Wound/Ostomy/Continence 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
Acute Care - Adult
Clinic - Adult
SNF/LTAC/Subacute
Hospice/Palliative Care
Acute/Long Term Care - Pediatrics
Clinic - Pediatrics
PRESSURE ULCERS
 1234
Assessment
Staging
Prevention/Risk Assessment Tools -Adult
Prevention/Risk Assessment Tools - Pediatrics
Support Surface Selection
NEUROPATHIC ULCERS
 1234
Assessment
Management
VENOUS STASIS ULCERS
 1234
Assessment
Management
PERIPHERAL ARTERIAL ULCERS
 1234
Assessment
Ankle Brachial Index
Management
OTHER WOUNDS
 1234
Fistulae- Pouching/Skin Care
Skin Care/Management of Drains
WOUND DEBRIDEMENT
 1234
Autolytic
Enzymatic
Mechanical
Sharp
DRESSINGS/TREATMENTS
 1234
Hydrogels
Hydrocolloids
Silver Products
Foams
Alginates
Vacuum Assisted Closure
Growth Factors
Skin Substitutes
Hyperbaric Oxygen Therapy
Wound Cultures
Electrical Stimulation
Enzymatic Debriding Agents
Mist Therapy
COLOSTOMY/ILEOSTOMY
 1234
Ostomy Equipment Selection
Continence Skin Care Management
Loop with Rod Stoma
End Stoma
Mucous Fistula
Double Barrel Stoma
Irrigation
Ileal Lavage
CONTINENT ILEOSTOMY
 1234
Kock Pouch
Pelvic Pouch
UROSTOMY/CONTINENT
 1234
Catheterization for C&S
Kock Pouch
Indiana Pouch
Neobladder
CONTINENCE EVALUATION
 1234
Urodynamics
Manometry
Electromyography
Leak Point Pressures
Cystometrogram
Uroflometry
Biofeedback
Pudendal Nerve Terminal Motor Latency
CONTINENCE THERAPEUTIC DEVICES
 1234
Vaginal Cones
Penile Clamps
Male External Catheters
Internal Urethral Inserts
Catheters - Mgmt& Self Care Teaching
Magnetic Therapy
Urinary Incontinence Program
Fecal Incontinence Program
BURNS
 1234
Burn Management
PROFESSIONAL KNOWLEDGE AND SKILLS
 1234
National Patient Safety Goals/Core Measures
Patient Family Teaching
Age Specific/Population-Based Care
Isolation Precautions
Infection Prevention
Pain Assessment & Management
Interpretation & Communication of Lab Values
COMPUTERIZED CHARTING
 1234
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. *