MATRIX PERSONNEL SERVICE, INC.
RN PROFICIENCY RECORD ( SKILLS CHECKLIST )
Medical/Surgical/Telemetry

 


NAME DATE

E -MAIL ADDRESS

 

LEVEL OF PROFICIENCY
Theory - NO Experience
1
Minimal Experience
2
Competent and Experienced
3

SKILLS
1
2
3
Medication Administration
IM Injections
Intradermal Injections
Subcutaneous Injections
Unit Dose
IV Push Medications
IV Additives and Piggybacks
Epidural Pumps
PCA Pumps
Infusion Pumps
Respiratory
Assessment of Breath Sounds
Establishing an Airway
Ambuing Techniques
Oxygen Therapy
Nasal Cannula Prongs
Ventimask
Rebreather/Non Rebreather Mask
Pulse Oxymeter
Sputum Collections
Orally      
Sputum Trap
Interpretation of ABG's
Use of IPPB
Incentive Spirometer
Oral Suctioning
Nasotracheal Suctioning
Tracheal Suctioning
Care of the Tracheostomy
COPD
ARDS
Thoracic Surgery
Asthma
Inhalation Injuries
Pneumonia
Pneumothorax
Tuberculosis
Pulmonary Edema
Pulmonary Embolism
Inhalation Therapies
Cardiac
Assessment of Heart Sounds
Cardiac Arrest/CPR
Administration of Emergency Medications
Use of Defibrillator
Use of Cardioversion
Neurology
Neuro Assessment
Glascow Coma Scale
Seizure Precautions
Seizure Activity
Assist with Lumbar Puncture
Halo Traction
Care of the Patient With
CVA/TIA
Overdose
Head Injury/Trauma
Spinal Cord Injury
Paraplegia
Quadraplegia
Neuro Sugery
Cranial Hemorrhage
AV-Shunt Placement
Multiple Sclerosis
Gastrointestinal
Assessment of Bowels Sounds
NG Tube Insertion
Gastrostomy Tube Insertion
Jejunostomy Tube Care
Enterostomal Care
Jackson-Pratt Drain
Penrose Drain
Insertion/Verfication of Feeding Tube
Continuous Feeding Pump
Gravity Drainage
Care of the Patient With
Appendicitis
GI Bleed
Pancreatitis
Bowel Obstruction
Paralytic Ileus
Liver Failure
Hepatitis
Laparoscopic Abd Procedures
Open Abd Procedures
Renal
Foley Catheter Insertion Male
Foley Catheter Insertion Female
GU Irrigation
Suprepubic Catheters
External Catheters
Nephrostomy Tubes
Electrolyte Imbalance/Replacement
Care of the Patient With
Chronic/Acute Renal Failure
Renal Calculi
Renal Trauma
Nephrectomy
TURP
Radical Prostectomy
Hemodialysis
Peritoneal Dialysis
Vascular
Care of the Gortex Graft
Care of the Ateriovenous Shunt
TPN/Hyperalimentation
Deep Vein Thrombosis
Cellulitis
Quinton/Permacaths
Groshong Catheters
Hickman/Broviac Catheters
Maintence of Heparin/Saline Lock
Assist with Insertion of Central Line
Venipuncture
Administration of Blood/Blood Products
Peripheral Pulses
Fluid Overload
Ultrasonic Doppler
Sickle Cell Anemia
Transfusion Reaction
Anaphylaxis
Septic Shock
Anasarea
Orthopedic
Amputation
Arthroscopic Surgery
Total Joint Replacement
Cast Care
Orthopedic Trauma
Skeletal Traction
Bucks Traction
Pin Site Care
Laminectomy
Passive ROM Exercises
Gynecology
Mastectomy
Hysterectomy
Tubal Ligation
Ectopic Pregnancy
Abdominoplasty
Reconstructive Breast Surgery
Thyroidectomy
Assist/Perform GYN Exam/Pap
Removal of Cysts
Other
Accuchecks
Burn Patients
Diabetic Teaching
Isolation Techniques
Chemotherapy
Oncology
Patient Teaching
Nutritional Teaching
Knowledge of Normal Lab Values
Simple Dressing Changes
Complex Dressing Changes
Skin Assessment
Fall Assessment
Soft Restraints
Posey Restraints
Informed Consent
Care of the Patient With
Delirium Tremors
HIV
Antibiotic Resistant Infection
Telemetry
Obtaining 12 Lead EKG's
Interpretation of EKG
Arrhythmia Interpretation
Monitor Set-Up
Lead Placement
Pacemakers
A Line (set-up and D/C)
Sheath Removal-Femoral
Care of Patient with
Angina
Aneurysm
MI
Hypertensive Crisis
Open Heart Surgery (Pre & Post)
CHF
Cardiac Cath
Fem/Pop Bypass
Respiratory
Chest Tubes
Obtaining Blood Sample for ABG
Artetial Puncture
Vascular
Care of the Gortex Graft
Care of the AV Shunt
Assist with Central Line Insertion
MEDICATIONS
Amiodarone
Atropine
Bretylium
Cardizem
Digoxin
Dopamine
Epinephrine
Heparin
Inderal
Lidocaine
Morphine
Vasopressin
Nipride
Nitroglycerin
Quinidine
Sodium Bircarbonate
Verapamil



Certification
Expiration Date
Certification
Expiration Date
ACLS
PALS
BLS
TNCC
CEN
Other  
ENPC
Other  


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10/2003