This checklist was electronically signed on
September 12, 2026
Instructions:
This checklist is meant to serve as a general guideline for our client
facilities as to the level of your skills within your nursing specialty.
Please use the scale below to describe your experience/expertise in each
area listed below.
Proficiency Scale:
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
PATIENT RIGHTS
COMMUNICATION
GENERAL INFECTION CONTROL MEASURES
TRANSMISSION-BASED PROTOCOL
NEUROLOGICAL ASSESSMENT
NEUROLOGICAL EQUIPMENT AND PROCEDURES
CARE OF PATIENT WITH NEUROLOGICAL DISEASE
PULMONARY ASSESSMENT
INTERPRETATION OF PULMONARY LABORATORY RESULTS
PULMONARY EQUIPMENT AND PROCEDURES
CARE OF PATIENT WITH PULMONARY DISEASE
CARDIOVASCULAR ASSESSMENT
CARDIOVASCULAR EQUIPMENT AND PROCEDURES
CARE OF PATIENT WITH CARDIOVASCULAR DISEASE
GASTROINTESTINAL ASSESSMENT
INTERPRETATION OF GASTROINTESTINAL LABORATORY RESULTS
GASTROINTESTINAL EQUIPMENT AND PROCEDURES
CARE OF PATIENT WITH GASTROINTESTINAL DISEASE
RENAL/GENITOURINARY ASSESSMENT
INTERPRETATION OF RENAL/GENITOURINARY LABORATORY RESULTS
RENAL/GENITOURINARY EQUIPMENT AND PROCEDURES
CARE OF PATIENT WITH RENAL/GENITOURINARY DISEASE
ENDOCRINE/METABOLIC ASSESSMENT
ENDOCRINE/METABOLIC EQUIPMENT AND PROCEDURES
CARE OF PATIENT WITH ENDOCRINE/METABOLIC DISEASE
ORTHOPEDIC ASSESSMENT
ORTHOPEDIC EQUIPMENT AND PROCEDURES
WOUND ASSESSMENT
WOUND EQUIPMENT AND PROCEDURES
CARE OF PATIENT WITH WOUND
INTERPRETATION OF INFECTIOUS DISEASE LABORATORY RESULTS
INFECTIOUS DISEASES EQUIPMENT AND PROCEDURES
CARE OF PATIENTS WITH INFECTIOUS DISEASES
PHLEBOTOMY/IV THERAPY EQUIPMENT AND PROCEDURES
CARE OF PATIENT WITH IVs
PAIN ASSESSMENT
CARE OF PATIENTS WITH PAIN
CARE OF PATIENTS WITH TRAUMA/SHOCK
MISCELLANEOUS
MEDICATIONS
AUTOMATED MEDICATION DISPENSING SYSTEMS
ELECTRONIC DOCUMENTATION
AGE-SPECIFIC COMPETENCIES