Skills Checklist:
LPN

Skills Checklist – LPN

This self-evaluation is for assessing your experience in specific clinical areas. This self-evaluation will not be a determining factor in accepting your application to become an employee of Connected Health Care.

0 = Not Applicable
1 = No Experience
2 = Some Experience
3 = Intermittent Experience
4 = Experienced
5 = Very Experienced

012345
Newborn/Neonatal (birth - 30 days)*
Infant (30 days - 1 year)*
Toddler (1 - 3 years)*
Preschooler (3 - 5 years)*
School Age (5 - 12 years)*
Adolescents (12 - 18 years)*
Young Adults (18 - 39 years)*
Middle Adults (39 - 64 years)*
Older Adults (64+ years)*
012345
Burn Unit*
Cardiac Care*
Emergency Department*
Intensive Care Unit*
Step Down*
Gynecology*
Labor and Delivery*
Medical*
Mother/Baby*
Neurology*
Nursery*
Obstetrics*
OR*
Oncology*
Orthopedics*
Pediatrics*
Post Partum*
Psychiatry*
Rehabilitation*
Renal/Dialysis*
Respiratory*
Surgical*
Telemetry*
Doctor's Office*
Health Department*
Corrections*
Home Health*
Long Term Care*
Hospice*
Respite Care*
Outpatient Clinic*
Nursing Home*
012345
Admissions of a Patient*
Transfer of a Patient*
Discharge of a Patient*
Assist with Emergency Sitations/Codes*
Vital Signs*
Post Mortem Care*
Assist with Defibrillation*
Assist with Cardioversion*
Documentation*
Patient and Family Education*
Assessment of Abuse*
Restraints*
Body Mechanics*
Aseptic Technique*
Isolation Precautions*
012345
Auscultation (rate, rhythm)*
Blood Pressure/Non-invasive*
Doppler*
Heart Sounds/Murmurs*
Abdominal Aortic Aneurysm/Bypass*
Angina*
Cardiac Arrest*
Cardiomyopathy*
Carotid Endarterectomy*
Congestive Heart Failure*
Femoral-Popliteal Bypass*
Myocarditis*
Status Post MI*
Post Angioplasty*
Post Cardiac Cath*
thrombophlebitis*
Temporary Pacemaker*
Permanent Pacemaker*
Cardiac Enzymes*
Blood Chemistries*
Basic Arrhythmia Interpretation*
Lead Placement*
012345
Ventilator/Weaning*
Breath Sounds*
Rate and Work of Breathing*
Arterial Blood Gases (ABG)*
Asthma*
COPD*
Tracheostomy*
Lobectomy*
Pneumonectomy*
Pneumonia*
Pulmonary Embolism*
Thoracotomy*
Tuberculosis*
Pulmonary Edema*
Pneumothorax*
Laryngospasm*
Endotracheal Tube/Suctioning*
Nasal Airway/Suctioning*
Oropharyngeal/Suctioning*
Sputum Specimen Collection*
Tracheostomy/Suctioning*
Assist with Intubation*
Assist with Thoracentesis*
Chest Tube Management*
Chest Physiotherapy*
Incentive Spirometry*
Pulse Oximetry*
Bag and Mask*
Face Mask*
Nasal Cannula*
Portable O2 Tank*
012345
Glascow Coma Scale*
Level of Consciousness*
Assist with Lumber Puncture*
Use of Hypo-Hyperthermia Blanket*
Aneurysm Precautions*
Basal Skull Fracture*
Closed Head Injuries*
Coma*
CVA*
TIA*
Delirium Tremens*
Encephalitis*
Meningitis*
Neuromuscular Disorders*
Psychiatric Disorders*
Seizures*
Overdose*
Guillain-Barre Syndrome*
Externalized VP Shunts*
Post Craniotomy*
Spinal Cord Injuries*
012345
Circulation Checks*
Gait*
Range of Motion*
Skin*
Wheelchair Use*
Cane/Crutches/Walker Use*
Amputation*
Arthroscopic Surgery*
Cast*
Splint*
Knee Immobilizer*
Osteoporosis*
Pinned Fractures*
Total Joint Replacements*
Continuous Passive Motion Devices*
Cervical Collar*
Prosthetics*
Traction- Bucks/Skeletal*
Auto Transfuser*
012345
Abdominal/Bowel Sounds*
Fluid Balance*
Placement of NG Tube*
Placement of Flexible Feeding Tube*
Administration of Tube Feeding*
Feeding Pumps*
Gravity Feeding*
Salem Sump to Suction*
Care of Gastrostomy Tube*
Colostomy Care*
Bowel Obstruction*
GI Bleeding*
Gi Surgery*
Hepatitis*
Inflammatory Bowel Disease*
Liver Failure*
Liver Transplant*
Paralytic Ileus
Colostomy/Ileostomy
Abdominal Trauma*
012345
Fluid Balance*
Urinary Output*
BUN & Creatine*
Catheter Care*
Specimen Collection- Routine*
Specimen Collection- 24 Hours*
Specimen Collection- Clean Catch*
Insertion & Care of Straight and Foley Catheters- Female*
Insertion & Care of Straight and Foley Catheters- Male*
Hemodialysis*
Nephrectomy*
Peritoneal Dialysis*
Renal Failure*
Renal Transplant*
TURP*
Ileal Conduit*
Bladder Irrigations*
Urinary Tract Infections*
Gyn Surgery*
Renal Trauma*
012345
S/S Diabetic Coma*
S/S Insulin Coma*
Blood Glucose Monitoring*
Performing Finger/Heel Stick*
Sliding Scale Insulin Protocols*
Adrenal Disorders (Addison's)*
Diabetic Mellitus*
Diabetes Insipidus (Pituitary Disorder)*
Diabetic Ketoacidosis*
Hyperthyroidism*
Hypothyroidism*
Thyroidectomy*
012345
Asses Skin for Impending Breakdown*
Surgical Wound Healing*
Sterile Dressing Change*
Wound Vac*
Wet to Dry Dressing*
First Degree Burns*
Second Degree Burns*
Third Degree Burns*
Decubitus Ulcers*
Surgical Wounds with Drains*
Gunshot Wound*
Stab Wound*
Lacerations*
Abrasions*
012345
Bone Marrow Transplant*
Inpatient Chemotherapy*
Leukemia*
Radiation Implant*
Lymphoma*
Depressed Immune System*
Radiation Therapy*
Fresh Oncology Surgery*
012345
HIV*
MRSA*
C. Difficile*
VRE*
Hepatitis*
Influenza*
Isolation Precautions*
012345
Site Assessment*
Administration of Blood & Blood Products*
Drawing Blood from a Central Line*
IV Insertion*
Heplock Flushes*
Administration of IV Fluid*
Administration of IV Piggy Back*
Administration of IV Push Medications*
Access VAD*
Central Line*
Peripheral Line*
Administration TPN/Lipids*
012345
Assessment of Pain Level/Tolerance*
Administration of Narcotic Analgesia*
PCA Pumps*
IV Conscious Sedation*
Epidural Anesthesia*
012345
Computerized Charting*
Automated Med. Dispensing Systems*
Safe Needle Devices*
PO Medications*
IM Injections*
SQ Injections*
Z- Track Injections*
Rectal Suppositories*
Nasal Sprays*
Ear Drops*
Eye Drops*
Inhalers*
Assist with Emergency Drugs/Code Cart*
Name
MM slash DD slash YYYY
By Signing this, I am authorizing that the information I have given is true and accurate to the best of my knowledge. I hereby authorize Connected Health Care to release this Skills Checklist to staffing clients of Connected Health Care. Submit this skills evaluation with your initial application.
Reset signature Signature locked. Reset to sign again