Geriatric & Long Term Care Skills Checklist - CrossMed Healthcare

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Skills Checklist

Geriatric & Long Term Care Skills Checklist

Let’s assess your clinical skills and experience. Fill out this checklist to get one step closer to your next opportunity.

1

= No theory and/or experience
2

= Limited Experience
3

= Experienced/minimal support needed to perform
4

= Proficient

Age of Patients Cared For
Newborn/Neonate (Birth to 30 days)*
- 1
- 2
- 3
- 4
Infant (31 days to 12 months)*
- 1
- 2
- 3
- 4
Toddler/Preschool (13 months to 5 years)*
- 1
- 2
- 3
- 4
School Age Child/Adolescent (6 years to 18 years)*
- 1
- 2
- 3
- 4
Young Adults/Middle Adult (19 years to 64 years)*
- 1
- 2
- 3
- 4
Older Adults/Elderly (65+ years)*
- 1
- 2
- 3
- 4
Type of Facility Experience
List facility types:*
General Skills
Standard Precautions*
- 1
- 2
- 3
- 4
Isolation Precautions*
- 1
- 2
- 3
- 4
Pain Management*
- 1
- 2
- 3
- 4
Care of Patient in Restraints*
- 1
- 2
- 3
- 4
Automated Med Dispensing Systems*
- 1
- 2
- 3
- 4
List Types:*
Peripheral IV Insertion, Care and Maintenance*
- 1
- 2
- 3
- 4
Access/Management of Implanted Ports*
- 1
- 2
- 3
- 4
Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, Etc.)*
- 1
- 2
- 3
- 4
Patient/Family Education*
- 1
- 2
- 3
- 4
Knowledge of "Do not use abbreviations"*
- 1
- 2
- 3
- 4
Charge/Supervisor Experience*
- 1
- 2
- 3
- 4
Knowledge of Current Joint Commission National Patient Safety Goals*
- 1
- 2
- 3
- 4
Knowledge/Familiarity with HCAHPS Scores*
- 1
- 2
- 3
- 4
Medications
Knowledge and Use of:
Pouring from Stock Medications*
- 1
- 2
- 3
- 4
Narcotic Administration*
- 1
- 2
- 3
- 4
IV Push/Drip Medications*
- 1
- 2
- 3
- 4
Antibiotics*
- 1
- 2
- 3
- 4
Oral*
- 1
- 2
- 3
- 4
Topical*
- 1
- 2
- 3
- 4
Otic*
- 1
- 2
- 3
- 4
Rectal*
- 1
- 2
- 3
- 4
Vaginal*
- 1
- 2
- 3
- 4
Ophthalmic*
- 1
- 2
- 3
- 4
Continuous Subcutaneous Infusion Pumps*
- 1
- 2
- 3
- 4
Peripheral Parenteral Nutrition*
- 1
- 2
- 3
- 4
Patient Controlled Analgesia (PCA)*
- 1
- 2
- 3
- 4
Phlebotomy / IV Therapy
Blood Draw-Peripheral*
- 1
- 2
- 3
- 4
Mixing IVs*
- 1
- 2
- 3
- 4
Regulating IVs*
- 1
- 2
- 3
- 4
IV Infusion Pumps*
- 1
- 2
- 3
- 4
Blood/Blood Product Administration*
- 1
- 2
- 3
- 4
IV Pumps*
- 1
- 2
- 3
- 4
List Types:*
Cardiac General
Recognizing Basic & Life-Threatening Dysrhythmias*
- 1
- 2
- 3
- 4
Congestive Heart Failure*
- 1
- 2
- 3
- 4
Cardiac-Care of Patient with:
Pulse Checks*
- 1
- 2
- 3
- 4
Cardiac Monitors*
- 1
- 2
- 3
- 4
Obtaining EKGs - 12 Lead*
- 1
- 2
- 3
- 4
Use Of Automatic Bp Cuff (ie Dinamap)*
- 1
- 2
- 3
- 4
Knowledge and Use of:
Nitrates (Oral, Topical)*
- 1
- 2
- 3
- 4
Antiarrythmics (Oral)*
- 1
- 2
- 3
- 4
Antihypertensives (Oral)*
- 1
- 2
- 3
- 4
Respiratory General
Emphysema*
- 1
- 2
- 3
- 4
COPD*
- 1
- 2
- 3
- 4
Asthma Exacerbation*
- 1
- 2
- 3
- 4
Tracheostomy*
- 1
- 2
- 3
- 4
Pneumonia*
- 1
- 2
- 3
- 4
Pre/Post Thoracic Surgery*
- 1
- 2
- 3
- 4
Chest Tubes*
- 1
- 2
- 3
- 4
Respiratory
Care of Patient with:
Collection of Sputum Specimen*
- 1
- 2
- 3
- 4
O2 Cannulas/Masks*
- 1
- 2
- 3
- 4
Non-Rebreather Mask*
- 1
- 2
- 3
- 4
Nebulizer Set-Up/Use*
- 1
- 2
- 3
- 4
Incentive Spirometry*
- 1
- 2
- 3
- 4
Chest PT*
- 1
- 2
- 3
- 4
Suctioning (Oral/Nasotracheal)*
- 1
- 2
- 3
- 4
Suctioning (Tracheostomy Tube)*
- 1
- 2
- 3
- 4
Ventilator Patient (Mouth Care, Suctioning, Ambu Bag)*
- 1
- 2
- 3
- 4
Knowledge and Use of:
Bronchodilators (Oral, IV, Inhaler)*
- 1
- 2
- 3
- 4
Steroids*
- 1
- 2
- 3
- 4
Neuro General
Spinal Cord Injury - Acute*
- 1
- 2
- 3
- 4
Spinal Cord Injury - Long Term*
- 1
- 2
- 3
- 4
CVA Stroke*
- 1
- 2
- 3
- 4
Neuromuscular Disease*
- 1
- 2
- 3
- 4
Alzheimer Disease*
- 1
- 2
- 3
- 4
Wandering*
- 1
- 2
- 3
- 4
Hallucinations*
- 1
- 2
- 3
- 4
Anxiousness*
- 1
- 2
- 3
- 4
Agitation*
- 1
- 2
- 3
- 4
Reality Orientation*
- 1
- 2
- 3
- 4
Neuro-Care of Patient with:
Assessing Levels of Consciousness*
- 1
- 2
- 3
- 4
Pupil Checks*
- 1
- 2
- 3
- 4
Seizure Precautions*
- 1
- 2
- 3
- 4
Stroke Precautions*
- 1
- 2
- 3
- 4
Swallow Precautions*
- 1
- 2
- 3
- 4
Assisting With Lumbar Puncture*
- 1
- 2
- 3
- 4
Use of Hyper/Hypothermia Blanket*
- 1
- 2
- 3
- 4
Sensory Deficits
Care of Patient with:
Dentures*
- 1
- 2
- 3
- 4
Hearing Aid Devices*
- 1
- 2
- 3
- 4
Care of Patients with Hearing Loss*
- 1
- 2
- 3
- 4
Prosthetic Eye*
- 1
- 2
- 3
- 4
Contact Lens Care*
- 1
- 2
- 3
- 4
Cataracts*
- 1
- 2
- 3
- 4
Blindness*
- 1
- 2
- 3
- 4
Macular Degeneration*
- 1
- 2
- 3
- 4
Knowledge and Use of:
Anticonvulsant*
- 1
- 2
- 3
- 4
Sedative*
- 1
- 2
- 3
- 4
GI General
Nasogastric Tubes (I.E. Salem Sump, Levine)*
- 1
- 2
- 3
- 4
Nasointestinal Tubes (I.E. Cantor, Miller-Abbot)*
- 1
- 2
- 3
- 4
Jejunostomy, Gastrostomy, Cecostomy Tubes*
- 1
- 2
- 3
- 4
Colostomy, Ileostomy*
- 1
- 2
- 3
- 4
Administration of Tube Feedings Via Flexible Tubes*
- 1
- 2
- 3
- 4
By Gravity Infusion*
- 1
- 2
- 3
- 4
By Feeding Pump*
- 1
- 2
- 3
- 4
Gastrointestinal
Care of Patient with:
Collection of Stool Specimens*
- 1
- 2
- 3
- 4
Bowel Preparation and Cleansing Procedures*
- 1
- 2
- 3
- 4
Bowel Disimpaction*
- 1
- 2
- 3
- 4
Bowel Retraining*
- 1
- 2
- 3
- 4
Sitz Bath Treatments*
- 1
- 2
- 3
- 4
Inserting and Checking Placement/Patency NG Tubes*
- 1
- 2
- 3
- 4
Endocrine General
Diabetes*
- 1
- 2
- 3
- 4
Hyper/Hypoglycemia*
- 1
- 2
- 3
- 4
Endocrine
Care of Patient with:
Blood Glucose Monitoring*
- 1
- 2
- 3
- 4
Performing Fingersticks*
- 1
- 2
- 3
- 4
Use of Blood Glucose Meter Device*
- 1
- 2
- 3
- 4
Use of Visual Blood Glucose Strips*
- 1
- 2
- 3
- 4
Knowledge and Use of:
Insulin*
- 1
- 2
- 3
- 4
Single Type*
- 1
- 2
- 3
- 4
Mixed Insulins*
- 1
- 2
- 3
- 4
Insulin Infusion*
- 1
- 2
- 3
- 4
Renal/GU General
Incontinence*
- 1
- 2
- 3
- 4
Urinary Retention*
- 1
- 2
- 3
- 4
UTI*
- 1
- 2
- 3
- 4
Renal/GU
Care of Patient with:
Insertion of Catheter - Female*
- 1
- 2
- 3
- 4
Insertion of Catheter - Male*
- 1
- 2
- 3
- 4
Insertion of Suprapubic Catheter*
- 1
- 2
- 3
- 4
Applications of Condom Catheter*
- 1
- 2
- 3
- 4
Bladder Retraining*
- 1
- 2
- 3
- 4
Urinary Diversion*
- 1
- 2
- 3
- 4
Bladder Irrigation (Continuous and Intermittent)*
- 1
- 2
- 3
- 4
Peritoneal Dialysis*
- 1
- 2
- 3
- 4
Manual*
- 1
- 2
- 3
- 4
Automatic Cycler Machine*
- 1
- 2
- 3
- 4
Orthopedic General
Total Joint Replacement*
- 1
- 2
- 3
- 4
Rheumatic/Arthritic Disease*
- 1
- 2
- 3
- 4
Amputation*
- 1
- 2
- 3
- 4
Fracture*
- 1
- 2
- 3
- 4
Orthopedic
Care of Patient with:
Cast Care*
- 1
- 2
- 3
- 4
CMS Checks*
- 1
- 2
- 3
- 4
Traction - Skin*
- 1
- 2
- 3
- 4
Traction - Skeletal*
- 1
- 2
- 3
- 4
Range of Motion*
- 1
- 2
- 3
- 4
Use of Assistive Devices*
- 1
- 2
- 3
- 4
Applications of Splints of Extremities*
- 1
- 2
- 3
- 4
Continuous Passive Motion Machine (CPM)*
- 1
- 2
- 3
- 4
Transfer Techniques*
- 1
- 2
- 3
- 4
Use of a Sliding Board*
- 1
- 2
- 3
- 4
Gait Training/Retraining*
- 1
- 2
- 3
- 4
Application of Prosthetic Devices*
- 1
- 2
- 3
- 4
Application of Orthotic Devices*
- 1
- 2
- 3
- 4
Wound/Skin
Care of Patient with:
Pressure Sores*
- 1
- 2
- 3
- 4
Leg Ulcers*
- 1
- 2
- 3
- 4
Burns*
- 1
- 2
- 3
- 4
Wound/Skin General
Acute Dressing Changes*
- 1
- 2
- 3
- 4
Wound Care*
- 1
- 2
- 3
- 4
Irrigations*
- 1
- 2
- 3
- 4
Identifying Common Skin Problems*
- 1
- 2
- 3
- 4
Recognizing Normal Skin Changes*
- 1
- 2
- 3
- 4
Use of Special Pressure Relief Devices*
- 1
- 2
- 3
- 4
Pressure Relief Mattress/Seat Cushion*
- 1
- 2
- 3
- 4
Additional Skills
Care of Patient with:
Hemovacs*
- 1
- 2
- 3
- 4
Jackson-Pratt Tubes*
- 1
- 2
- 3
- 4
Enrose Drains*
- 1
- 2
- 3
- 4
Please list the EMR systems you have used*
*
I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form.*
*
I hereby consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*
Your Recruiter:*
Name*
First Last
Email*
Phone*
TODAY'S DATE*
MM slash DD slash YYYY

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