Medical / Surgical Skills Checklist

Name(Required)

Proficiency:

1 = Minimal Experience
2 = Limited Experience
3 = Competent
4 = Highly Skilled

Age Specific Competency

Infants & Toddlers (0 - 3 years)(Required)
Young Children (4 - 6 years)(Required)
Older Children (7 - 12 years)(Required)
Adolescents (13 - 20 years)(Required)
Young Adults (21 - 39 years)(Required)
Middle Adults (40 - 64 years)(Required)
Older Adults (65 - 79 years)(Required)
Adults (>80 years)(Required)

Medication Administration

Pouring from Stock Medications(Required)
Narcotic Administration(Required)
IV Push Medications(Required)
IV Drip Medications(Required)
IV Drip Antibiotics(Required)
IV Drip Narcotics(Required)
IV Drip Chemotherapy(Required)

Phlebotomy / IV Therapy

Draw Blood(Required)
Draw Blood Arterial Line(Required)
Draw Blood Central Line(Required)
Insert IVs(Required)
Mixing IVs(Required)
Regulating IVs(Required)
Discontinue Peripheral IV(Required)
IV Infusion Pumps(Required)
CVP Lines - Measurement of CVP(Required)
Central Line Dressing Changes(Required)
Blood / Blood Product Administration(Required)
Administration of Total Parenteral Nutrition (TPN)(Required)
Administration of Peripheral Parenteral Nutrition (PPN)(Required)
Multi-Lumen Central Catheters(Required)
Port-A-Caths (Infusa-Ports)(Required)
Continuous Subcutaneous Infusion Pumps(Required)
Patient Controlled Analgesia (PCA)(Required)

Patients with Neurological Problems

Assessing Levels of Consciousness(Required)
Pupil Checks(Required)
Seizure Precautions(Required)
Aneurysm Precautions(Required)
Assisting with Lumbar Puncture(Required)
Administration of Anticonvulsant(Required)
Administration of IV Drip Steroids(Required)
Use of Hyper / Hypothermia Blanket(Required)
Spinal Cord Injury - Acute(Required)
Spinal Cord Injury - Long Term(Required)
CVA - Stroke(Required)
Neuromuscular Disease(Required)
Alzheimer Disease(Required)

Patients with Wound / Skin Problems

Dressing Changes(Required)
Pressure Sores(Required)
Leg Ulcers(Required)
Burns(Required)
Use of Special Pressure Relief Devices(Required)
Air Fluidized, Low Airloss Beds(Required)
Pressure Relief Mattress / Seat Cushion(Required)

Patients with Endocrine Problems

Insulin Administration(Required)
Single Type Insulin(Required)
Mixed Insulins(Required)
Insulin Infusion(Required)
Blood Glucose Monitoring(Required)
Performing Fingersticks(Required)
Use of Blood Glucose Meter Device(Required)
Use of Visual Blood Glucose Strips(Required)

Additional Medical / Surgical Skills

Hemovacs(Required)
Jackson-Pratt Tubes(Required)
Penrose Drains(Required)
T-Tubes(Required)
Surgical Wound Irrigation & Dressings(Required)
Universal Precautions(Required)

Patients with Cardiovascular Problems

Cardiac Monitors(Required)
Taking EKGs - 12 Lead(Required)
Basic & Life-Threatening Dysrhythmias(Required)
Recognizing Basic & Life-Threatening Dysrhythmias(Required)
Cardiopulmonary Resuscitation (CPR)(Required)
Defibrillation(Required)
Cardioversion(Required)
General Pulse Checks(Required)
General Use of Doppler(Required)
Use of Automatic BP Cuff (i.e. Dinamap)(Required)
Administration of Nitrates (Oral, Topical)(Required)
Administration of Antiarrhythmics (Oral)(Required)
Administration of Antihypertensives (Oral)(Required)

Respiratory

O2 Cannulas / Mask(Required)
Nebulizer Set-up / Use(Required)
Incentive Spirometry(Required)
Chest PT(Required)
Pulse Oximetry(Required)
Suctioning(Required)
Oral(Required)
Tracheostomy Tube(Required)
Care of the Ventilator Patient(Required)
Mouth Care(Required)
Suctioning - Endotracheal Tube(Required)
Ambu Bags(Required)
Weaning the Patient off the Ventilator(Required)
Bronchodilator Administration(Required)
Oral(Required)
IV(Required)
Inhaler(Required)
Tracheostomy Tube(Required)
COPD(Required)
Asthma Exacerbation(Required)
Pneumonia(Required)
Pre / Post Thoracic Surgery(Required)
Chest Tubes(Required)

Patients with Renal / GU Problems

Insertion of Catheter(Required)
Female(Required)
Male(Required)
Bladder Irrigation(Required)
Continuous(Required)
Intermittent(Required)
Peritoneal Dialysis(Required)
Manual(Required)
Automatic Cycler Machine(Required)
Collection of Urine Specimens(Required)
Care of Patient on Hemodialysis(Required)
A-V Fistula / Shunt Care(Required)
Pre- & Post-Dialysis Care(Required)
Urinary Diversion(Required)
Suprapubic Catheter(Required)
Nephrostomy Tube(Required)

Patients with Gastrointestinal Problems

Nasogastric Tubes (i.e. Salem Sump, Levine)(Required)
Nasointestinal Tubes (i.e. Cantor, Miller-Abbot)(Required)
Jejunostomy, Gastrostomy, Cecostomy Tubes(Required)
Inserting Nasogastric Tubes(Required)
Tube Feedings via Flexible Tubes(Required)
Nasogastric(Required)
by Gravity Infusion(Required)
by Feeding Pump(Required)
Collection of Stool Specimens(Required)
Bowel Preparation & Cleansing Procedures(Required)
Ileostomy(Required)
Colostomy(Required)
Inflammatory Bowel Disease(Required)

Patients with Orthopedic Problems

Cast Care(Required)
Circulation Checks(Required)
Traction - Skin(Required)
Traction - Skeletal(Required)
Range of Motion(Required)
Use of Assistive Devices(Required)
Total Joint Replacement(Required)
Rheumatic / Arthritic Disease(Required)
Amputation(Required)
Applications of Splints of Extremities(Required)
Continuous Passive Motion Machine (CPM)(Required)

Texas Licensing Information

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