List Types

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

Advance Directives(Required)

Collect Appropriate Data(Required)

Discharge Teaching(Required)

Preoperative Teaching(Required)

Patient Prep(Required)

CARDIOVASCULAR

Assess Heart Tones(Required)

Bedside Tele Monitoring(Required)

Interpretation of Coagulation Studies(Required)

Perform Pulse/Circulation Checks(Required)

Pre Post-Op Pacemaker Care(Required)

PULMONARY

Assess Breath Sounds(Required)

Apply Oxygen(Required)

Interpret ABGs(Required)

Thoracentesis(Required)

Oximetry(Required)

NEUROLOGY

Assess Neurological Signs(Required)

Epidurals(Required)

Selective Nerve Root Blocks(Required)

Assess Level of Consciousness(Required)

GI

Insertion/Monitoring NG Tubes(Required)

Assessment(Required)

Assess Level of Consciousness(Required)

Flexible Sigmoidoscopy(Required)

Hemorrhoid Banding(Required)

Liver Biopsy(Required)

Paracentesis(Required)

Lap Band Surgery(Required)

GU

Bladder Biopsy(Required)

Cystoscopy(Required)

Urethral Dilation(Required)

Nephrostomy(Required)

Kidney Biopsy(Required)

Suprapubic Catheter(Required)

Prostate Biopsy(Required)

ENDOCRINE

Care of Diabetic Patient(Required)

Diabetic Teaching(Required)

Blood Glucose Testing(Required)

ENT AND MOUTH

Prosthodontics – Restorative Dentistry(Required)

Mouth Biopsy(Required)

Myringotomy(Required)

Maxillofacial Prosthetics(Required)

Nose Biopsy(Required)

Thyroid Aspirate Biopsy(Required)

Fiberoptic Laryngoscopy(Required)

Tonsillectomy(Required)

WOUNDS/INTEGUMENT

Application of Burn Dressing(Required)

Dressing Changes(Required)

Debridement of Wound(Required)

Wound Care(Required)

Wounds Vac(Required)

OB/GYN

Electrodesiccation and Curettage(Required)

Assist with In-Office Procedures(Required)

ORTHO

Arthrocentesis(Required)

External Hardware and Pin Care(Required)

Arthroscopy(Required)

Open Reduction and Internal Fixation(Required)

Closed Reduction and Internal Fixation(Required)

Trigger Point Injections(Required)

PLASTICS

Rhinoplasty(Required)

Liposuction(Required)

Nipple Reconstruction(Required)

MOHS Repairs(Required)

Blepharoplasty(Required)

Mole/Cyst Removal(Required)

GENERAL MEDICATIONS/ THERAPEUTIC INTERVENTIONS

Administer IM and SQ Medications(Required)

Administer Inhalation Medications(Required)

Administer PO Medications(Required)

Bladder Irrigation and Installation(Required)

Needleless System(Required)

Chemotherapy(Required)

IV THERAPY

Infusion Pumps(Required)

Peripheral IV Insertion(Required)

Syringe Pumps(Required)

Vascular Access Devices Care/Maintenance(Required)

Administer IV Medications(Required)

OXYGEN ADMINISTRATION

Ambu-Bag(Required)

Nasal Cannula(Required)

Non-Rebreather Mask(Required)

Venti Mask(Required)

Face Mask(Required)

NUTRITIONAL THERAPY

Lipids(Required)

TPN(Required)

Procalamine(Required)

Enteral Administration(Required)

PAIN MANAGEMENT/ANESTHESIA

Implantable Narcotic Pump(Required)

Moderate Sedation(Required)

Epidural(Required)

Spinal(Required)

Local(Required)

General(Required)

Axillary Block(Required)

Bier Block(Required)

GENERAL PROCEDURES/EQUIPMENT

Apply Immobilizers(Required)

Assist with Code Resuscitation(Required)

Assist with Lumbar Puncture(Required)

Laser(Required)

Dermabrasion(Required)

Drain Removal(Required)

Incision and Drainage(Required)

NGT Insertion(Required)

Patch Test(Required)

Punch Biopsy(Required)

Shave Biopsy(Required)

Procedure Set Up(Required)

Remove External Fixators with Pin(Required)

Scrub(Required)

Screw Hardware Removal(Required)

Set-Up Assist Suturing(Required)

Staple Removal(Required)

Suture Removal(Required)

Foley/Straight Catheter -Male(Required)

Foley/Straight Catheter -Female(Required)

TENS Unit(Required)

Use of Doppler(Required)

SPECIMEN COLLECTIONS

Venipuncture(Required)

Clean Catch Urine(Required)

Sterile Urine Collection(Required)

Stool(Required)

Sputum(Required)

Butterfly Stick(Required)

Central Line Draw(Required)

CLINICAL SETTINGS

Sugi-Center(Required)

Out Patient Clinic(Required)

Physician Office(Required)

Ambulatory Surgery clinic(Required)

OTHER SKILLS

List Type(Required)