Home Care RN/LPN Skills Checklist

Candidate Self Assessment

Personal Information

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Legends

1 = Can function well independently

2 = Experienced, but may need review

3 = Limited or no experience

CARDIOVASCULAR SYSTEM

Administration of Antiarrhythmics:
Administration of Antihypertensives

NEUROLOGICAL PROBLEMS

Traction
Care of Patient With:
Administration of Anticonvulsants
Administration of Steroids

GENITOURINARY PROBLEMS

Care of Patient With
Insertion of Foley Catheter
Bladder irrigations
Administration Diuretics & Patient Teaching:

RESPIRATORY SYSTEM

Care of Patient With:
Administration of Oxygen
Administration of Bronchodilators

GASTROINTESTINAL PROBLEMS

ORTHOPEDIC PROBLEMS

Care of Patient With
Traction

WOUND & SKIN PROBLEMS

Care of Patient With

IV ADMINISTRATION

SPECIAL PATIENT CONSIDERATIONS

Documentation of
Documentation Using

HOME IV THERAPY

Care/Maintenance of Central Venous Catheters

COLLECTION OF SPECIMENS

ADMINISTRATION OF MEDICATIONS

Other Skills:

Experience YEARS
Intermittent Home Health Care Experience:
Private Duty Home Care Experience:
Experience with Adults:
Experience with Pediatrics:
Experience with Infants:
Experience YES/NO
Experience with Medicare-certifed agency
IV Therapy Certified
Venipuncture Certified
Chemotherapy Certified