HIS

Information

Name *

Last 4 digits of SSN *

Phone *

Email *

Proficiency Scale

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Medication Administration

Rating Stars (Click) *

Documentation on M.A.R. *

Dose Calculation *

Generic Equivalents *

Usage of PDR *

Knowledge of Drug Actions/Interactions *

Verification of Narcotic Wastage *

Oral Medications *

Sublingual Medications *

Intradermal Medications *

Parenteral Medications *

Subcutaneous Medications *

Intramuscular Medications *

Topical Medications *

Eye Drops *

Ear Drops *

Swallowing Precautions *

Inventory and Storage Control *

Infectious Control

AIDS/HIV Interaction *

Hepatitis Interaction *

Hospice *

MRSA *

VRE *

Fever Management *

Interpretation of Labs *

Decubitus/Wound Care (Contaminated) *

Linen - Transporting, Storing, & Handling *

Cleaned *

Soiled *

Personal Clothing *

Proper Disposal of Sharps and Waste *

Standard Precautions *

Pain Management

Documentation and Assessment of Site, Character, & Frequency of Pain *

Assessment of Pain Levels *

Documentation of Response to Pain Medications *

Intraveneous Therapy

I.V. Certified (Check 4) *

Administration of I.V. Antibiotics *

Administration of I.V. Fluids *

Administration of I.V. Pain Medications *

Administration of I.V. Cardiac Meds *

Blood Draws - Peripheral *

Blood Draws - Central Line *

Blood Draws - Implanted Catheter *

Care of I.V. Site - Peripheral *

Care of I.V. Site - Central Line *

Care of I.V. Site - Implanted Catheter *

I.V. Dose Calculations *

I.V. Insertion - Peripheral *

Use of Infusion Pumps *

Diabetic Care

Diabetic Monitoring *

S/S Hyper/Hypoglycemia *

Diabetic Patient Teaching *

Performing Fingersticks *

Use of Glucometers *

Insulin Infusions *

Regular, Long-Acting Insulin *

Mixed Insulin *

Psychosocial Problems

Assessment and Documentation of Behavioral Problems (Target Behaviors) *

Assessment and Documentation of S/S of Depression *

Assessment and Documentation of Patient Response to Psychotropic Medications *

Parameters for Use of Restraints in Long-Term Care Settings *

Assessment and Documentation of Effectiveness of Preventive Medicine Medications *

Orthopedics

Assessment of Circulation *

Assessment of Gait *

Assessment of Range of Motion *

Amputation Care *

Post-Arthroscopy Care *

Casts and Related Care *

Osteoporosis *

Pinned Fractures *

Total Hip Replacement *

Total Knee Replacement *

Rheumatic/Arthritic Disease *

Continuous Passive Motion *

Canes *

Cervical Collars *

Gait Belts *

Prostheses *

Slings *

Transfer Board *

Walker *

Wheelchair *

Cardiovascular Problems

Auscultation of Rate/Rhythm *

Blood Pressure *

Doppler *

Pulses *

Circulation Checks *

CPR *

Post-Abdominal Aortic Bypass *

Aneurysm *

Angina *

Post Carotid Endarterectomy *

Fem-Pop Bypass *

Permanent Pacemaker *

Post Acute M.I. *

Post Cardiac Surgery *

Thrombophlebitis *

DVT *

Congestive Heart Failure *

Administration of Post-Op Cardiac Meds *

Gastrointestinal Problems

Administration of Tube Feedings *

Administration of Medications via Tube *

Inflammatory Bowel Disease *

Bowel Prep *

G.I. Bleeding *

Gualac *

Nutritional Status *

Colostomy Care *

Post Abdominal Surgery *

NG Tube Placement and Care *

Nasointestinal Tube Care *

Assessment of Bowel Tones *

Post Acute M.I. *

Enema Administration *

Assessment of Bowel Incontinence *

Signs and Symptoms of Fecal Impaction *

Neurological Problems

Post-Op Anticonvulsant Medications *

Assessing Levels of Consciousness *

Dementias (Re-Direction/Validation) *

Neuromuscular Disease *

CVA *

Pupil Check *

A.I.M.S. *

Seizure Precautions *

Administration of Anticonvulsant Medications *

Medications *

Aneurysm Precautions *

Spinal Cord Injuries - Long Term *

Urinary Problems

Assessment and Care of AV Shunt *

Post Renal Surgery *

Renal Failure *

Assessment of Urinary Incontinence *

Assessment of I and O Data *

Use of Bladder Scanner *

Signs and Symptoms of UTI *

Indwelling Catheter Insertion *

Straight Catheter Insertion *

Suprapubic Catheter Care *

Screening for UTI via Urine Dipstick *

Wounds, Pressure Sores, and Skin Impairments

Assessment and Care of Post-Surgical Wounds *

Assessment, Prevention, and Care of Pressure Ulcers *

Assessment and Documentation of Skin Conditions/Wounds *

Dressing Changes - Aseptic *

Dressing Changes - Sterile *

Wound Irrigation *

Application of Wound Care Products *

Use of Air Fluidized/Low Air Loss Beds *

Use of pressure-relieving seat cushions *

Staple and suture removal *

Other Skills

Alert Charting System *

Use of 24-hour Written and Verbal Reporting Systems *

Use of "911" in LTC Setting *

Regulatory Guidelines Related to the Prevention of Abuse and Neglect of Residents *

Regulatory Guidelines Related to Resident Rights in LTC Setting *

Discerning Code Status *

Incident and Accident Reporting *

Age Specific Competencies

Infant (Birth - 1 year) *

Preschooler (ages 2-5 years) *

Childhood (ages 6-12 years) *

Adolescents (ages 13-21 years) *

Young Adults (ages 22-39 years) *

Adults (ages 40-64 years) *

Older Adults (ages 65-79 years) *

Elderly (ages 80+ years) *

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