Skill Checklists
Corrections
Name
Email
LAST 4 OF SSN
This checklist was electronically signed on (Today’s date)
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
Advanced directives
Cultural diversity
Patient teaching
Restrictive devices (restraints)
Ambulatory cuffs
End of life care/palliative care
Correctional admission & discharge
Correctional alarm systems
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Diabetes mellitus
Blood Glucose Monitoring (BGM)
Insulin administration
National Patient Safety Goals
Accurate patient/inmate identification
Effective communication
Interpretation & communication of lab values
Medication administration
Labeling: obtain lab specimens
Anticoagulation therapy
Pain assessment & management
Infection control
Universal precautions
Isolation
Assist with treatment procedures
Wound care
Starting & maintaining peripheral IVs
Venous blood draw
Cardiac monitors
Interpretation of rhythm strips
Obtains 12 lead EKG
Treatment of dysrythmias
Cardiac arrest/CPR
O2 therapy & delivery
Pulse oximetry
Use of doppler
Assessment of heart sounds
Vascular assessment
Awareness of HCAHPS
Angina
CHF
Post MI
Assessment of breath sounds
Establishing an airway
Ambuing techniques
Suctioning
COPD
Pneumocystis
Pneumonia
Emphysema
Asthma
Tuberculosis
Bronchodilators
Steroids
Expectorants
Gyn exam/pap
Self breast exam
Ectopic pregnancy
Pelvic inflammatory disease
Endometriosis
Neurological assessment
Glasgow coma scale
Seizure precautions
Assist with lumbar puncture
Post CVA
TIA
Seizure activity
Head & spinal cord injury/trauma
Cranial hemorrhage
Delirium tremors
Neuromuscular diseases
Antiepileptics
Psych assessment
Suicide risk assessment
Suicide precautions
Major depression
Bipolar disorder (manic-depressive illness)
Anxiety disorders
Post Traumatic Stress Disorder (PTSD)
Psychotic disorders
Schizophrenia
Personality disorders
Antisocial
Passive / aggressive
Paranoia
Schizotypal personality disorder
Eating disorders
Anorexia nervosa
Bulemia nervosa
Pica
Homicide
Suicide
Rape
Violent individual
Alcoholism
Alcohol withdrawal syndrome
Delirium Tremens (DTs)
Wernicke-Korsakoff syndrome
Drug use / abuse
Hallucinogenics
Opiates (heroin, morphine, oxycodone, codeine)
Stimulants (cocaine / amphetamines)
Benzodiaepams
Delusions
Hallucinations
Gastrointestinal Experience
GI assessment
NG tube insertion & management
Enterostomal care
Pancreatitis
Hepatitis
G.I. bleed
Esophageal bleeding
Bowel obstruction
Anticholinergics (antispas, Bentyl or Robinul)
Cathartics
AV shunt/fistula
Catheter insertion
GU irrigations
Splints
Cast care
Cast removal
Ortho trauma
Staple/suture removal
Oncology
Chemotherapy
Leadership skills (team leader or charge nurse)
Supervision of unlicensed assistive personnel
Post mortem care
Training in over familiarization with inmates
Training in potential/actual weapon recognition
Newborn / neonate (birth-30 days)
Infant (31 days-1 year)
Toddler (ages 2-3 years)
Preschool (ages 4-5 years)
School age (ages 6-12 years)
Adolescent (ages 13-21 years)
Young adult (ages 22-39 years)
Adult (ages 40-64 years)
Older adult (ages 65-79 years)
Elderly (ages 80+ years)
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.
