Infusion Control Skills Checklist

Fill Out and Submit your Skills Checklist

    (Infusion Control)

    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
    AGE OF PATIENTS CARE FOR

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    GENERAL SKILLS

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    KNOWLEDGE OF CURRENT IV THERAPY GUIDELINES

    0

    0

    0

    0

    INSERTION OF

    0

    0

    0

    0

    0

    MIDLINE/PICC LINES

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    CARE AND MAINTENANCE

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    MEDICATION ADMINISTRATION

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    EQUIPMENT

    0

    0

    0

    0

    0

    0

    0

    0

    0

    TROUBLESHOOTING / COMPLICATIONS

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    DISCONTINUING IV THERAPY

    0

    0

    0

    ADDITIONAL INFORMATION