Administrative Registered Nurse Skills Checklist

Home Health Skills Checklist

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(Home Health)

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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.

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

CARDIOVASCULAR

ACS/Post MI:

★★★★

Heart Failure:

★★★★

Post Cardiac Surgery:

★★★★

Cardiac Auscultation (Rate/Rhythm):

★★★★

Peripheral Pulse/Circulation Checks:

★★★★

PULMONARY

Asthma:

★★★★

COPD:

★★★★

Pneumonia:

★★★★

Lung Cancer:

★★★★

Pulmonary Emboli:

★★★★

Auscultate Lung Sounds:

★★★★

Oxygen Administration:

★★★★

Oxygen Safety:

★★★★

Oro/Nasotracheal Suctioning:

★★★★

CPAP/BiPAP:

★★★★

Ventilator Management (Specify):

★★★★

NEUROLOGICAL

CVA:

★★★★

Alzheimer's Disease/Dementia:

★★★★

Parkinson's:

★★★★

Degenerative Neurologic Disorders (ALS, MS, etc.):

★★★★

Brain Tumor:

★★★★

Brain Injury:

★★★★

Para/Quadriplegia:

★★★★

Seizure Disorder:

★★★★

Level of Consciousness/Neuro Changes:

★★★★

ORTHOPEDICS

Joint Replacement:

★★★★

DVT Prophylaxis/Recognition:

★★★★

Incision Checks:

★★★★

Staple Removal:

★★★★

Fractures:

★★★★

Cast/Brace:

★★★★

Amputation:

★★★★

Arthritis:

★★★★

Assistive Equipment/Lift Devices:

★★★★

In Home PT/INR (Specify):

★★★★

GASTROINTESTINAL

Nutritional Assessment:

★★★★

Colostomy/Ileostomy Management:

★★★★

Fecal Incontinence/Diarrhea:

★★★★

Bowel Obstruction:

★★★★

GI Bleed:

★★★★

Post GI Surgery:

★★★★

Hepatitis Liver Failure:

★★★★

NG Tubes:

★★★★

Feeding Tubes:

★★★★

Feeding Pumps (Specify):

★★★★

Enter Here:

Drainage Devices:

★★★★

WOMEN'S HEALTH/MATERNAL-INFANT CARE

Pregnancy Related Complications:

★★★★

Fetal Heart Tones:

★★★★

Contractions:

★★★★

Post Partum Mother/Baby Visit:

★★★★

Newborn Care:

★★★★

Phototherapy:

★★★★

Breast Feeding Support:

★★★★

PEDIATRICS

Growth and Development:

★★★★

Respiratory Distress Syndrome:

★★★★

Bronchopulmonary Dysplasia:

★★★★

Cystic Fibrosis:

★★★★

Muscular Dystrophy:

★★★★

Spina Bifida:

★★★★

Spinal Surgery:

★★★★

Sickle Cell Disease:

★★★★

Trach Care/Suctioning:

★★★★

Ventilator Management:

★★★★

Ventilator Type (Specify):

★★★★

PAIN MANAGEMENT

Verbal/Nonverbal Pain Scales:

★★★★

Response to Pain Management Interventions:

★★★★

PCA Pump:

★★★★

Epidural Cath/Site Monitoring/Pump:

★★★★

Non-Pharmacologic Pain Measures:

★★★★

PALLIATIVE AND END OF LIFE CARE

Palliative Symptom Management:

★★★★

Pain Management/Response:

★★★★

Family Support/Teaching:

★★★★

After Death Protocols:

★★★★

MEDICATIONS

Alzheimer's Medications:

★★★★

Antiarrhythmics:

★★★★

Antibiotics/Antivirals:

★★★★

Anti-Depressants:

★★★★

Anti-Hypertensives:

★★★★

Anti-Psychotics:

★★★★

Anti-Seizure Medications:

★★★★

Benzodiazepines:

★★★★

Calculation of Pediatric Dosages:

★★★★

Coumadin:

★★★★

Diuretics:

★★★★

Enoxaparin:

★★★★

Inhaled Medications:

★★★★

Nebulizer Medications:

★★★★

Insulin:

★★★★

Opioid and Non-Opioid Analgesics:

★★★★

Oral Chemotherapy:

★★★★

Oral Hypoglycemics:

★★★★

Oral & Topics Nitrates:

★★★★

Rivaroxaban:

★★★★

Sedative/Hypnotics:

★★★★

Steroids:

★★★★

HOME HEALTH

Intake/Admissions:

★★★★

Case Manager:

★★★★

Case Load - Pts/Day(specify):

★★★★

Supervise LVNs/HHAs:

★★★★

Medicare/Medicaid:

★★★★

Long/Short Term Disability:

★★★★

Private Insurance:

★★★★

Telephonic Assessments:

★★★★

Management of Complaints:

★★★★

APS Reports:

★★★★

OASIS:

★★★★

Diagnosis Coding:

★★★★

Document Plan of Care:

★★★★

Clinical Assessment Documentation:

★★★★

PROFESSIONAL KNOWLEDGE AND SKILLS

National Patient Safety Goals/Core Measures:

★★★★

Safety Assessment:

★★★★

Fall Assessment and Prevention:

★★★★

Patient/Family Teaching:

★★★★

Age Specific/Population Based Care:

★★★★

EMR

Allscripts:

★★★★

Cerner:

★★★★

Epic:

★★★★

HomeCare Home Base:

★★★★

McKesson:

★★★★

Meditech:

★★★★

Other Computerized Documentation System:

★★★★

EMR Conversion:

Age Specific Competencies

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):

★★★★

Certifications

BLS

ACLS

PALS

IV Certification

Other Certification 1

Other Certification 2

Other Certification 3

Other Certification 4

Home Health Skills Checklist

Fill Out and Submit your Skills Checklist

(Home Health)

Proficiency Scale:

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