Med/Surgical Skills Checklist Medical/Surgical Skills ChecklistName* Date MM slash DD slash YYYY PLEASE CHECK THE APPROPRIATE COLUMN THAT MOST ACCURATELY REFLECTS YOUR LEVEL OF EXPERIENCE OR SKILL: LEVELS OF PROFICIENCY 0 - No Experience or skills | 1 - Minimal experience, need review and supervision, have performed at least once | 2 - Comfortable performing with resource available | 3 -Competent to perform independently and safely | 4 -Expert, able to act as resource to othersPATIENT RIGHTS01234Communicates and obtains information while respecting the rights and privacy and confidentiality of information.Involves the patient and family and respects their role in determining the nature of care to be provided, including Advanced Directives.Complies with nursing staff responsibility include in the hospital policy related to Organ Donation.Meets patient and families needs regarding communication, including interpreter services.Provides accurate information to patient and families in a timely manner.NEUROLOGY01234Neuro Assessment/Neuro VitalsSeizure PrecautionsStryker FrameCrutchfield TongsHalo TractionImmobilization TechniquesManaging patient with epidural catheterManaging patient with spinal precautionsNEUROLOGY: Care of Patient with:01234Spinal Cord InjuryPre/Post Neurological SurgeryCNS InfectionsDegenerative Diseases of the Nervous SystemDrug OverdoseAcute Head InjuryCerebral AneurysmAcute/Chronic C.V.A/T.I.A.Rehabilitation of the Neuro patientCARDIOVASCULAR01234Cardio pulmonary arrestsRunning code 99Caring for 48+ hour post-op Open Heart patientCaring for a pacemaker patientPre/post-op angioplastyPost-op vascular surgery patients (i.e. aneurysms)Angina (acute and chronic)Ability to interpret cardiac rhythmsAssessing and treating orthostatic BPAssessing abnormal heart tonesCare of patient with: Valvular diseaseCare of patient with: Central linesMEDICATION AND ADMINISTRATION Knowledge of Indications, Actions, Contraindications, Side Effects, Methods of Administration, Calculation of Dose, Rate of Infusion, caring for and monitoring patient receiving the following:01234AcetaminophenAcetylsalicylic AcidAntibioticsBeta blockersCalcium Channel BlockersCimetidineCodeineDexamethasoneDiazepamDigoxinDuramorphFurosemideHeparinInsulinLorazepamMorphineNaloxoneNitroglycerinePhenytoinPotassium ChlorideTheophyllineVerapamilWarfarinInhalersOral MedicationsSuppositories: VaginalSuppositories: RectalOrdering MedsPULMONARY01234Assessment of breath soundsAssist with set-up maintenance of chest tubesAdminister oxygen (nasal canula, mask, endotracheal)Oxygen saturation monitorUse of chest drainage systemsCare of patient with: Pulmonary emboliCare of patient with: TracheostomyCare of patient with: Pre/post thoracic surgeryCare of patient with: AsthmaCare of patient with: COPDCare of patient with: CHFCare of patient with: TuberculosisNasal Tracheal SuctioningChanging TracheostomyInstructing patient in use of incent. spirometerGASTROINTESTINAL01234Assessment of bowel soundsIdentification of abnormalitiesStool testsInsert/Maintain Feeding tubes/NG tubesAdministering Tube FeedingsChecking Tube Feeding ResidualsInserting/maintaining intermittent & continuous suction NG tubesChecking tube feeding and NG tube placementCare of acute GI bleedIleostomy/Colostomy and drain careAbdominal wounds or infectionsPre/post-op GI SurgeryDehiscenceCare of patient on Total Parenteral NutritionGENITOURINARY/RENAL01234Ability to insert/maintain urinary drainage tubesCare of patient with: Acute renal failureCare of patient with: Chronic renal failureCare of patient with: Post renal/genitourinary surgeryCaring for a patient recovering from Peritoneal dialysisCaring for a patient recovering from HemodialysisAssessment of fluid and electrolyte problemsKnowledge of UA valuesManaging urostomyManaging suprapubic catheterPlacing condom catheterCollecting specimensENDOCRINE01234Caring for a diabetic patientAdministration of IV insulin dripCapillary blood glucose checksHormone therapyONCOLOGY01234Caring for AIDS patientIsolation/Universal precautionsPain managementMixing/Administering chemo agentsMUSCULOSKELETAL01234TractionBracesCastsCollarsSlingsSplintsSkeletal tractionSkin tractionUsing T.E.N.S. unitBeds i.e. Clinitron, Roto RestTotal knee replacementTotal hip replacementCrutch walking/walkersCare of patient with: Joint disordersCare of patient with: Bone disordersCare of patient with: AmputationCaring for patient on CPMMISCELLANEOUS01234Pain managementBurn patientsInserting IV’s/IV therapySet-up for Cut DownPerforming complex dressing changesAdministration of blood and blood productsAdministering and monitoring IV AnticoagulantsObtaining peripheral venous bloodObtaining blood from central venous lineKnowledge of Serum Lab Values: Chem 7, Chem 10Knowledge of Serum Lab Values: CBCKnowledge of Serum Lab Values: Serum Drug LevelsIV TherapyCare of drains/tubes (i.e. hemovac, etc.)Monitoring and assessing I & OUsing PCA SystemUsing SCD or Venidyne DevicesUsing PICC, Hickman, Central LineProviding for safe patient environmentEXPERIENCE AREAS: Please provide the number of years/months of experience you have in each of the following. Insert zero (0) for those areas in which you have no experience. Medical/Surgical ExperienceYearsMonthsTelemetry/Stepdown ExperienceYearsMonthsOrtho ExperienceYearsMonthsRehabilitation ExperienceYearsMonthsMother - Baby ExperienceYearsMonthsOncology ExperienceYearsMonthsNeurology ExperienceYearsMonthsPediatrics ExperienceYearsMonthsUrology ExperienceYearsMonthsSkilled ExperienceYearsMonthsHospice ExperienceYearsMonthsGeneral Medicine ExperienceYearsMonthsGeneral Surgery ExperienceYearsMonthsCharge Experience ExperienceYearsMonthsIV Certified ExperienceYearsMonthsOther Experience & Years/MonthsBy clicking 'Submit', you acknowledge that the information provided is true and accurate to the best of your knowledge and further authorize Galileo Search, LLC. to share the above skills checklist with their clients/potential employees.
