Med Surg RN Skills Assessment Today's Date: MM slash DD slash YYYY Name* First Last Email* Phone Number*Meds / IV TherapyAdminister PO Medications 0 1 2 3 Administer NG / GT Meds 0 1 2 3 Administer IM & SQ Meds 0 1 2 3 Peripheral IV Insertion 0 1 2 3 Mix IV Infusion w/ Additives 0 1 2 3 Administer IV Medications 0 1 2 3 Heparin/Saline Locks 0 1 2 3 Needle-less Systems 0 1 2 3 Infusion Pumps 0 1 2 3 Discontinue Peripheral IVs 0 1 2 3 Pain Assessment/Management 0 1 2 3 IV Rate Calculation 0 1 2 3 Antibiotics 0 1 2 3 Antihypertensives 0 1 2 3 Anticoagulants 0 1 2 3 Anticonvulsants 0 1 2 3 Diuretics 0 1 2 3 IV Conscious Sedation 0 1 2 3 VascularDraw Blood for Lab Studies 0 1 2 3 Administer Blood 0 1 2 3 Administer Blood Products 0 1 2 3 Hyperalimentation / TPN 0 1 2 3 Central Venous Lines (CVL) 0 1 2 3 CVLs Dressing Change 0 1 2 3 Hickman/Broviac Catheters 0 1 2 3 Intake and Output 0 1 2 3 Assess for Edema/Fluid Overload 0 1 2 3 Peripheral Pulses 0 1 2 3 Ultrasonic Doppler 0 1 2 3 GenitourinaryStraight/Foley Cath 0 1 2 3 Obtain/Instruct Clean Catch Urine 0 1 2 3 Suprapubic Tube 0 1 2 3 Nephrostomy Tube 0 1 2 3 GU Irrigations 0 1 2 3 Care of Patients with:Shunts & Fistulas 0 1 2 3 Renal Failure 0 1 2 3 Renal Transplant 0 1 2 3 Nephrectomy 0 1 2 3 Nephrostomy Tube 0 1 2 3 Hemodialysis 0 1 2 3 Peritoneal Dialysis 0 1 2 3 Hysterectomy 0 1 2 3 Prostate Surgery 0 1 2 3 Bladder Irrigation 0 1 2 3 CardiacUse of Cardiac Monitors 0 1 2 3 Interpretation of Arrhythmias 0 1 2 3 Telemetry 0 1 2 3 Perform 12-lead EKG 0 1 2 3 Assist with Code 0 1 2 3 Defibrillation/Cardioversion 0 1 2 3 Cardiac Arrest / CPR 0 1 2 3 Arterial Lines 0 1 2 3 Central Venous Pressure Readings 0 1 2 3 Care of Patient with:Acute MI 0 1 2 3 Congestive Heart Failure 0 1 2 3 Pre/Post Cardiac Cath 0 1 2 3 Pre/Post Cardiac Surgery 0 1 2 3 Aneurysm 0 1 2 3 Permanent Pacemaker 0 1 2 3 Temporary Pacemaker 0 1 2 3 Heart Transplant 0 1 2 3 NeurologicalPre/Post Neuro Surgery 0 1 2 3 Neuro Assessment / Vital Signs 0 1 2 3 Glascow Coma Scale 0 1 2 3 Assist with Lumbar Puncture 0 1 2 3 Monitoring Intracranial Pressure 0 1 2 3 Seizure Precautions 0 1 2 3 Aneurysm Precautions 0 1 2 3 Coma 0 1 2 3 Spinal Cord Injuries 0 1 2 3 Care of Patient with:Open/Closed Head Injury 0 1 2 3 CVA 0 1 2 3 Spinal Cord Injury 0 1 2 3 Craniotomy 0 1 2 3 Drug Overdose / DTs 0 1 2 3 OrthopedicCrutch Walking 0 1 2 3 Cast Care 0 1 2 3 Traction 0 1 2 3 K Wires 0 1 2 3 Amputation 0 1 2 3 Total Joint Replacement 0 1 2 3 Care of Patient with:Amputation 0 1 2 3 Skeletal Traction 0 1 2 3 Arthroscopy/Arthrotomy 0 1 2 3 Total Hip Replacement 0 1 2 3 Total Knee Replacement 0 1 2 3 GastrointestinalAssess Bowel Sounds 0 1 2 3 Assess GI Distress/Bleeding 0 1 2 3 Insertion/Monitoring NG Tube 0 1 2 3 Tube Feedings via Flexible Tubes 0 1 2 3 Gastrostomy Tube Monitor/Feed 0 1 2 3 Colostomy Care 0 1 2 3 Enemas 0 1 2 3 Care of Patient with:GI Bleed 0 1 2 3 Wound Dehiscence 0 1 2 3 Abdominal Wounds 0 1 2 3 Drains 0 1 2 3 RespiratoryEstablish Airway 0 1 2 3 Assist with Intubation (ETT) 0 1 2 3 ETT Extubation 0 1 2 3 Ventilate with Ambu-bag 0 1 2 3 Suctioning 0 1 2 3 Incentive Spirometry 0 1 2 3 Nasal Cannula 0 1 2 3 Face Masks 0 1 2 3 Ventilators 0 1 2 3 Obtain Arterial Blood Gases (ABGs) 0 1 2 3 Interpret ABGs 0 1 2 3 Chest Tubes 0 1 2 3 Chest Percussion 0 1 2 3 Care of Patient with:Pre/Post Thoracic Surgery 0 1 2 3 Tracheostomy 0 1 2 3 Pulmonary Emboli 0 1 2 3 Lung Transplant 0 1 2 3 Lobectomy 0 1 2 3 Bronchoscopy 0 1 2 3 Pneumonia 0 1 2 3 Chest Tubes 0 1 2 3 Thoracotomy 0 1 2 3 General NursingAdmit & Orient Patients 0 1 2 3 Discharge Patients 0 1 2 3 Supervise Unlicensed Personnel 0 1 2 3 Vital Sign Monitoring 0 1 2 3 Pulse Oximetry 0 1 2 3 Urine Dipstick 0 1 2 3 Blood Glucose Monitoring 0 1 2 3 Wound Care / Debridement 0 1 2 3 Dressing Changes 0 1 2 3 Wound Drains (JP/Hemovac) 0 1 2 3 Positioning / Transferring 0 1 2 3 Restraints 0 1 2 3 Isolation Techniques 0 1 2 3 Advance Directives 0 1 2 3 Knowledge/familiarity with HCAHPS scores 0 1 2 3 OtherPre-Operative Care/Preparation 0 1 2 3 Post-anesthesia Care: General 0 1 2 3 Post-anesthesia Care: Spinal 0 1 2 3 Post-anesthesia Care: Block 0 1 2 3 Multiple Trauma Patient 0 1 2 3 Burn Patients 0 1 2 3 Oncology 0 1 2 3 Chemotherapy 0 1 2 3 Bone Marrow Transplant 0 1 2 3 Liver Transplant 0 1 2 3 AIDS 0 1 2 3 Diabetic Teaching/Care 0 1 2 3 Postmortem Care 0 1 2 3 Age of Patients Cared ForNewborn (birth-30 days) 0 1 2 3 Infant (30 days - 1 year) 0 1 2 3 Toddler (1 - 3 years) 0 1 2 3 Preschooler (3 - 5 years) 0 1 2 3 School Age (5 - 12 years) 0 1 2 3 Adolescents (12 - 18 years) 0 1 2 3 Young Adults (18 - 39 years) 0 1 2 3 Middle Adults (39 - 64 years) 0 1 2 3 Older Adults (64+ years) 0 1 2 3 Candidate SignatureSignature of* Section Break
[9:30 AM] Katie Iglewski
