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Rating Stars (Click)
| WORK SETTING EXPERIENCE: |
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| Inpatient Acute Care Facility |
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| Trauma Center |
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| Academic/Teaching Facility |
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| Outpatient Care Facility |
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| Long term care/Skilled Nursing |
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| Clinic/Ambulatory |
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| Home Health Setting |
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Rating Stars (Click)
| GENERAL SKILLS: |
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| Advanced directives |
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| Patient/family teaching |
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| Restrictive devices (restraints) |
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| Lift/transfer devices |
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| Specialty beds |
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| End of life care/palliative care |
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| Automated Medication Dispensing System, Pyxis, Omnicell, or other |
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| Bar coding for medication administration |
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| National Patient Safety Goals |
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| Accurate patient identification |
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| Effective communication |
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| Interpretation & communication of lab values |
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| Medication administration |
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| Labeling |
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| Anticoagulation therapy |
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| Reconciliation |
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| Monitoring conscious sedation |
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| Pain assessment & management |
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| Use of PCA (IV, intrathecal, epidural) |
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| Infection control |
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| Universal precautions |
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| Isolation |
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| Minimize risk for falls |
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| Prevention of pressure ulcers |
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| Wound care |
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| Wound vacs |
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| Awareness of HCAHPS |
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Rating Stars (Click)
| CARDIAC MONITORING & EMERGENCY CARE: |
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| Obtains 12 lead EKG |
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| Interpretation of rhythm strips |
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| Treatment of dysrhythmias |
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| Use of rapid response teams |
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| Cardiac arrest/CPR |
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| O2 therapy & delivery |
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| Pulse oximetry |
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| Use of doppler |
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| Automatic/manual blood pressure checks |
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Rating Stars (Click)
| IV THERAPY: |
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| Starting & maintaining peripheral IVs |
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| Blood draw: venous |
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| Central line care |
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| Blood draw: central line |
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| Care & management of ports |
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| Care & management of PICC / Groshong / Hickman |
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| TPN & lipids |
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| Administration of blood / blood products |
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| Administration of chemotherapy |
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| Monitoring chemotherapy (does not initiate) |
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| Management of IV Pumps ( Alaris , Baxter,) |
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| Management of elastomeric infusion |
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| Management of intrathecal pumps |
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Rating Stars (Click)
| OTHER EXPERIENCE: |
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| Diabetes mellitus |
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| Blood Glucose Monitoring (BGM) |
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| Insulin administration |
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| Sepsis |
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| External and temporary pacemakers |
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| Management of permanent pacemaker/AICD |
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Rating Stars (Click)
| CARDIAC EXPERIENCE: |
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| Assessment of heart sounds |
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| Pacemakers – permanent |
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Rating Stars (Click)
| CARE OF PATIENT WITH: |
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| Aneurysm |
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| Angina |
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| Acute MI |
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| Angioplasty (pre/post) |
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| CHF |
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| Carotid endarterectomy |
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| Post MI |
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| Pre/post cardiac cath |
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| Pre/post cardiac surgery (CABG & valves) |
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| Pre/post vascular surgery (abdominal or thoracic AA, fem-pop, carotid) |
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| Cardiogenic shock |
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Rating Stars (Click)
| USE & ADMINISTRATION OF THE FOLLOWING: |
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| Antiarrhythmic |
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| Antihypertensives |
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| Beta blockers |
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| Diuretics |
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| Nitrates |
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| Fibrinolytics / IIb IIIa inhibitors |
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| Preparation & administration of emergency (ACLS) meds |
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| Antilipemic’s (Statins) |
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| Inotropic’s (i.e. digoxin, dopamine. epinephrine) |
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Rating Stars (Click)
| RESPIRATORY EXPERIENCE: |
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| Assessment of breath sounds |
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| Airway management/suctioning (ETT, oral,trach) |
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| Chest tubes (Emerson / Pleuravac) |
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| Interpretation of ABG |
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| Incentive spirometer |
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| Mechanical ventilation |
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| Ambu Bag |
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| Nasal Canula |
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| Non-rebreather |
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| Bronchoscopy |
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| Venti Mask |
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| Oral suctioning |
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| Nasotracheal suctioning |
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| Tracheostomy care |
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| Heimlich Valve |
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Rating Stars (Click)
| CARE OF PATIENT WITH: |
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| COPD |
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| Tracheostomy |
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| Thyroidectomy |
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| Pulmonary embolism |
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| Pulmonary edema |
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| Pneumothorax |
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| Pneumonia |
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| Inhalation injuries |
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| Tuberculosis |
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| Emphysema |
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| Asthma |
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| Thoracentesis/paracentesis |
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| Lung Transplant |
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Rating Stars (Click)
| USE & ADMINISTRATION OF THE FOLLOWING: |
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| Bronchodilators |
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| Steroids |
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| Expectorants & Antitussives |
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| Antihistamines |
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| Use of nebulizer treatments |
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Rating Stars (Click)
| GYNECOLOGY/GYN MALIGNANCIES EXPERIENCE: |
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| Endometriosis |
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| Gyn exam / pap |
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| Self-breast exam |
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| Tubal ligation |
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| Ectopic pregnancy |
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| Mastectomy / lumpectomy |
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| Hysterectomy (vaginal or TAHBSO) |
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| Repair of cystocele / rectocele |
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| Pelvic inflammatory disease |
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| Abnormal uterine bleeding |
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| Management of D&C |
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Rating Stars (Click)
| EXPERIENCE WITH: |
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4
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| Adenosine administration |
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| Insertion |
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| & management of arterial line |
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| Chest tube insertion & management |
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| Femoral hemostasis devices (femStop/vasoseal) |
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| Ventilator management |
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| Interpretation weaning parameters |
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Rating Stars (Click)
| DRUG DOSE CALCULATION FOR: |
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3
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4
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| Non-titrated IV vasoactive agents (Dobutrex/ dopamine) |
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| Nitrates (IV nitroglycerine) |
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| Platelet inhibitors (reopro) |
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| Fibrinolytics/IIb IIIa inhibitors |
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| Anti-arrhythmic agents (amiodarone/ Cardizem/lidocaine) |
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| Patient Monitoring (Pre/Post Procedure) |
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| Cardioversion |
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| TEE |
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| Cardiac catheterization |
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| Bronchoscopy |
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| EGD |
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| PEG placement |
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Rating Stars (Click)
| NEUROLOGY EXPERIENCE: |
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4
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| Glasgow coma scale |
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| Seizure precautions |
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| Assist with lumbar puncture |
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| Halo traction |
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| Comprehensive neuro assessment |
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Rating Stars (Click)
| CARE OF PATIENT WITH: |
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4
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| CVA/TIA |
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| Aspiration precautions |
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| Overdose/DT’s |
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| Spinal cord injury/trauma |
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| TBI (Traumatic Brain Injury) |
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| Pre/post neuro surgery |
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| Cranial hemorrhage |
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| Delirium tremors |
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| Meningitis |
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| Neuromuscular diseases |
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| Degenerative neurological disorders |
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| CMS Infection |
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| Metastatic Tumor/ tumor resection |
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| Encephalitis |
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| Alzheimer’s |
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| Laminectomy |
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| Traumatic Brain Injury |
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Rating Stars (Click)
| USE & ADMINISTRATION OF THE FOLLOWING: |
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3
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4
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| Antiepileptics |
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| Corticosteroids |
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| Steroids |
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| Anticonvulsants (Dilantin/Neurontin/phenobarbital) |
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| Anti-depressants |
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| Anti-Parkinson (Cogentin/levodopa/Sinemet) |
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Rating Stars (Click)
| GASTROINTESTINAL EXPERIENCE: |
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2
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3
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4
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| NG tube insertion |
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| Management of small-bore feeding tubes (Dobhoff, Keofeed) |
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| Jejunostomy tube |
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| PEG tube |
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| Management of post-surgery drains |
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Rating Stars (Click)
| CARE OF PATIENT WITH: |
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4
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| Pancreatitis |
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| Hepatitis |
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| G.I. bleed |
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| Esophageal bleeding |
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| Bowel obstruction |
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| Bowel resection |
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| Gastric bypass |
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| Gastric banding |
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| Whipple procedure |
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| Transplants |
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| Colostomy / ileostomy |
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| Paralytic ileus |
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| E.R.C.P. |
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| Peritonitis |
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| IBD(Crohn’s/Ulcerative Colitis |
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| Electrolyte imbalance |
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| Pancreatic cancer |
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| Liver failure/cancer |
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Rating Stars (Click)
| USE & ADMINISTRATION OF THE FOLLOWING: |
1
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2
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3
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4
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| Anticholinergics (antispam, Bentyl or Robinul) |
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| Antiemetics |
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| Antacids |
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| Digestive enzymes |
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| Cathartics |
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Rating Stars (Click)
| GENITOURINARY/RENAL EXPERIENCE: |
1
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2
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3
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4
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| Catheter insertion |
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| GU irrigations |
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| Nephrostomy tube |
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| Suprapubic tube |
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| Fluid & electrolyte disturbance |
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Rating Stars (Click)
| CARE OF PATIENT WITH: |
1
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2
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3
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4
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| Hemodialysis |
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| T.U.R.P. |
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| Shunts and fistulas |
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| Nephrectomy |
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| Peritoneal dialysis |
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| Renal transplant |
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| Chronic/acute renal failure |
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| UTI |
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| BPH |
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| Prostate cancer |
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| Ileoconduit |
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Rating Stars (Click)
| ORTHOPEDIC EXPERIENCE: |
1
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2
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3
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4
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| Total joint replacement |
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| Arthroscopic surgery |
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| Bucks extension |
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| Fasciotomy |
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| Fractures |
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| Spika cast/body cast |
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| Splints |
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| CPM |
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| TENS unit |
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| Cast care & removal |
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| Amputation |
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| Skeletal traction |
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| Ortho trauma |
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| Cervical fusion |
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| Laminectomy |
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Rating Stars (Click)
| OTHER EXPERIENCE: |
1
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2
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3
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4
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| Care of patient with sepsis |
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| Oncology |
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| Chemotherapy |
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| Radiation therapy |
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| Radiation implants |
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| Inpatient hospice |
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| Suicide precautions |
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| Burn patients |
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| Leadership skills (team leader or charge nurse) |
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Rating Stars (Click)
| AGE-SPECIFIC EXPERIENCE: |
1
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2
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3
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4
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| Newborn / neonate (birth-30 days) |
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| Infant (31 days-1 year) |
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| Toddler (ages 2-3 years) |
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| Preschool (ages 4-5 years) |
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| School age (ages 6-12 years) |
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| Adolescent (ages 13-21 years) |
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| Young adult (ages 22-39 years) |
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| Adult (ages 40-64 years) |
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| Older adult (ages 65-79 years) |
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| Elderly (ages 80+ years) |
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