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CNA

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 Fusion Medical Staffing.

  • 0 = Not Applicable
  • 1 = No Experience
  • 2 = Some Experience
  • 3 = Intermittent Experience
  • 4 = Experienced
  • 5 = Very Experienced
*Required
n/a
1
2
3
4
5

* Required

Skill

Assist with Admission of Patient*

Assist with Ambulation*

Assist with bedpan/urinal/commode*

Backrubs/ Back care*

Basic Medical Asepsis*

Bathing: Complete/Partial/Sitz*

Bed Cradles*

Bed Making- occupied/unoccupied/surgical*

Bed Rails: when/how to use them*

Cast Care*

Charting/ Checklist/Graphic Charts*

Compresses: Warm/ Cold*

Coughing/ deep breathing*

CPR*

Crutch Walking: Assist Patient*

Dangling Patient*

Diabetic Testing*

Dietary Restrictions*

Documentation: vital signs, I & O*

Documentation of Patient’s Belongings*

Douches*

Elastic Stockings (AE hose)*

Elimination Check & Record*

Enemas, Rectal Tubes, Harris Flush*

Fall Precautions*

Feed Patient*

Foley Catheter Care & Emptying*

Footboard*

Glucometer*

Hand Hygiene*

Height: Measure & Record*

Intake & Output Measure & Record*

Orthostatic Blood Pressure*

Transfers*

Use of Assistive Devices*

Vital Signs*

Weight: Measure and Record*

Electronic Documentation

Specimen Collection

Routine Urine*

Clean Catch*

12 & 24- hour Specimen*

Stool*

Culture*

Sputum*

From Foley Catheter*

Infection Control Precautions

Standard Universal Precautions*

Reverse Isolation*

TB / Airborne Precautions*

MRSA / VRE Precautions*

Nourishment for Patients*

Observing Patients*

Oral Hygiene*

Patient Safety Standards/Precautions*

Perineal Care*

Positioning Patients*

Prosthetic Devices (care of dentures, contact lenses, etc)*

Range of Motion Exercises*

Reporting Changes of Patient Condition*

Reporting/ Recording of Patient’s Pain Level*

Restraints*

Skin Care*

Behavioral Health Care

Collaboration with Interdisciplinary Team*

Observe patients to detect behavior patterns*

Report observation to medical staff*

Monitoring of Neurological Vital Signs*

Monitoring for Suicide Risk*

Group Therapy Leader*

Management of Detox Symptoms*

Management of Assaultive Behavior*

Crisis Intervention*

Therapeutic Communication*

De-escalation Techniques*

Care of Behavioral Health Patients With

Restraints*

Alcohol Dependency*

Drug Dependency*

Electroconvulsive Therapy*

Hallucinations*

Manic Behavior*

Organic Disorder*

Seizure Disorder*

Application Agreement

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 Fusion Medical Staffing. Submit this skills evaluation with your initial application. To be updated annually.

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