NAME:________________________

NURSING SKILLS CHECKLIST

This skills checklist was initiated as a result of a joint meeting between the local nursing schools and local hospitals. The nursing skills checklist was developed by Kern Health Education Council. It is intended to improve documentation and communication between nursing education and nursing service. If you apply for employment at a local hospital, you may be asked to share your checklist with your employer.

To improve the utilization of the checklist during your two years of nursing courses, the following instructions are recommended.

1. Write your name on every page of the checklist.

2. Bring the checklist to the clinical laboratory.

3. A different color pen will be used for each semester of the nursing program:

1st semester – black2nd semester – green3rd semester – red

4. The observed column is for the student to initial when the topic has been covered/observed in lecture, demonstration, or clinical. This does NOT include observation of a procedure when you have not had an adequate explanation of the procedure.

5. The lab column is for demonstration in the skills laboratory (Anything you did in the skills lab). Please place your initials in this column.

6. The clinical laboratory is for demonstration of skills in the various healthcare agencies/settings. Please place a check ( ) in the appropriate space. Your faculty member will initial the skill when he/she has seen you perform the skill.

7. On the last page, the faculty will indicate their full name which corresponds to their coded initials.

NURSING SKILLS CHECKLISTCARDIOVASCULAR Observed Lab Clinical

1. Pulses (see BASIC SKILLS) 2. Blood Pressure

a. Auscultate _______________________________________________b. Palpate __________________________________________________c. Orthostatic _______________________________________________d. CVP ____________________________________________________e. Automatic BP device _______________________________________

3. Assessment ofa. PMI ____________________________________________________b. S1, S2 __________________________________________________c. Adventitious Sounds _______________________________________d. Homan’s sign _____________________________________________

4. Observation ofa. Edema

Sacral ___________________________________________________Extremity ________________________________________________

b. Neck vein distention ________________________________________5. Cardiac Monitoring

a. Electrode Application _______________________________________b. Lead Placement ___________________________________________c. Recognition of Life

Threatening Dysrhythmias:Cardiac Standstill __________________________________________V Fib ___________________________________________________V Tach __________________________________________________

6. Basic CPR ____________________________________________________

ENDOCRINE

1. Finger stick Blood sugar __________________________________________2. Urine-S & A ____________________________________________________

GASTROINTESTINAL

1. Auscultate bowel sounds _________________________________________2. Management of Test Prep (list) ____________________________________

a. ________________________________________________________b. ________________________________________________________

3. Enemasa. SS _____________________________________________________b. H2O ____________________________________________________c. Fleets ___________________________________________________d. Retention ________________________________________________e. Harris Flush ______________________________________________

Observed Lab Clinical

4. Feedingsa. Bottle ___________________________________________________b. Gastrostomy _____________________________________________c. Gavage with/without Pump __________________________________d. Hand ___________________________________________________e. Force Fluids ______________________________________________f. Calorie Count _____________________________________________g. Diet Correct for Client ______________________________________

5. Nasogastric tube or GI tubea. Insertion _________________________________________________b. Irrigation/Lavage __________________________________________c. Salem Sump Care _________________________________________d. Decompression ___________________________________________

6. T-Tube Care ___________________________________________________7. Specimen Collection

a. Stool ____________________________________________________b. Occult Blood _____________________________________________c. guaiac __________________________________________________

8. Ostomiesa. Ostomy Care _____________________________________________b. Colostomy Irrigation ________________________________________

9. Fecal Disimpaction ______________________________________________10.Bowel Training _________________________________________________11.Measure abdominal girth _________________________________________

GYNECOLOGICAL/REPRODUCTIVE

1. Obstetricsa. Timing Contractions ________________________________________b. Abdominal Prep ___________________________________________c. Postpartum Check _________________________________________d. Fetal Heart Tones _________________________________________e. Assist with breastfeeding ____________________________________f. Demonstrate self breast exam ________________________________g. Apply external FHT monitor __________________________________h. Apply contraction monitor ___________________________________i. Leopold’s Maneuver _______________________________________j. Fundal measurement _______________________________________k. Remove cord clamp ________________________________________l. Infant footprints ___________________________________________

INTEGUMENTARY Observed Lab Clinical

1. Prevention/Decubitus ____________________________________________Assessment/Care _______________________________________________

2. Drain Carea. Hemovac _____________________________________________b. Jackson-Pratt __________________________________________c. Penrose ______________________________________________

3. Sterile Dressingsa. Wet __________________________________________________b. Dry __________________________________________________c. Clear _________________________________________________d. Wound Packing ________________________________________e. Montgomery Straps _____________________________________

4. Removal ofa. Sutures _______________________________________________b. Staples _______________________________________________

5. Wound Care ___________________________________________________6. Wound Irrigation ________________________________________________

MUSCULOSKELETAL

1. Cast Care _____________________________________________________2. Range of Motion

a. Passive _________________________________________________b. Active ___________________________________________________c. Assisted _________________________________________________

3. Traction Carea. Pin Care _________________________________________________b. Halo ____________________________________________________c. Tongs ___________________________________________________d. Balanced ________________________________________________e. Bucks ___________________________________________________f. Pelvic Sling ______________________________________________g. Bryants __________________________________________________h. Pelvic Belt _______________________________________________i. Skeletal _________________________________________________j. Russells _________________________________________________

4. Sling Application ________________________________________________5. Cervical Collar _________________________________________________6. Stump Care ___________________________________________________7. Neurovascular Check ____________________________________________8. ABD Pillow ____________________________________________________9. Assists with Mobility

a. Ambulation _______________________________________________b. Cane ___________________________________________________

Observed Lab Clinicalc. Crutches ________________________________________________d. Walker __________________________________________________e. Chair/WC ________________________________________________

NEUROLOGICAL/SENSORY/ENT

1. Neurological Check _____________________________________________2. Seizure Precautions _____________________________________________3. Mental Status Exam _____________________________________________4. Balance/coord/grip strength _______________________________________5. Measure head circumference ______________________________________6. Assess fontanel ________________________________________________7. Assess DTRs/clonus ____________________________________________

RENAL

1. Bladder Palpation _______________________________________________2. Bladder Training ________________________________________________3. Catheter Care

a. Male ____________________________________________________b. Female __________________________________________________c. Suprapubic _______________________________________________

4. Catheterizationa. Indwelling ________________________________________________b. Straight _________________________________________________c. Male ____________________________________________________d. Female __________________________________________________

5. Fistula or Shunt Care ____________________________________________6. Intake & Output _________________________________________________

Weigh diapers _______________________________________________7. Bladder Irrigation _______________________________________________8. Urine Specimen Collection/Testing

a. C & S ___________________________________________________b. Midstream _______________________________________________c. Pedi Bag ________________________________________________d. From catheter ____________________________________________e. Urometer ________________________________________________f. Urine pH _________________________________________________

9. Urostomy Care _________________________________________________10.Assists with

a. Bedpan _________________________________________________b. Urinal ___________________________________________________c. Fracture Pan _____________________________________________d. Bedside Commode ________________________________________

RESPIRATORY Observed Lab Clinical

1. Croupette/Ohio Care ____________________________________________2. Oxygen Administration

a. Mask ___________________________________________________b. Prongs __________________________________________________c. Portable _________________________________________________

3. Postural Drainage _______________________________________________4. Chest Percussion _______________________________________________5. Sputum Specimen ______________________________________________6. Suctioning

a. Oral ____________________________________________________b. Tracheal/Endotracheal ______________________________________c. Nasal ___________________________________________________d. Bulb syringe ______________________________________________

7. Tracheostomy Care _____________________________________________8. TCDB ________________________________________________________9. Auscultate Breath Sounds

a. Physiological _____________________________________________b. Adventitious ______________________________________________

10.Palpate: Crepitus _______________________________________________11.Chest tubes

a. Set up __________________________________________________Water Seal _______________________________________________Pleurovac ________________________________________________Emerson Suction __________________________________________

b. Patency _________________________________________________12.Pulse Oximeter _________________________________________________13.Apnea Monitor _________________________________________________

PSYCHOSOCIAL

1. Spiritual Needs _________________________________________________2. Suicide Precautions _____________________________________________3. Therapeutic Communication _______________________________________4. Death and Dying ________________________________________________5. Play therapy ___________________________________________________6. Labor Coaching ________________________________________________

COMFORT & HYGIENE Observed Lab Clinical1. Bed making

a. Occupied ________________________________________________b. Unoccupied ______________________________________________c. Foot Cradle ______________________________________________

2. Bathsa. Bed ____________________________________________________b. Tub _____________________________________________________c. Sitz _____________________________________________________d. Shower __________________________________________________e. Infant’s first bath __________________________________________

3. Back Massage _________________________________________________4. Hair Care

a. Shampoo ________________________________________________b. Shave ___________________________________________________c. Brush/Comb ______________________________________________

5. Oral Hygiene ___________________________________________________6. Denture Care __________________________________________________7. Positioning

a. Lift _____________________________________________________b. Turn ____________________________________________________c. Support _________________________________________________

8. Perineal Carea. Male ____________________________________________________b. Female __________________________________________________

9. Postmortum Care _______________________________________________PHYSICAL SAFETY MEASURES1. Restraints/Application and Care of

a. Jacket __________________________________________________b. Wrist ____________________________________________________c. Leather __________________________________________________d. Elbow ___________________________________________________e. Hand Mitts _______________________________________________

2. Sterile Gloving _________________________________________________3. Sterile Field ____________________________________________________4. Isolation

a. Standard precautions (universal) _______________________________________________

b. Airborne precautions _______________________________________c. Droplet precautions ________________________________________d. Contact precautions ________________________________________

5. Transferring to a. Guerney _________________________________________________b. W/C ____________________________________________________

6. Transporting ___________________________________________________7. Hand washing __________________________________________________

BASIC SKILLS Observed Lab Clinical

1. Temperature ___________________________________________________a. Oral ____________________________________________________b. Rectal ___________________________________________________c. Axillary __________________________________________________d. Electronic device __________________________________________

2. Pulsea. Apical ___________________________________________________b. Radial ___________________________________________________c. Pulse deficit ______________________________________________d. Carotid __________________________________________________e. Brachial _________________________________________________f. Dorsalis Pedis ____________________________________________g. Post Tibial _______________________________________________h. Femoral _________________________________________________

3. Respirations ___________________________________________________4. Blood Pressure (see CARDIOVASCULAR)5. Height ________________________________________________________6. Weight

a. Standing _________________________________________________b. Bed Scales _______________________________________________c. Infant Scales _____________________________________________

7. Application ofa. Cold ____________________________________________________b. Moist Heat _______________________________________________c. Aqua K __________________________________________________

8. Ace Bandages _________________________________________________9. Anti-embolic Stockings ___________________________________________10.ABD Binder ____________________________________________________11.Use of Equipment

a. Egg Crate ________________________________________________b. Bed Cradle _______________________________________________c. Air Mattress ______________________________________________d. Slide Board ______________________________________________e. Specialty Bed (specify)

________________________________________________________________________________________________________________

f. Chemstick machine ________________________________________

MEDICATIONS Observed Lab Clinical

1. Dosage Computation ____________________________________________a. Adult ____________________________________________________b. Child ____________________________________________________

2. Oral __________________________________________________________3. Topical

a. Cream/Ointment __________________________________________b. Spray ___________________________________________________

4. Suppositoriesa. Rectal ___________________________________________________b. Vaginal __________________________________________________

5. Eyea. Gtts ____________________________________________________b. Ointment ________________________________________________

6. Ear Gtts ______________________________________________________7. Injections

a. S.C. ____________________________________________________b. IM ______________________________________________________c. IM Z Track _______________________________________________d. Heparin _________________________________________________e. Insulin __________________________________________________f. Site Identification __________________________________________

8. Narcotic Control ________________________________________________9. Administer to a group of clients ____________________________________10. IVPush _______________________________________________________11. IVPB _________________________________________________________12.Buritrol _______________________________________________________13. IV drips (specify)

a. Insulin drip _______________________________________________b. Heparin drip ______________________________________________c. Aminophyllin drip __________________________________________d. Morphine drip _____________________________________________e. ________________________________________________________f. ________________________________________________________

IV1. Basic procedure for Insertion

a. Cath over Needle __________________________________________b. Heparin Lock _____________________________________________c. Butterfly _________________________________________________

2. Regulate ______________________________________________________3. Calculate ______________________________________________________4. Saline Lock

a. Flush ___________________________________________________b. ________________________________________________________

Observed Lab Clinical5. Bottle Change __________________________________________________

Labeling ______________________________________________________6. Tubing Change _________________________________________________

Labeling ______________________________________________________7. Discontinued

a. Peripheral _______________________________________________b. Central __________________________________________________

8. Site Carea. Peripheral _______________________________________________b. Central __________________________________________________

________________________________________________________________________________________________________________________________________________________________________

9. Automatic Infusion Devicea. Regulation-primary ________________________________________b. Regulation-Secondary ______________________________________

10.Arterial Puncture Hold ___________________________________________11.Admin Blood and Blood Products ___________________________________12.Administer Hyperalimentation

a. With medications __________________________________________b. Without medications _______________________________________

13.Medications through a central line __________________________________14.Patient Controlled Analgesic (PCA)

a. Primary Line ______________________________________________b. Loading Dose _____________________________________________c. Dose ___________________________________________________d. Lock Out Interval __________________________________________e. 4 Hour Limit ______________________________________________f. Syringe Change ___________________________________________g. Clear Pump q4h ___________________________________________

15.Blood drawsa. Butterfly _________________________________________________b. Vacuum Container _________________________________________c. Central Line ______________________________________________d. Arterial Line ______________________________________________

OTHER

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PROFESSIONAL RESPONSIBILITIES Observed Lab Clinical

1. Receive Essential Componentsof Change of Shift Report _________________________________________

2. Communicate Essential Components of Change of Shift Report _________________________________________

3. Communicate Essential Componentsof Clarification Report ____________________________________________

4. Communicate Essential Componentsof Client’s Health Status to Physician ________________________________

5. Communicate Essential Components of Events to Appropriate ManagerialPersonnel _____________________________________________________

6. Receive Verbal/Phone Orders fromPhysician _____________________________________________________

7. Transcribe Physician Orders ______________________________________8. Implement Physician Orders ______________________________________9. Assess Client Health Status _______________________________________10.Review Reports from Ancillary Departments

a. Laboratory _______________________________________________b. X-ray ___________________________________________________c. Special Procedures ________________________________________

11. Initiate Client Care Plan __________________________________________12. Implement Client Care Plan _______________________________________13.Revise Client Care Plan as

Client’s Health Status Warrants ____________________________________14.Makes Client Care Assignments

According to Intensity ____________________________________________15. Integrate the Nursing

Process in Nursing Rounds _______________________________________16.Actively Participates in

Physician Rounds _______________________________________________17.Documentation in the Medical

Record to Meet Professionaland Legal Standards

a. Assessment of Clientphysical _________________________________________________developmental ____________________________________________plotting growth chart _______________________________________

b. Response to Medical Planof Treatment _____________________________________________

c. Response to Nursing Planof Treatment _____________________________________________

d. Vital signs graphic sheet ____________________________________e. Medication Administration ___________________________________f. IV start __________________________________________________

Observed Lab Clinicalg. IV fluid balance ___________________________________________h. ________________________________________________________i. ________________________________________________________

18.Participate in Client Education (specify)____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

19. Initiates Discharge Planning _______________________________________20.Conduct Outcome Oriented

Nursing Team Conference ________________________________________21.Delegate Responsibility __________________________________________22. Implement Disciplinary

Measures _____________________________________________________23.Admission Routine ______________________________________________24.Discharge Routine ______________________________________________25.Client Advocacy ________________________________________________

REVISED FALL 2000

FACULTY FACULTY NAME COURSE SEMESTERINITIALS________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________