Medical Surgical Skills Checklist

Please mark your level of experience
1.  No theory and/or experience
2.  Limited experience/need supervision and/or support
3.  Experienced/minimal support needed to perform
4.  Proficient/can perform independently
WORK SETTINGS
 1234
LTAC
MS/Tele
Med/Surg
Rehab
Short Stay- 23 hour Stay Unit
Telemetry
CARDIAC
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Angina
Post Acute MI
Congestive Heart Failure
Post Cardiac Cath
Post Cardiac Surgery
Aneurysm
Carotid Endarterectomy
Post Vascular Surgery
Post Cardiac Transplant
PULMONARY
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Pneumonia
COPD
Tuberculosis
Pulmonary Embolism
Tracheostomy Management
CPAP/BiPAP
Interpretation of Arterial Blood Gases
Post Lung Transplant
NEUROLOGICAL & PSYCHIATRIC
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Stroke Scale Assessment
Traumatic Brain Injury
CVA
Post Craniotomy
Seizure Disorders
Spinal Cord Injuries
Mood Disorders
Substance Withdrawal
ORTHOPEDICS
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Circulation/Skin Checks
Continuous Passive Motion Devices
Ambulation Assistive Devices
Prosthetics
Cast Care
Pin Care
Traction
Total Joint Replacement
Amputation
GASTROINTESTINAL
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Bariatrics
Feeding Tubes
GI Bleeding
Bowel Obstruction
GI Surgery
Liver Disease
Pancreatitis
Post Liver Transplant
Post Pancreas Transplant
RENAL/GENITOURINARY
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Arteriovenous Fistula/Shunt
3 Way Catheter & Bladder Irrigation
Suprapubic Catheter
Renal Failure
Peritoneal Dialysis
GU Surgery
Nephrostomy Tubes
Renal Transplant
Management Pre/Post Hemodialysis
Gyn Surgery
ENDOCRINE METABOLIC
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Diabetes Type I
Diabetes Type II
Blood Glucose Monitoring
IV Insulin Protocols
Management of Hypoglycemia
Indwelling Insulin Pumps
Pituitary Disorders
ONCOLOGY
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Chemotherapy Administration
Radiation Therapy
Medical Oncology
Surgical Oncology
Radiation Implants
Bone Marrow Transplant
MEDICATIONS
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Antiarrhythmics
Anticoagulants (IV, oral, & injection)
Anti-Depressants
Anti-Hypertensives
Anti-Psychotics
Benzodiazepines
Emergency Medications
Epidural Analgesia
Inhaled Medications
Insulin
Narcotics/Opioid Analgesics (IV, oral, & injection)
Nitrates (Oral & Topical)
Non-Opioid Analgesics (IV, Oral, & Injection)
Oral Hypoglycemics
Patient Controlled Analgesia
Procedural Sedation Administration
Reversal Agents
Steroids (IV, Oral, Inhaled)
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
IV THERAPY
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Starting IVs
Central Line Blood Draws
Central Line/Implanted Line Care
TPN & Lipids
Blood Product Administration
Monitoring of Chemotherapy
CARDIAC MONITORING & EMERG. RESPONSE
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Placement of Telemetry Leads
Rhythm Interpretation
Dysrhythmia Management
Obtain 12 Lead EKG
Use of Rapid Response Teams
PROFESSIONAL KNOWLEDGE AND SKILLS
 1234
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
Pressure Ulcer Risk Assessment/Prevention
Restraints/Use of Least Restrictive Device
Patient/Family Teaching
Age Specific/Population-Based Care
Isolation Precautions
Infection Prevention
Pain Assessment & Management
Charge Experience
Interpretation and Communication of Lab Values
Wound Care /Wound Vac
Specialty Beds
COMPUTERIZED CHARTING
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Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
 YesNo
EMR Conversion
By checking the "Agree" box and clicking “Submit” below you certify and acknowledge the information provided on this checklist is accurate to the best of your knowledge and an accurate representation of your abilities. *