Acute Rehab Skills Checklist
   NAME  
   Email-Id
   DATE    
I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Instructions:

This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

 
Proficiency Scale: 1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

 
Rating Stars (Click)
Work Settings 1
2
3
4
General Acute Care
Home Health
Nursing Home
Outpatient Clinic
Pediatric Rehab
Acute Rehab Hospital
Rehab Unit in Hospital
Rating Stars (Click)
Neuro 1
2
3
4
Cerebral Vascular Accident
Coma Patients
Head Trauma
Spinal Cord Injury
Parkinson’s Disease
Traumatic Brain Injury
Neuromuscular Disease
Post Craniotomy
Bowl/Bladder Programs
Rating Stars (Click)
Ortho 1
2
3
4
Arthritis Programs
Back Syndrome
Cervical Traction
Continuous Passive Motion Machine N/A
Gait Training
Hand Injury
Hip Fractures
Care of Patient with Halo
Hot/Cold Packs
Mobilization Techniques
Neck Injuries
TMJ Dysfunction
Total Hip Replacement
Total Knee Replacement
Rating Stars (Click)
Pulmonary 1
2
3
4
Assessment of breath sounds
Chest Physiotherapy
Oximetry
Nasal cannula
Face Mask
Portable O2 tank
Nasotracheal Suctioning
Tracheal Suctioning
Care of patient w/Mechanical Vent
COPD
Rating Stars (Click)
Pediatrics 1
2
3
4
Cerebral Palsy
Activities of Daily Living
Learning Disabilities
Orthotics
Spina Bifida
Autism
AK Prosthetics
Amputees
BK Prosthetics
Bracing/Joint Immobilization
Resting Splints
Casts/Check for Circulation
Upper Extremity Prosthetics
Rating Stars (Click)
Nutritional Requirements 1
2
3
4
Thickened Liquids
Minimal
Thick
Extra Thick
Pudding Thick
NG Tubes
Peg Tubes
Rating Stars (Click)
Restraints 1
2
3
4
4pt
Shoulder Strap
Hand Mitts
Wrist
Ankle
Pelvic Strap
Rating Stars (Click)
EMR 1
2
3
4
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
Rating Stars (Click)
Other 1
2
3
4
Ability to evaluate and assign Functional Independence Score
AIDS Patients
Burn Management
Cardiac Rehabilitation
Function Capacity Evaluation
Geriatrics
Manual Therapy
Massage Therapy
Muscle Stimulation
Pain Management/Giving Meds
Physical Capacity
Pulmonary Rehab
Sterilization Technique
TENS
Wound Debridement/Dressing Change
Rating Stars (Click)
Age Specific Competencies 1
2
3
4
Infant (Birth - 1 year)
Preschooler (ages 2-5 years)
Childhood (ages 6-12 years)
Adolescents (ages 13-21 years)
Young Adults (ages 22-39 years)
Adults (ages 40-64 years)
Older Adults (ages 65-79 years)
Elderly (ages 80+ years)