Carolina Travel Nurses Medical Surgical Skills Checklist.
(888) 894-2900 (bus)
(888) 894-2073 (fax)
enter name above
MEDICAL / SURGICAL SKILLS CHECKLIST
1
=
> 2 years experience
2
= 1-2 years experience
3
= < 1 year experience
4
= theory only
ORTHOPEDICS
IV THERAPY / PHLEBOTOMY
EXPERIENCE WITH ASSESSMENT
EQUIPMENT and PROCEDURES
Range of motion
*
1
2
3
4
Drawing venous blood
*
1
2
3
4
Skin
*
1
2
3
4
Drawing blood from central line
*
1
2
3
4
Circulation checks
*
1
2
3
4
Starting IV's
Gait
*
1
2
3
4
Heparin lock
*
1
2
3
4
EQUIPMENT and PROCEDURES
Butterfly
*
1
2
3
4
Support Devices
Angiocath
*
1
2
3
4
Wheelchair
*
1
2
3
4
Administration of blood/blood products
Prosthetic
*
1
2
3
4
Plasma
*
1
2
3
4
Cane
*
1
2
3
4
Packed red blood cells
*
1
2
3
4
Transfer boards
*
1
2
3
4
Albumin
*
1
2
3
4
Cervical collar
*
1
2
3
4
Cryoprecipate
*
1
2
3
4
Walker
*
1
2
3
4
Whole blood
*
1
2
3
4
Sling
*
1
2
3
4
Gait belt
*
1
2
3
4
PATIENT CARE WITH
Continuous passive motion devices
*
1
2
3
4
Peripheral line dressing
*
1
2
3
4
Traction
*
1
2
3
4
PATIENT CARE WITH
Central line/catheter/dressing
Cast
*
1
2
3
4
Quinton
*
1
2
3
4
Total hip replacement
*
1
2
3
4
Hickman
*
1
2
3
4
Pinned fractures
*
1
2
3
4
Groshong
*
1
2
3
4
Osteoporosis
*
1
2
3
4
Broviac
*
1
2
3
4
Amputation
*
1
2
3
4
Portacath
*
1
2
3
4
Total knee replacement
*
1
2
3
4
Rheumatic/arthritic disease
*
1
2
3
4
Arthroscopic Surgery
*
1
2
3
4
PULMONARY
PULMONARY
EQUIPMENT and PROCEDURES
PATIENT CARE WITH
Airway management devices/suctioning
Tuberculosis
*
1
2
3
4
Tracheostomy/suctioning
*
1
2
3
4
Pneumonia
*
1
2
3
4
Oropharyngeal/suctioning
*
1
2
3
4
Bronchoscopy
*
1
2
3
4
Nasal airway/suctioning
*
1
2
3
4
COPD
*
1
2
3
4
Endotracheal tube/suctioning
*
1
2
3
4
Lobectomy
*
1
2
3
4
Sputum specimen collection
*
1
2
3
4
Pulmonary embolism
*
1
2
3
4
Assist with thoracentesis
*
1
2
3
4
Fresh tracheostomy
*
1
2
3
4
Assist with intubation
*
1
2
3
4
Thoracotomy
*
1
2
3
4
Chest physiotherapy
*
1
2
3
4
Pneumonectomy
*
1
2
3
4
Incentive spirometry
*
1
2
3
4
O
2
therapy and medication delivery systems
INTERPRETATION OF LAB RESULTS
Trach collar
*
1
2
3
4
Blood gases
*
1
2
3
4
Inhalers
*
1
2
3
4
Blood chemistry
*
1
2
3
4
Face masks
*
1
2
3
4
Bag and mask
*
1
2
3
4
EXPERIENCE WITH ASSESSMENT
External CPAP
*
1
2
3
4
Rate and work of breathing
*
1
2
3
4
Nasal cannula
*
1
2
3
4
Breath Sounds
*
1
2
3
4
Portable O
2
tank
*
1
2
3
4
Oximetry
*
1
2
3
4
(888) 894-2900 (bus)
(888) 894-2073 (fax)
MEDICAL / SURGICAL SKILLS CHECKLIST
1
=
> 2 years experience
2
= 1-2 years experience
3
= < 1 year experience
4
= theory only
CARDIOVASCULAR
CARDIOVASCULAR
EXPERIENCE WITH ASSESSMENT
PATENT CARE WITH
Auscultation ( rate , rhythm )
*
1
2
3
4
Angina
*
1
2
3
4
Blood pressure/non-invasive
*
1
2
3
4
Cardiac arrest
*
1
2
3
4
Doppler
*
1
2
3
4
Post cardiac cath
*
1
2
3
4
Heart sounds/murmurs
*
1
2
3
4
Post cardiac surgery
*
1
2
3
4
Pulses/circulation checks
*
1
2
3
4
Post acute MI (1-2 days)
*
1
2
3
4
Myocarditis
*
1
2
3
4
EQUIPMENT and PROCEDURES
Carotid endarterectomy
*
1
2
3
4
Telemetry
Aneurysm
*
1
2
3
4
Basic 12 lead interpretation
*
1
2
3
4
Abdominal aortic bypass
*
1
2
3
4
Basic arrhythmia interpretation
*
1
2
3
4
Thrombophlebitis
*
1
2
3
4
Lead placement
*
1
2
3
4
Cardiomyopathy
*
1
2
3
4
Pacemaker
Femoral-popliteral
*
1
2
3
4
Temporary
*
1
2
3
4
Congestive heart failure
*
1
2
3
4
Permanent
*
1
2
3
4
PAIN MANAGEMENT
PATIENT CARE WITH
Medications
Narcotic analgesia
*
1
2
3
4
Oral and topical nitrates
*
1
2
3
4
Epidural anesthesia/analgesia
*
1
2
3
4
Oral and IVP antihypertensives
*
1
2
3
4
Patient controlled analgesia (PCA pump)
*
1
2
3
4
Oral anticoagulants
*
1
2
3
4
Heparin drip
*
1
2
3
4
Assessment of pain level/tolerance
*
1
2
3
4
ONCOLOGY
NEUROLOGICAL
EXPERIENCE WITH ASSESSMENT
EXPERIENCE WITH ASSESSMENT
Pain Control
*
1
2
3
4
Level of consciousness
*
1
2
3
4
Nutritional Status
*
1
2
3
4
Glasgow coma scale
*
1
2
3
4
EQUIPMENT and PROCEDURES
Reverse Isolation
*
1
2
3
4
EQUIPMENT and PROCEDURES
INTERPRETATION OF LAB RESULTS
Use of hype/hypothermia blanket
*
1
2
3
4
Blood counts
*
1
2
3
4
Assist with lumbar puncture
*
1
2
3
4
Blood chemistry
*
1
2
3
4
PATENT CARE WITH
PATIENT CARE WITH
Inpatient chemotherapy
*
1
2
3
4
Seizures
*
1
2
3
4
Inpatient hospice
*
1
2
3
4
Coma
*
1
2
3
4
Radiation implant
*
1
2
3
4
Spinal cord injury
*
1
2
3
4
Bone marrow transplant
*
1
2
3
4
Meningitis
*
1
2
3
4
Fresh oncologic surgery
*
1
2
3
4
Closed head injury
*
1
2
3
4
Leukemia
*
1
2
3
4
Post craniotomy
*
1
2
3
4
INFECTIOUS DISEASES
CVA
*
1
2
3
4
INTERPRETATION OF LAB RESULTS
*
1
2
3
4
Basal skull fracture
*
1
2
3
4
EQUIPMENT and PROCEDURES
Encephalitis
*
1
2
3
4
Isolation
*
1
2
3
4
Neuromuscular disease
*
1
2
3
4
Fever management
*
1
2
3
4
External VP shunts
*
1
2
3
4
PATENT CARE WITH
DT's
*
1
2
3
4
Hepatitus
*
1
2
3
4
Aneurysm precautions
*
1
2
3
4
Lyme Disease
*
1
2
3
4
AIDS
*
1
2
3
4
(888) 894-2900 (bus)
(888) 894-2073 (fax)
MEDICAL / SURGICAL SKILLS CHECKLIST
1
=
> 2 years experience
2
= 1-2 years experience
3
= < 1 year experience
4
= theory only
GENITOURINARY / RENAL
GASTROINTESTINAL
EXPERIENCE WITH ASSESSMENT
EXPERIENCE WITH ASSESSMENT
Fluid balance
*
1
2
3
4
Fluid balance
*
1
2
3
4
Arterio venous fistula/shunt
*
1
2
3
4
Nutritional
*
1
2
3
4
INTERPRETATION OF LAB RESULTS
Interpretation of blood chemistry
*
1
2
3
4
Electrolytes
*
1
2
3
4
BUN & creatinine
*
1
2
3
4
EQUIPMENT and PROCEDURES
EQUIPMENT and PROCEDURES
Placement of nasogastric tube
*
1
2
3
4
Catheter care
Salem pump to suction
*
1
2
3
4
Supra-pubic
*
1
2
3
4
Flexible feeding tube (Dobhoff, Corpak, etc.)
*
1
2
3
4
3 - way Foley
*
1
2
3
4
Management of:
Bladder irrigations
T tube
*
1
2
3
4
Intermittent
*
1
2
3
4
Gastrostomy tube
*
1
2
3
4
Continuous
*
1
2
3
4
Jejunostomy tube
*
1
2
3
4
Specimen collection
Administration of tube feeding
Routine
*
1
2
3
4
Gravity feeding
*
1
2
3
4
Twenty four hour
*
1
2
3
4
Feeding pump
*
1
2
3
4
Insertion and care of straight and Foley catheter
Saline lavage
*
1
2
3
4
Male
*
1
2
3
4
Female
*
1
2
3
4
PATENT CARE WITH
PATENT CARE WITH
Liver failure
*
1
2
3
4
Renal failure
*
1
2
3
4
Hepatitis
*
1
2
3
4
Urinary tract infection
*
1
2
3
4
GI surgery
*
1
2
3
4
Hemodialysis
*
1
2
3
4
GI bleeding
*
1
2
3
4
Renal transplant
*
1
2
3
4
Bowel obstruction
*
1
2
3
4
TURP
*
1
2
3
4
Invasive diagnostic testing
*
1
2
3
4
Nephrectomy
*
1
2
3
4
Inflammatory bowel disease
*
1
2
3
4
Urinary diversion/ileal conduit nephrostomy
*
1
2
3
4
Colostomy/ileostomy
*
1
2
3
4
Peritoneal dialysis
*
1
2
3
4
Paralytic ileus
*
1
2
3
4
METABOLIC / ENDOCRINE
WOUND MANAGEMENT
EXPERIENCE WITH ASSESSMENT
EXPERIENCE WITH ASSESSMENT
S / S insulin reaction
*
1
2
3
4
Surgical wound healing
*
1
2
3
4
S / S diabetic coma
*
1
2
3
4
Skin for impending breakdown
*
1
2
3
4
MEDICATIONS
Stasis ulcers
*
1
2
3
4
Steroids
*
1
2
3
4
Insulin
*
1
2
3
4
EQUIPMENT and PROCEDURES
Thyroid
*
1
2
3
4
Wound care / irrigations
*
1
2
3
4
Oral hypoglycemics
*
1
2
3
4
Sterile dressing changes
*
1
2
3
4
EQUIPMENT and PROCEDURES
Air fluidized, low airloss beds
*
1
2
3
4
Indwelling insulin pump
*
1
2
3
4
Blood glucose monitoring
PATENT CARE WITH
Performing finger stick
*
1
2
3
4
Traumatic wounds
*
1
2
3
4
Visual blood glucose strips
*
1
2
3
4
Burns
*
1
2
3
4
Electronic measuring devices
*
1
2
3
4
Pressure sores
*
1
2
3
4
PATENT CARE WITH
Staged decubitus ulcers
*
1
2
3
4
Hypothyroidism
*
1
2
3
4
Surgical wounds with drains
*
1
2
3
4
Thyroidectomy
*
1
2
3
4
Hyperthyroidism
*
1
2
3
4
Diabetes insipidus
*
1
2
3
4
Diabetes mellitus
*
1
2
3
4
Addison's disease
*
1
2
3
4
(888) 894-2900 (bus)
(888) 894-2073 (fax)
MEDICAL / SURGICAL SKILLS CHECKLIST
1
=
> 2 years experience
2
= 1-2 years experience
3
= < 1 year experience
4
= theory only
MATERNAL/CHILD CARE
PEDIATRICS
PATENT CARE WITH
PATENT CARE WITH
Premature labor
*
1
2
3
4
Child abuse
*
1
2
3
4
Placenta previa
*
1
2
3
4
Cleft palate
*
1
2
3
4
Pregnancy induced hypertension
*
1
2
3
4
Post tonsillectomy
*
1
2
3
4
Multiple gestation
*
1
2
3
4
Dying infant/child
*
1
2
3
4
DIC
*
1
2
3
4
Psych patients
*
1
2
3
4
Apgar score
*
1
2
3
4
Diabetic acidosis
*
1
2
3
4
Pre-eclampsia/eclampsia
*
1
2
3
4
Diabetes mellitus
*
1
2
3
4
Diabetes mellitus
*
1
2
3
4
Psych patients
*
1
2
3
4
Abruptia placenta
*
1
2
3
4
Failure to thrive
*
1
2
3
4
Rh incompatibilities
*
1
2
3
4
Neonatal resuscitation
*
1
2
3
4
EQUIPMENT
Malpresentations
*
1
2
3
4
Ventilator
*
1
2
3
4
ASSESSMENT
Cardiac monitor
*
1
2
3
4
Lochia
*
1
2
3
4
Apnea monitor
*
1
2
3
4
Bladder distention
*
1
2
3
4
ECMO
*
1
2
3
4
Fundus consistency
*
1
2
3
4
Episiotomy/incision for caesarean
*
1
2
3
4
ADMINISTRATION OF MEDICATION
GENERAL SKILLS
Oral
*
1
2
3
4
Specimen collection
*
1
2
3
4
Intramuscular
*
1
2
3
4
Discharge teaching
*
1
2
3
4
Subcutaneous
*
1
2
3
4
Wound and skin care
*
1
2
3
4
Pain management
*
1
2
3
4
PEDIATRIC NURSING
Patient education
*
1
2
3
4
Pneumonia
*
1
2
3
4
Lab value assessment
*
1
2
3
4
Chest tubes
*
1
2
3
4
Admission assessment
*
1
2
3
4
Spinabifida
*
1
2
3
4
Isolation procedures
*
1
2
3
4
Croup
*
1
2
3
4
Use of restraints
*
1
2
3
4
Anorexic patient care
*
1
2
3
4
Legal principles of charting
*
1
2
3
4
Asthma
*
1
2
3
4
Diabetic teaching
*
1
2
3
4
Meningitis
*
1
2
3
4
LDR
*
1
2
3
4
Child with seizures
*
1
2
3
4
LDRP
*
1
2
3
4
Assist with lumbar puncture
*
1
2
3
4
MATERNAL/CHILD
Sickle cell
*
1
2
3
4
Post natal patient care
*
1
2
3
4
Hydrocephalus
*
1
2
3
4
Breast care
*
1
2
3
4
Near SIDS
*
1
2
3
4
Vaginal exam
*
1
2
3
4
Cystic fibrosis
*
1
2
3
4
Forceps vaginal delivery
*
1
2
3
4
Epiglotitis
*
1
2
3
4
Hyperbilirubin infant care
*
1
2
3
4
Respiratory distress syndrome
*
1
2
3
4
Pitocin therapy
*
1
2
3
4
Lead play therapy
*
1
2
3
4
Assist with vaginal delivery
*
1
2
3
4
Near drowning
*
1
2
3
4
Antepartum patient care
*
1
2
3
4
Broncho-pulmonary dysplasia
*
1
2
3
4
LaMaze instruction
*
1
2
3
4
Reye's syndrome
*
1
2
3
4
Labor and delivery patient care
*
1
2
3
4
Newborn infant care
*
1
2
3
4
Use of fetoscope doppler
*
1
2
3
4
Magnesium sulfate theory
*
1
2
3
4
Internal monitor/calibration
*
1
2
3
4
Assist with epidural
*
1
2
3
4
Fetal stress testing
*
1
2
3
4
Teaching-pre-natal care
*
1
2
3
4
Teaching-post-natal care
*
1
2
3
4
Circulate for c-section
*
1
2
3
4
Scub for c-section
*
1
2
3
4
YES
NO
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