HIS - Hospital Information System

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.

Proficiency Scale

1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
Medication Administration Rating Stars (Click) 1 2 3 4
Rating Stars (Click)
Documentation on M.A.R.
Dose Calculation
Generic Equivalents
Usage of PDR
Knowledge of Drug Actions/Interactions
Verification of Narcotic Wastage
Oral Medications
Sublingual Medications
Intradermal Medications
Parenteral Medications
Subcutaneous Medications
Intramuscular Medications
Topical Medications
Eye Drops
Ear Drops
Swallowing Precautions
Inventory and Storage Control
Infectious Control Rating Stars (Click) 1 2 3 4
AIDS/HIV Interaction
Hepatitis Interaction
Hospice
MRSA
VRE
Fever Management
Interpretation of Labs
Decubitus/Wound Care (Contaminated)
Linen - Transporting, Storing, & Handling
Cleaned
Soiled
Personal Clothing
Proper Disposal of Sharps and Waste
Standard Precautions
Pain Management Rating Stars (Click) 1 2 3 4
Documentation and Assessment of Site, Character, & Frequency of Pain
Assessment of Pain Levels
Documentation of Response to Pain Medications
Intraveneous Therapy Rating Stars (Click) 1 2 3 4
I.V. Certified (Check 4)
Administration of I.V. Antibiotics
Administration of I.V. Fluids
Administration of I.V. Pain Medications
Administration of I.V. Cardiac Meds
Blood Draws - Peripheral
Blood Draws - Central Line
Blood Draws - Implanted Catheter
Care of I.V. Site - Peripheral
Care of I.V. Site - Central Line
Care of I.V. Site - Implanted Catheter
I.V. Dose Calculations
I.V. Insertion - Peripheral
Use of Infusion Pumps
Diabetic Care Rating Stars (Click) 1 2 3 4
Diabetic Monitoring
S/S Hyper/Hypoglycemia
Diabetic Patient Teaching
Performing Fingersticks
Use of Glucometers
Insulin Infusions
Regular, Long-Acting Insulin
Mixed Insulin
Psychosocial Problems Rating Stars (Click) 1 2 3 4
Assessment and Documentation of Behavioral Problems (Target Behaviors)
Assessment and Documentation of S/S of Depression
Assessment and Documentation of Patient Response to Psychotropic Medications
Parameters for Use of Restraints in Long-Term Care Settings
Assessment and Documentation of Effectiveness of Preventive Medicine Medications
Orthopedics Rating Stars (Click) 1 2 3 4
Assessment of Circulation
Assessment of Gait
Assessment of Range of Motion
Amputation Care
Post-Arthroscopy Care
Casts and Related Care
Osteoporosis
Pinned Fractures
Total Hip Replacement
Total Knee Replacement
Rheumatic/Arthritic Disease
Continuous Passive Motion
Canes
Cervical Collars
Gait Belts
Prostheses
Slings
Transfer Board
Walker
Wheelchair
Cardiovascular Problems Rating Stars (Click) 1 2 3 4
Auscultation of Rate/Rhythm
Blood Pressure
Doppler
Pulses
Circulation Checks
CPR
Post-Abdominal Aortic Bypass
Aneurysm
Angina
Post Carotid Endarterectomy
Fem-Pop Bypass
Permanent Pacemaker
Post Acute M.I.
Post Cardiac Surgery
Thrombophlebitis
DVT
Congestive Heart Failure
Administration of Post-Op Cardiac Meds
Gastrointestinal Problems Rating Stars (Click) 1 2 3 4
Administration of Tube Feedings
Administration of Medications via Tube
Inflammatory Bowel Disease
Bowel Prep
G.I. Bleeding
Gualac
Nutritional Status
Colostomy Care
Post Abdominal Surgery
NG Tube Placement and Care
Nasointestinal Tube Care
Assessment of Bowel Tones
Post Acute M.I.
Enema Administration
Assessment of Bowel Incontinence
Signs and Symptoms of Fecal Impaction
Neurological Problems Rating Stars (Click) 1 2 3 4
Post-Op Anticonvulsant Medications
Assessing Levels of Consciousness
Dementias (Re-Direction/Validation)
Neuromuscular Disease
CVA
Pupil Check
A.I.M.S.
Seizure Precautions
Administration of Anticonvulsant Medications
Medications
Aneurysm Precautions
Spinal Cord Injuries - Long Term
Urinary Problems Rating Stars (Click) 1 2 3 4
Assessment and Care of AV Shunt
Post Renal Surgery
Renal Failure
Assessment of Urinary Incontinence
Assessment of I and O Data
Use of Bladder Scanner
Signs and Symptoms of UTI
Indwelling Catheter Insertion
Straight Catheter Insertion
Suprapubic Catheter Care
Screening for UTI via Urine Dipstick
Wounds, Pressure Sores, and Skin Impairments Rating Stars (Click) 1 2 3 4
Assessment and Care of Post-Surgical Wounds
Assessment, Prevention, and Care of Pressure Ulcers
Assessment and Documentation of Skin Conditions/Wounds
Dressing Changes - Aseptic
Dressing Changes - Sterile
Wound Irrigation
Application of Wound Care Products
Use of Air Fluidized/Low Air Loss Beds
Use of pressure-relieving seat cushions
Staple and suture removal
Other Skills Rating Stars (Click) 1 2 3 4
Alert Charting System
Use of 24-hour Written and Verbal Reporting Systems
Use of "911" in LTC Setting
Regulatory Guidelines Related to the Prevention of Abuse and Neglect of Residents
Regulatory Guidelines Related to Resident Rights in LTC Setting
Discerning Code Status
Incident and Accident Reporting
Age Specific Competencies Rating Stars (Click) 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)