Legends

1 = No experience; Theory/observed only

2 = Limited competency; < 5 times per year; Needs supervision

3 = Acceptable competency; > 5 times per year

4 = Competent; Performs on a daily or weekly basis; Proficient

Cardiac

1

2

3

4

Abnormal Heart Sounds/Murmurs

Apical Pulse

Auscultation (Rate/Rhythm)

Capillary Refill

Color

Pulses/Circulation Checks

Abdominal Aortic

Aneurysm

Acute MI

Angina

Cardiac Tamponade

Cardiac Teaching

Cardiomyopathy

Cardiopulmonary Arrest

Carotid Endarterectomy

Congestive Heart Failure

Endocarditis

EP Study & Ablation

Femoral-Popliteal Bypass

Heart Transplant

Hypertension

Hypovolemic Shock

Multi-System Organ Failure

Myocardial Contusion

Pacemaker-External

Pacemaker-Permanent

Pacemaker-Temporary

Pacemaker-Transthoracic (Epicardial)

Pericarditis

Post AICD Insertion

Pre/Post Cardiac Cath

Pre/Post Cardiac Surgery

Pre/Post PTCA/Stents

Valve Replacement

Ventricular Assist Device (RVAD or LVAD)

Cardiac (Labs)

1

2

3

4

BNP

Cardiac Enzymes & Isoenzymes

Coagulation Studies

Troponin

Neurological

1

2

3

4

Glasgow Coma Scale

Level of Consciousness

Reflex/Motor Deficits

Visual/Communication Deficits

Acute Head Injury

Alzheimer’s Disease

CNS Infection

Coma

CVA

DTS

Encephalitis

Halo Traction/Cervical Tongs

Increased ICP

Intracranial Hemorrhage

Laminectomy

Meningitis

Metastatic Tumor

Multiple Sclerosis

Neuromuscular Disease

Pre/Post Neuro Surgery

Seizure Disorder

Spinal Cord Injury

TIAs

Tumor Resection

Ventriculostomy

Renal/Genitourinary

1

2

3

4

Skin Turgor

Acute Renal Failure

End Stage Renal Disease

Hemodialysis

Nephrectomy

Nephrostomy Tube

Peritoneal Dialysis

Renal Transplant

Suprapubic Cath

V Fistula/Shunt

Fluid Balance Monitoring

Measurement I & O Monitoring

BUN & Creatinine Lab

Serum Electrolytes Lab

Musculoskeletal

1

2

3

4

Cast Care

Circulation/Pulse Checks

Amputation

External Fixation

Joint Replacements

Multiple Trauma

Paraplegia

Rheumatoid Arthritic Disease

Wounds/Integument

1

2

3

4

S/S Infection Assessment

Skin Assessment

Burns

Staged Decubitus Ulcers

Stasis Ulcers

Surgical Wounds with Drains

Skin Breakdown Monitoring

IV Therapy

1

2

3

4

Assess/Maintain IV Insertion Site

PICCs

Inserting IVs

Multi-Lumen Central Venous Catheters

Nutritional Therapy

1

2

3

4

Dobhoff Insertion

Enteral Administration

Gravity/Bolus Tube Feedings

J-Tube

NGT Insertion

PEG

TPN and Hyperalimentation

Pain Management

1

2

3

4

Assess Pain Level/Tolerance

Epidural Anesthesia/Analgesia

Moderate Sedation

Patient Controlled Analgesia

Ramsey Scale

Procedures/Equipment (Specimen Collection)

1

2

3

4

Arterial Line Draw

Butterfly Stick

Central Line Draw

Clean Catch Urine

Cultures-Blood

Dip Stick

Finger Stick

Stool

Sputum

Sterile Urine

Throat Swabs

Venipuncture

Critical Care Settings

1

2

3

4

Interventional Unit

PCU

Stepdown

Tele

EMR

1

2

3

4

AllScripts

ARIA

Canopy

Epic

Cerner

Eclipsys

McKesson

Meditech

Other Computerized System

Computerized Physician Order Entry

Bar Coding for Medication Administration

I hereby certify that ALL information I have provided to Tricehealthcare on this skills checklist is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct.

Personal Information

Legends

General Patient Care

Cardiac

Cardiac (Monitoring)

Cardiac (Labs)

Pulmonary

Neurological

Gastrointestinal

Renal/Genitourinary

Endocrine/Metabolic

Musculoskeletal

Immunology/Hematology/Oncology

Wounds/Integument

Medications Administration

IV Therapy

Blood

Nutritional Therapy

Oxygen Administration

Pain Management

Procedures/Equipment

Procedures/Equipment (Specimen Collection)

Procedures/Equipment (Assisting with)

Critical Care Settings

Age Specific Practice Criteria

EMR