Administrative Registered Nurse Skills Checklist

Pre-Op RN Skills Checklist

Fill Out and Submit your Skills Checklist

(Pre-Op RN Skills Checklist)

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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

Age of Patients Cared For

Newborn/Neonate (birth to 30 days):

★★★★

Infant (1 month to 1 year):

★★★★

Toddler (1 year to 3 years):

★★★★

Preschooler (3 years to 5 years):

★★★★

School Age Child (5 years to 12 years):

★★★★

Adolescents (12 years to 18 years):

★★★★

Young Adults (18 years to 39 years):

★★★★

Middle Adults (39 years to 64 years):

★★★★

Older Adults (64 years to 79 years):

★★★★

Elderly Adults (over 79+ years):

★★★★

General Skills

Standard Precautions:

★★★★

Adult Respiratory/Cardiac Arrest:

★★★★

Pediatric Respiratory/Cardiac Arrest:

★★★★

Crash Carts:

★★★★

Defibrillators:

★★★★

Patient/Family Education:

★★★★

Admit & Assess Patients:

★★★★

Automated Med Dispensing Systems:

★★★★

List Types:

Obtaining Cultures (Blood, Sputum, Swab, Urine):

★★★★

Advance Directives:

★★★★

Collect Appropriate Data:

★★★★

Discharge Teaching:

★★★★

Preoperative Teaching:

★★★★

Patient Prep:

★★★★

CARDIOVASCULAR

Assess Heart Tones:

★★★★

Bedside Tele Monitoring:

★★★★

Interpretation of Coagulation Studies:

★★★★

Perform Pulse/Circulation Checks:

★★★★

Pre-Post Op Pacemaker Care:

★★★★

PULMONARY

Assess Breath Sounds:

★★★★

Apply Oxygen:

★★★★

Interpret ABGs:

★★★★

Thoracentesis:

★★★★

Oximetry:

★★★★

NEUROLOGY

Assess Neurological Signs:

★★★★

Epidurals:

★★★★

Selective Nerve Root Blocks:

★★★★

Assess Level of Consciousness:

★★★★

Insertion/Monitoring NG Tubes:

★★★★

Assessments:

★★★★

Flexible Sigmoidoscopy:

★★★★

Hemorrhoid Banding:

★★★★

Liver Biopsy:

★★★★

Paracentesis:

★★★★

Lap Band Surgery:

★★★★

Bladder Biopsy:

★★★★

Cystoscopy:

★★★★

Urethral Dilation:

★★★★

Nephrostomy:

★★★★

Kidney Biopsy:

★★★★

Suprapubic Catheter:

★★★★

Prostate Biopsy:

★★★★

ENDOCRINE

Care of Diabetic Patient:

★★★★

Diabetic Teaching:

★★★★

Blood Glucose Testing:

★★★★

ENT & Mouth

Prosthodontics/Restorative Dentistry:

★★★★

Mouth Biopsy:

★★★★

Myringotomy:

★★★★

Maxillofacial Prosthetics:

★★★★

Nose Biopsy:

★★★★

Thyroid Aspirate Biopsy:

★★★★

Fiberoptic Laryngoscopy:

★★★★

Tonsillectomy:

★★★★

WOUNDS/INTEGUMENT

Application of Burn Dressing:

★★★★

Dressing Changes:

★★★★

Debridement of Wound:

★★★★

Wound Care:

★★★★

Wound Vac:

★★★★

OB/GYN

Electrodesiccation and Curettage (ED&C):

★★★★

Assist with In-Office Procedures:

★★★★

ORTHO

Arthrocentesis:

★★★★

External Hardware and Pin Care:

★★★★

Arthroscopy:

★★★★

Open Reduction and Internal Fixation:

★★★★

Closed Reduction and Internal Fixation:

★★★★

Trigger Point Injections:

★★★★

PLASTICS

Rhinoplasty:

★★★★

Liposuction:

★★★★

Nipple Reconstruction:

★★★★

MOHS Repairs:

★★★★

Blepharoplasty:

★★★★

Mole/Cyst Removal:

★★★★

GENERAL MEDICATIONS/THERAPEUTIC INTERVENTIONS

Administer IM and SQ Medications:

★★★★

Administer Inhalation Medications:

★★★★

Administer PO Medications:

★★★★

Bladder Irrigation and Installation:

★★★★

Chemotherapy:

★★★★

Needleless System:

★★★★

IV THERAPY

Infusion Pumps:

★★★★

Peripheral IV Insertion:

★★★★

Syringe Pumps:

★★★★

Vascular Access Devices Care/Maintenance:

★★★★

Administer IV Medications:

★★★★

OXYGEN ADMINISTRATION

Nasal Cannula:

★★★★

Ambu-Bag:

★★★★

Non-Rebreather Mask:

★★★★

Venti Mask:

★★★★

Face Mask:

★★★★

NUTRITIONAL THERAPY

Lipids:

★★★★

TPN:

★★★★

Procalamine:

★★★★

Enteral Administration:

★★★★

PAIN MANAGEMENT/ ANESTHESIA

Moderate Sedation:

★★★★

Implantable Narcotic Pump:

★★★★

Epidural:

★★★★

Spinal:

★★★★

Local:

★★★★

General:

★★★★

Bier Block:

★★★★

Axillary Block:

★★★★

GENERAL PROCEDURES/ EQUIPMENT

Apply Immobilizers (clavicle, knee, etc.):

★★★★

Assist with Code Resuscitation:

★★★★

Assist with Lumbar Puncture:

★★★★

Dermabrasion:

★★★★

Laser:

★★★★

Drain Removal:

★★★★

Incision and Drainage:

★★★★

NGT Insertion:

★★★★

Patch Test:

★★★★

Punch Biopsy:

★★★★

Shave Biopsy:

★★★★

Procedure Set Up:

★★★★

Remove External Fixators with Pin:

★★★★

Scrub:

★★★★

Screw-Hardware Removal:

★★★★

Set-Up/ Assist Suturing:

★★★★

Staple Removal:

★★★★

Suture Removal:

★★★★

Foley/ Straight Catheter - Male:

★★★★

Foley/ Straight Catheter - Female:

★★★★

TENS Unit:

★★★★

Use of Doppler:

★★★★

SPECIMEN COLLECTIONS

Venipuncture:

★★★★

Clean Catch Urine:

★★★★

Sterile Urine Collection:

★★★★

Stool:

★★★★

Sputum:

★★★★

Butterfly Stick:

★★★★

Central Line Draw:

★★★★

CLINICAL SETTINGS

Surgi-Center:

★★★★

Out Patient Clinic:

★★★★

Physician Office:

★★★★

Ambulatory Surgery Clinic:

★★★★

ADDITIONAL INFORMATION

Please list the EMR systems you have used:

Pre-Op RN Skills Checklist

Fill Out and Submit your Skills Checklist

(Pre-Op RN Skills Checklist)

Proficiency Scale:

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