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1.877.891.4286
1.877.891.4286
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Home Health Nurse RN – Skills Checklist
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 Precision Nationwide Staffing.
0 = Not Applicable
1 = No Experience
2 = Some Experience
3 = Intermittent Experience
4 = Experienced
5 = Very Experienced
Age of Patients Cared For
Newborn (birth - 30 days)
*
0
1
2
3
4
5
Infant (30 days - 1 year)
*
0
1
2
3
4
5
Toddler (1 - 3 years)
*
0
1
2
3
4
5
Preschooler (3 - 5 years)
*
0
1
2
3
4
5
School Age (5 - 12 years)
*
0
1
2
3
4
5
Adolescents (12 - 18 years)
*
0
1
2
3
4
5
Young Adults (18 - 39 years)
*
0
1
2
3
4
5
Middle Adults (39 - 64 years)
*
0
1
2
3
4
5
Older Adults (64+ years)
*
0
1
2
3
4
5
General Skills
Standard Precautions
*
0
1
2
3
4
5
Isolation Precautions
*
0
1
2
3
4
5
Pediatric Respiratory/Cardiac Arrest
*
0
1
2
3
4
5
Adult Respiratory/Cardiac Arrest
*
0
1
2
3
4
5
Defibrillators
*
0
1
2
3
4
5
Care Planning & Discharge Planning
*
0
1
2
3
4
5
Patient/Family Education
*
0
1
2
3
4
5
Pain Management
*
0
1
2
3
4
5
Electronic Documentation
*
0
1
2
3
4
5
Electronic Documentation - List Types
*
Patient Head to Toe Assessment
*
0
1
2
3
4
5
Cardiovascular
Angina
*
0
1
2
3
4
5
Apical Pulse Rate/Rhythm
*
0
1
2
3
4
5
Cardiac Auscultation (Rate, Rhythm)
*
0
1
2
3
4
5
Clinical Identification of Arrhythmias
*
0
1
2
3
4
5
Fluid Overload
*
0
1
2
3
4
5
Peripheral Pulses/Circulation Checks
*
0
1
2
3
4
5
Interpretation of Lab Results
PT/PTT/INR
*
0
1
2
3
4
5
Serum Electrolytes
*
0
1
2
3
4
5
Equipment & Procedures
Holter Monitor
*
0
1
2
3
4
5
Pacemaker/AID
*
0
1
2
3
4
5
Care of Patient With
Hypotension
*
0
1
2
3
4
5
CAD/Post Myocardial Infarction (MI)
*
0
1
2
3
4
5
Congestive Heart Failure (CHF)
*
0
1
2
3
4
5
Fluid Retention
*
0
1
2
3
4
5
Hypertension
*
0
1
2
3
4
5
Pre/Post Cardiac Surgery
*
0
1
2
3
4
5
Pre/Post Vascular Surgery
*
0
1
2
3
4
5
Medication Administration
ACE Inhibitors
*
0
1
2
3
4
5
Anti-Arrhythmic
*
0
1
2
3
4
5
Antibiotics
*
0
1
2
3
4
5
Anticoagulants
*
0
1
2
3
4
5
Antihypertensives
*
0
1
2
3
4
5
Antiplatelet Medications
*
0
1
2
3
4
5
Beta Blockers
*
0
1
2
3
4
5
Calcium Channel Blockers
*
0
1
2
3
4
5
Diuretics
*
0
1
2
3
4
5
Digoxin (Lanoxin)
*
0
1
2
3
4
5
Oral and Topical Nitrates
*
0
1
2
3
4
5
Narcotics
*
0
1
2
3
4
5
Potassium Supplements
*
0
1
2
3
4
5
Statin Medications
*
0
1
2
3
4
5
Pulmonary
Auscultation of Lung Sounds/Rate & Work of Breathing
*
0
1
2
3
4
5
Pulse Oximetry
*
0
1
2
3
4
5
ABGs
*
0
1
2
3
4
5
Equipment & Procedures
Administration of O2 via Nasal Cannula
*
0
1
2
3
4
5
Apnea Monitor
*
0
1
2
3
4
5
Chest Percussion
*
0
1
2
3
4
5
Establishing an Airway
*
0
1
2
3
4
5
Incentive Spirometry
*
0
1
2
3
4
5
Orotracheal and Nasotracheal Suctioning
*
0
1
2
3
4
5
Sputum Specimen Collection
*
0
1
2
3
4
5
Nebulizer
*
0
1
2
3
4
5
CPAP
*
0
1
2
3
4
5
BiPAP
*
0
1
2
3
4
5
Ventilator Management
*
0
1
2
3
4
5
Care of Patient With
Asthma
*
0
1
2
3
4
5
Chronic Obstructive Pulmonary Disease (COPD)
*
0
1
2
3
4
5
Lung Cancer
*
0
1
2
3
4
5
Primary Pulmonary Hypertension
*
0
1
2
3
4
5
Pulmonary Fibrosis
*
0
1
2
3
4
5
Pulmonary Emboli
*
0
1
2
3
4
5
Medication Administration
Bronchodilators
*
0
1
2
3
4
5
Steroids
*
0
1
2
3
4
5
Expectorants
*
0
1
2
3
4
5
Inhalers
*
0
1
2
3
4
5
Neurological
Neurological Signs/Level of Consciousness (LOC)
*
0
1
2
3
4
5
Neuro-Motor/Sensory Functions
*
0
1
2
3
4
5
Equipment & Procedures
Seizure Precautions
*
0
1
2
3
4
5
Traction
*
0
1
2
3
4
5
Care of Patient With
Alzheimer’s Disease
*
0
1
2
3
4
5
Dementia
*
0
1
2
3
4
5
Degenerative Neurological Disorders (ALS, MS, etc.)
*
0
1
2
3
4
5
Cerebral Tumors
*
0
1
2
3
4
5
Post-Cerebrovascular Accident
*
0
1
2
3
4
5
Guillain-Barre Syndrome
*
0
1
2
3
4
5
Hemiparesis
*
0
1
2
3
4
5
Meningitis
*
0
1
2
3
4
5
Parkinson’s Disease
*
0
1
2
3
4
5
Seizure Disorders
*
0
1
2
3
4
5
Paraplegia/Quadriplegia
*
0
1
2
3
4
5
Traumatic Brain Injury (TBI)
*
0
1
2
3
4
5
Transient Ischemic Attacks (TIAs)
*
0
1
2
3
4
5
Medication Administration
Alzheimer’s Medications
*
0
1
2
3
4
5
Anti-Parkinson’s Medications
*
0
1
2
3
4
5
Anti-Seizure Medications
*
0
1
2
3
4
5
Corticosteroids
*
0
1
2
3
4
5
Sedative/Hypnotics
*
0
1
2
3
4
5
Orthopedics
Incision Checks
*
0
1
2
3
4
5
Circulation/Skin Checks
*
0
1
2
3
4
5
Gait
*
0
1
2
3
4
5
Range of Motion
*
0
1
2
3
4
5
Equipment & Procedures
Range of Motion (Active & Passive)
*
0
1
2
3
4
5
Cast/Brace
*
0
1
2
3
4
5
Crutch/Walking
*
0
1
2
3
4
5
Assistive Devices
*
0
1
2
3
4
5
TENS Units
*
0
1
2
3
4
5
Wheelchairs/Lift Equipment
*
0
1
2
3
4
5
Total Hip/Knee/Joint Replacement
*
0
1
2
3
4
5
Medication Administration
Enoxaparin (Lovenox)
*
0
1
2
3
4
5
Gastronintestinal
Bowel Habits
*
0
1
2
3
4
5
Fluid Balance
*
0
1
2
3
4
5
Nutritional Status
*
0
1
2
3
4
5
Equipment & Procedures
Colostomy/Ileostomy Care
*
0
1
2
3
4
5
Long-Term Feeding Tube
*
0
1
2
3
4
5
Nasogastric (NG) Tube
*
0
1
2
3
4
5
PEG/Gastronomy Tube
*
0
1
2
3
4
5
Drainage Devices/Tubes
*
0
1
2
3
4
5
Tube Feeding
*
0
1
2
3
4
5
Feeding Pumps
*
0
1
2
3
4
5
Care of Patient With
Bowel Obstruction
*
0
1
2
3
4
5
Fecal Incontinence
*
0
1
2
3
4
5
Gastrointestinal Bleeding (G.I. Bleed)
*
0
1
2
3
4
5
Post-Gastrointestinal Surgery
*
0
1
2
3
4
5
Hepatitis
*
0
1
2
3
4
5
Inflammatory Bowel Disease
*
0
1
2
3
4
5
Liver Failure/Transplant
*
0
1
2
3
4
5
Renal/Genitourinary
Arterio-Venous Fistula/Shunt
*
0
1
2
3
4
5
Fluid Balance
*
0
1
2
3
4
5
Interpretation of Lab Results
Blood Urea Nitrogen (BUN)
*
0
1
2
3
4
5
Serum Creatinine
*
0
1
2
3
4
5
Serum Electrolytes
*
0
1
2
3
4
5
Equipment & Procedures
3-Way Bladder Catheter
*
0
1
2
3
4
5
Foley Catheter Insertion/Maintenance
*
0
1
2
3
4
5
Straight Catheterization
*
0
1
2
3
4
5
Self-Catheterization
*
0
1
2
3
4
5
Ileostomy
*
0
1
2
3
4
5
Irrigations
*
0
1
2
3
4
5
Nephrostomy Tube
*
0
1
2
3
4
5
Suprapubic Catheter
*
0
1
2
3
4
5
Care of Patient With
Hemodialysis (Receiving in an Out Pt. Clinic Setting)
*
0
1
2
3
4
5
Home Hemodialysis
*
0
1
2
3
4
5
Peritoneal Dialysis
*
0
1
2
3
4
5
Post-Bladder Surgery
*
0
1
2
3
4
5
Post-Prostate Surgery
*
0
1
2
3
4
5
Shunts and Fistulas
*
0
1
2
3
4
5
Urinary Incontinence
*
0
1
2
3
4
5
Endocrine/Metabolic
Diabetic Skin Assessment
*
0
1
2
3
4
5
Hyperglycemia/Hypoglycemia
*
0
1
2
3
4
5
Interpretation of Lab Results:
Hemoglobin A1C
*
0
1
2
3
4
5
Serum Glucose
*
0
1
2
3
4
5
Equipment & Procedures
Glucometers
*
0
1
2
3
4
5
Insulin Pumps
*
0
1
2
3
4
5
Care of Patient With
Diabetes
*
0
1
2
3
4
5
Post-Tranplantation Surger
*
0
1
2
3
4
5
Medication Administration
Insulin
*
0
1
2
3
4
5
Oral Hypoglycemics
*
0
1
2
3
4
5
Wound/Skin Care Management
Wound Assessment Scale
*
0
1
2
3
4
5
Skin Assessment
*
0
1
2
3
4
5
Surgical Wound Healing
*
0
1
2
3
4
5
Skin Grafts
*
0
1
2
3
4
5
Equipment & Procedures
Burns
*
0
1
2
3
4
5
Care of Pressure Ulcers
*
0
1
2
3
4
5
Dry and Wet to Dry Dressing Changes
*
0
1
2
3
4
5
Positioning of Patients
*
0
1
2
3
4
5
Specialty Beds
*
0
1
2
3
4
5
Special Mattresses and Positioning Devices
*
0
1
2
3
4
5
Wound Care (Sterile)
*
0
1
2
3
4
5
Wound Cultures
*
0
1
2
3
4
5
Wound Irrigations
*
0
1
2
3
4
5
Wound Vac
*
0
1
2
3
4
5
Care of Patient With
Burns
*
0
1
2
3
4
5
Pressure Ulcers
*
0
1
2
3
4
5
Surgical Wounds
*
0
1
2
3
4
5
Skin Grafts
*
0
1
2
3
4
5
Oncology
Immune Status
*
0
1
2
3
4
5
Symptoms Management
*
0
1
2
3
4
5
Signs/Symptoms of Infection
*
0
1
2
3
4
5
Interpretation of Lab Results
CBC with Differential
*
0
1
2
3
4
5
CMP
*
0
1
2
3
4
5
Equipment & Procedures
Reverse Isolation
*
0
1
2
3
4
5
Care of Patient With
Radiation Therapy
*
0
1
2
3
4
5
Leukemia/Lymphoma
*
0
1
2
3
4
5
Post-Oncology Surgery
*
0
1
2
3
4
5
Medication Administration
Oral Chemotherapy
*
0
1
2
3
4
5
Intravenous Chemotherapy Administration
*
0
1
2
3
4
5
Intravenous Chemotherapy Monitoring
*
0
1
2
3
4
5
Bone Marrow Stimulating Agents
*
0
1
2
3
4
5
Infectious Disease
Signs/Symptoms of Infection
*
0
1
2
3
4
5
Infectious Disease
Blood Counts
*
0
1
2
3
4
5
Culture and Sensitivity
*
0
1
2
3
4
5
Equipment & Procedures
Isolation Precautions
*
0
1
2
3
4
5
Care of Patient With
C. Diff
*
0
1
2
3
4
5
HIV Infection
*
0
1
2
3
4
5
Tuberculosis
*
0
1
2
3
4
5
MRSA/VRE
*
0
1
2
3
4
5
Medication Administration
Antibiotics
*
0
1
2
3
4
5
Antivirals
*
0
1
2
3
4
5
Anti-HIV
*
0
1
2
3
4
5
Immunizations
*
0
1
2
3
4
5
Psychiatry
Monitoring Symptoms
*
0
1
2
3
4
5
Compliance with Medications
*
0
1
2
3
4
5
Care of Patient With
Cognitive Disorders
*
0
1
2
3
4
5
Schizophrenia/Psychotic Disorders
*
0
1
2
3
4
5
Substance-Related Disorders
*
0
1
2
3
4
5
Mood Disorders (Anxiety/Depression, etc)
*
0
1
2
3
4
5
Women's Health/Maternal-Infant Care
Fetal Heart Tones
*
0
1
2
3
4
5
Contractions
*
0
1
2
3
4
5
Care of Patient With
Breast Feeding
*
0
1
2
3
4
5
Pregnancy-Related Complications
*
0
1
2
3
4
5
Post-Mastectomy
*
0
1
2
3
4
5
Post-Partum Mother/Baby Visit
*
0
1
2
3
4
5
Newborn Care
*
0
1
2
3
4
5
Bulb Suctioning
*
0
1
2
3
4
5
Cord and Circumcision Care
*
0
1
2
3
4
5
Phototherapy
*
0
1
2
3
4
5
Pediatrics
Growth
*
0
1
2
3
4
5
Development Stages
*
0
1
2
3
4
5
Nutrition
*
0
1
2
3
4
5
Family/Caregiver Interaction
*
0
1
2
3
4
5
Equipment & Procedures
Calculations of Pediatric Dosages
*
0
1
2
3
4
5
Croup Tent
*
0
1
2
3
4
5
Ventilator
*
0
1
2
3
4
5
Trach
*
0
1
2
3
4
5
Pediatric Ambu
*
0
1
2
3
4
5
Near Drowning
*
0
1
2
3
4
5
Pre/Post-Cardiac Surgery
*
0
1
2
3
4
5
Care of Patient With
Broncho Pulmonary Dysplasia
*
0
1
2
3
4
5
Cystic Fibrosis
*
0
1
2
3
4
5
Respiratory Distress Syndrome (RDS)
*
0
1
2
3
4
5
Reye’s Syndrome
*
0
1
2
3
4
5
Pre/Post-Spinal Surgery
*
0
1
2
3
4
5
Sickle Cell Disease
*
0
1
2
3
4
5
Spina Bifida
*
0
1
2
3
4
5
Pain Management
Pain Scale
*
0
1
2
3
4
5
Response to Pain Management Interventions
*
0
1
2
3
4
5
Equipment & Procedures
Pharmacologic Pain Relief
*
0
1
2
3
4
5
Non-Pharmacologic Pain Relief Measures
*
0
1
2
3
4
5
PCA Pump
*
0
1
2
3
4
5
Care of Patient With
Epidural Catheter/Site Monitoring/Pump
*
0
1
2
3
4
5
Patient Controlled Analgesia
*
0
1
2
3
4
5
Palliative and End-of-Life Care
Family Support and Teaching
*
0
1
2
3
4
5
Medication Protocols
*
0
1
2
3
4
5
Symptom Management
*
0
1
2
3
4
5
After Death Protocol and Management
*
0
1
2
3
4
5
Patient and Family Teaching
Diabetic
*
0
1
2
3
4
5
Pre/Post-Procedure
*
0
1
2
3
4
5
Post-Partum/Infant Care
*
0
1
2
3
4
5
Medications
*
0
1
2
3
4
5
Monitoring
*
0
1
2
3
4
5
Nutrition
*
0
1
2
3
4
5
Safety
*
0
1
2
3
4
5
Self-Care
*
0
1
2
3
4
5
Equipment
*
0
1
2
3
4
5
Resources
*
0
1
2
3
4
5
Miscellaneous
APS/CPS Reporting
*
0
1
2
3
4
5
Fall Assessment and Prevention
*
0
1
2
3
4
5
National Patient Safety Goals
*
0
1
2
3
4
5
Safety Assessment
*
0
1
2
3
4
5
Recognizing Failure to Thrive Across the Lifespan
*
0
1
2
3
4
5
Advanced Directives
*
0
1
2
3
4
5
Wheelchairs/Lift Equipment
*
0
1
2
3
4
5
Case Management
Experience as a Case Manager
*
0
1
2
3
4
5
Case Load
*
0
1
2
3
4
5
Supervision of Home Health Aides
*
0
1
2
3
4
5
Experience With
Long-term/Short-term Disability
*
0
1
2
3
4
5
Management of Complaints
*
0
1
2
3
4
5
Medicare/Medicaid
*
0
1
2
3
4
5
Pre-Certifications
*
0
1
2
3
4
5
Private Insurance
*
0
1
2
3
4
5
Telephone Assessments
*
0
1
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Utilization Review
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Workman’s Compensation
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Documentation
Diagnosis Coding (ICD Coding)
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Document Plan of Care (Form 485)
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OASIS Documentation
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Information & Agreement
Application ID
*
Please enter your application ID. This ID should be 15 characters long and have the format of PHNMS##########. You should have received an email containing your application ID when you submitted your initial application. If not, please contact our staff.
Applicant Name
*
First
Last
Applicant Email
*
Applicant Phone
*
I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified within the last 2 years.
*
I agree to the terms below.
The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Precision Nationwide Staffing. Submit this skills evaluation with your initial application. To be updated annually.
Signature
*