Ambulatory Skills Checklist

Fill Out and Submit your Skills Checklist
Skills Checklist
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:
1No Experience
2Need Training
3Able to perform with supervisione
4Able to perform independently
General Patient Care
Admit and Assess Patients
0
Advance Directives
0
Collect Appropriate Data
0
Discharge Teaching
0
Preoperative Teaching
0
Patient Prep
0
Computerized Documentation
0
Cardiovascular
Assess Heart Tones
0
Bedside Tele Monitoring
0
Interpretation of Coagulation Studies
0
Perform Pulses/Circulation Checks
0
Pre/Post Op Care Pacemaker
0
Pulmonary
Assess Breath Sounds
0
Apply Oxygen
0
Interpret ABGs
0
Thoracentesis
0
Oximetry
0
Neurology
Assess Neurological Signs
0
Epidurals
0
Selective Nerve Root Blocks
0
Level of Consciousness
0
GI
Insertion/Monitoring NG Tubes
0
Assessment/Patient Care Continued
0
Flexible Sigmoidoscopy
0
Hemorrhoid Banding
0
Liver Biopsy
0
Paracentesis
0
Lap Band Surgery
0
GU
Bladder Biopsy
0
Cystoscopy
0
Urethral Dilation
0
Nephrostomy
0
Kidney Biopsy
0
Suprapubic Catheter
0
Prostate Biopsy
0
Endocrine
Care of Diabetic Patient
0
Diabetic Teaching
0
ENT and Mouth
Prosthondontics - Restorative Dentistry
0
Mouth Biopsy
0
Myringotomy
0
Maxillofacial Prosthetics
0
Nose Biopsy
0
Thyroid Aspirate Biopsy
0
Fiberoptic Laryngoscopy
0
Tonsilectomy
0
Rhinoplasty
0
Wounds/Integument
Application of Burn Dressings
0
Application of Dressing
0
Debridement of Wound
0
Wound Care
0
OB/GYN
Electrodesiccation and Curettage (ED&C)
0
Nipple Reconstruction
0
Musculoskeletal
Arthrocentesis
0
External Hardware and Pin Care
0
Arthroscopy
0
Open Reduction and Internal Fixation
0
Closed Reduction and Internal Fixation
0
Trigger Point Injections
0
Plastics
Liposuction
0
Plastic Surgery
0
Cosmetic
0
General Medications/Therapeutic Interventions
Administer IM and SQ Meds
0
Administer Inhalation Medications
0
Administer PO Medications
0
Bladder Irrigation and Instillation
0
Needleless Systems
0
Chemotherapy
0
IV Therapy
Infusion Pumps
0
Peipheral IV Insertion
0
Syringe Pumps
0
Vascular Access Devices Care/Maintenance
0
Administer IV Medications
0
Oxygen Administration
Ambu-Bug
0
Nasal Cannula
0
Non-ReBreather Mask
0
Pulse Oximetry
0
Venti Mask
0
Face Mask
0
Nutritional Therapy
Lipids
0
TPN
0
Procalamine
0
Enteral Administration
0
Pain Management/Anesthesia
Inplantable Narcotic Pump Re ll
0
Moderate Sedation
0
Epidural
0
Spinal
0
Local
0
General
0
Axillary Block
0
Bier Block
0
Blood
Blood and Blood Products
0
Albumin
0
General Procedures/Equipment
Apply Immobilizers (clavicle, knee, etc.)
0
Assist with Code Resuscitation
0
Assist with Lumbar Puncture
0
Laser
0
Dermabrasion
0
Drain Removal
0
Incision and Drainage
0
NGT Insertion
0
Patch Test
0
Punch Biopsy
0
Procedure Set Up
0
Procedures/Equipment Continued
0
Remove External Fixators With Pin
0
Scissor Biopsy
0
Scrub
0
Screw-Hardware Removal
0
Set-up Assist Suturing
0
Staple Removal
0
Straight/Foley Cath Female
0
Straight/Foley Cath Male
0
Suture Removal
0
TENS (Transcutaneous Elec. Nerve Stimulator)
0
Use of Doppler
0
Specimen Collections
Venipuncture
0
Clean Catch Urine
0
Sterile Urine Collection
0
Stool
0
Sputum
0
Butter y Stick
0
Central Line Draw
0
Clinical Settings
Surgi-Center
0
Out Patient Clinic
0
Age Group Experience Continued
0
Physician O ce
0
Ambulatory Surgery Clinic
0
Joint Commission
National Safety Goals
0
“Do Not Use” Abbreviations and Terms
0
Age Specific Competencies
Infant (Birth - 1 year)
0
Preschooler (ages 2-5 years)
0
Childhood (ages 6-12 years)
0
Adolescents (ages 13-21 years)
0
Young Adults (ages 22-39 years)
0
Adults (ages 40-64 years)
0
Older Adults (ages 65-79 years)
0
Elderly (ages 80+ years)
0

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