Nurse Practitioner
Proficiency Scale
1 =
No Experience
2 =
Need Training
3 =
Able to perform with supervision
4 =
Able to perform independently
| Areas Worked | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Emergency | |||||
| Urgent Care | |||||
| Private Practice | |||||
| HMO | |||||
| MD Office | |||||
| Schools | |||||
| Health Department | |||||
| Ambulatory Clinic | |||||
| Rural Health Clinic | |||||
| Psychiatric Facility | |||||
| Correctional Facility | |||||
| Mobile Medical Unit | |||||
| Corporate Worksite | |||||
| Occupational Health | |||||
| Rehabilitation | |||||
| Nursing Home/ Long-term Care Facility | |||||
| Women's Health Clinic | |||||
| Government Health Agency | |||||
| Hospice/Palliative Care |
| Experience With | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Diabetes | |||||
| Contractures | |||||
| Bedridden residents | |||||
| Splinting of extremities | |||||
| Local infiltration | |||||
| Comprehensive physical assessment | |||||
| Acute disease condition | |||||
| Differential diagnosis | |||||
| Order, may perform, & interpret screening & diagnostic test | |||||
| Central line management |
| Disorders Emergencies | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Anaphylaxis | |||||
| Cardiac arrest | |||||
| Seizures | |||||
| Minor head injuries | |||||
| Animal bites | |||||
| Ingestions and poisonings | |||||
| Overdose of sedative, hypnotics, opiates | |||||
| Snake bites | |||||
| Minor burns | |||||
| Shock | |||||
| Open wounds |
| Collaboration | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Family, support system, community resources | |||||
| Consulting with Physicians | |||||
| Consulting with Pharmacists | |||||
| Consulting with Speech Therapist | |||||
| Consulting with Dietician and Diet Aide | |||||
| Consulting with Occupational Therapist | |||||
| Referral to Pastoral Services |
| Respiratory | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Croup | |||||
| Influenza | |||||
| Tracheobronchitis | |||||
| Bronchitis | |||||
| COPD (chronic obstructive pulmonary disease) | |||||
| Asthma | |||||
| URI (upper respiratory infection) | |||||
| Obstructive Sleep Apnea | |||||
| Viral | |||||
| Bacterial (1) | |||||
| Bacterial (2) | |||||
| Nonbacteria | |||||
| Oxygen administration | |||||
| Liquid oxygen | |||||
| IPPB machine use | |||||
| Tracheotomies | |||||
| Interpret ABG (blood gases) | |||||
| Intubations | |||||
| Sputum Collection |
| Cardiovascular System | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Congestive heart failure | |||||
| Chronic obstructive pulmonary disease | |||||
| Stasis ulcer of lower extremities | |||||
| Angina | |||||
| Post Thoracic Surgery | |||||
| Coronary artery disease | |||||
| Functional murmurs | |||||
| Congenital heart disease | |||||
| Hypertension | |||||
| ASHD (arteriosclerotic heart disease) | |||||
| Dyslipidemia | |||||
| PVD (peripheral vascular disease) | |||||
| Peripheral neuropathy | |||||
| Interpreting 12 lead EKG's |
| OB/GYN | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Candida vaginitis | |||||
| Dysmenorrhea | |||||
| Abnormal pap smear findings | |||||
| Pap smears | |||||
| Trichomonal vaginitis | |||||
| Atrophic vaginitis | |||||
| Fibrocystic breast disease | |||||
| Menopause | |||||
| Intrapartum medications | |||||
| Bartholin's cyst/abscess | |||||
| Preparation for childbirth | |||||
| Pregnancy - diagnosis and referral | |||||
| Medications in the third stage | |||||
| Dysfunctional uterine bleeding | |||||
| Medications in the postpartum phase | |||||
| Rh blood factor | |||||
| Mastitis | |||||
| Birth control methods | |||||
| Prenatal care | |||||
| Fetal well-being | |||||
| Nausea and vomiting with pregnancy | |||||
| Pregnancy test kits |
| GI System | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Constipation | |||||
| Diarrhea (simple) | |||||
| Acute gastroenteritis | |||||
| Cholecystitis | |||||
| Pyloric stenosis | |||||
| Colic | |||||
| Appendicitis | |||||
| Naso-gastric tubes | |||||
| Gastrostomy Care |
| Skin | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Warts | |||||
| Basal cell carcinoma | |||||
| Scabies | |||||
| Impetigo | |||||
| Diaper dermatitis | |||||
| Acne | |||||
| Folliculitis | |||||
| Furuncles | |||||
| Carbuncles | |||||
| Herpes Simplex | |||||
| Herpes Zoster | |||||
| Malignant melanoma | |||||
| Pityriasis Rosea | |||||
| Contact dermatitis | |||||
| Tinea corporis | |||||
| Staph infections | |||||
| Wound care | |||||
| Single layer wound closure | |||||
| Incision and drainage | |||||
| Excisions |
| Ears, Nose and Throat | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Epistaxis | |||||
| Otitis externa | |||||
| Serous otitis media | |||||
| Acute purulent otitis media | |||||
| Pharyngitis | |||||
| Oral candidiasis |
| Eye | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Conjunctivitis | |||||
| Strabismus | |||||
| Chalazion | |||||
| Stye | |||||
| Visual acuity | |||||
| Fluorescein staining of eyes | |||||
| Audiometry | |||||
| Tympanometry |
| Musculoskeletal | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Osteoporosis | |||||
| Osteomyelitis | |||||
| Rheumatoid arthritis | |||||
| Juvenile diabetes | |||||
| Gout | |||||
| Minor sprains and strains | |||||
| Osteoarthritis | |||||
| Carpal tunnel syndrome | |||||
| Scoliosis | |||||
| Tendonitis | |||||
| Bursitis | |||||
| Muscular dystrophy |
| Parasitic Infections | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Pinworms | |||||
| Ascariasis | |||||
| Pediculosis |
| Genitourinary System | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| philis | |||||
| Chlamydia | |||||
| Herpes | |||||
| Cystitis | |||||
| Pyelonephritis | |||||
| Urinary tract infection | |||||
| Benign prostatic hypertrophy | |||||
| Vulvovaginitis | |||||
| Hydrocele | |||||
| Gonococcal infections | |||||
| Prostatitis | |||||
| Catheter Care | |||||
| Incontinence care-bowel | |||||
| Dermal ulcers | |||||
| Urine collection |
| Nervous System | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Vasovagal syncope | |||||
| Migraine headaches | |||||
| Multiple sclerosis | |||||
| Headaches | |||||
| Head injury | |||||
| Tension | |||||
| Anxiety | |||||
| Parkinson's | |||||
| zheimer's | |||||
| Bell's Palsy | |||||
| TIA (transient ischemic attacks) | |||||
| Trigeminal neuralgia |
| Endocrine | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Type I diabetes mellitus | |||||
| Type II diabetes mellitus | |||||
| Graves disease | |||||
| Addison's disease | |||||
| Juvenile diabetes | |||||
| Hypoglycemia | |||||
| Hypothyroidism |
| Hematological | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Folic acid deficiency anemia | |||||
| Aplastic anemia | |||||
| Iron deficiency | |||||
| Sickle cell anemia | |||||
| Pernicious anemia | |||||
| Hemoglobinmeter |
| Psychosocial | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Depression | |||||
| Suicide | |||||
| Obesity | |||||
| Grief | |||||
| Anxiety | |||||
| Anorexia | |||||
| Bulimia |
| Drug Therapy | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Prescription | |||||
| Over the counter (OTC) | |||||
| Herbal drugs | |||||
| Knowledge of pharmacology | |||||
| Knowledge of pharmacokinetics | |||||
| Knowledge of drug interactions | |||||
| Knowledge of side effects | |||||
| Allergic reactions | |||||
| Anaphylaxis reaction | |||||
| TPN/Lipid Management | |||||
| Management/Titration of IV Therapies | |||||
| IV/PO Antibiotic Therapy and understanding of cultures |
| Dispensing Medication | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Monitoring drug therapy | |||||
| Management of controlled substances | |||||
| Injections |
| Non-Pharmacologic Interventions | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Medical nutrition therapy | |||||
| Exercise | |||||
| Cessation of substance abuse (alcohol, tobacco) | |||||
| Mental health issues (stress management, depression) | |||||
| Obesity management | |||||
| Tube Feeding Management |
| Miscellaneous | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Public health and health promotion | |||||
| Research | |||||
| Quality assurance | |||||
| Leadership and teaching skills | |||||
| Legal and ethical issues | |||||
| Confidentiality | |||||
| Cultural awareness | |||||
| Self evaluation to improve patient care | |||||
| ntinuing education | |||||
| Working within scope of practice | |||||
| Discharge planning / collaboration | |||||
| Suturing | |||||
| Cell biopsy | |||||
| Starting IV | |||||
| Casting and splinting | |||||
| Radiographic interpretation (initial) | |||||
| Informed consent | |||||
| Explanation to patient/family | |||||
| Documentation | |||||
| Ultrasounds | |||||
| Venipuncture |
| Programs | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| OSHA (Occupational Safety and Health Administration) | |||||
| Medicare and Medicaid | |||||
| CLIA waiver (Clinical Laboratory Improvement Amendments) | |||||
| TJC (The Joint Commission) | |||||
| HEDIS (Health Plan Employer Data and Information Set) | |||||
| DQIP (Diabetes Quality Improvement Program) | |||||
| HIPAA (Health Insurance Portability & Accountability Act) | |||||
| HCAHPS |
| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| 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) | |||||
| Young adult (ages 22-39 years) | |||||
| Adults (ages 40-64 years) | |||||
| Elderly (ages 80+ years) | |||||
| Older adult (ages 65-79 years) |