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Medical Surgical Telemetry

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

Age

Age-Appropriate Care: Ability to adapt care to incorporate normal growth and development, adapt method and terminology of client instructions as it relates to the age and comprehension level of the client, and to ensure a safe environment - reflecting specific needs of the client and various age groups.

Newborn (birth-30 days)*

Infant (30 days - 1 year)*

Toddler (1 - 3 years)*

Preschooler (3 - 5 years)*

School Age (5 - 12 years)*

Adolescents (12 - 18 years)*

Young Adults (18 - 39 years)*

Middle Adults (39 - 64 years)*

Older Adults (64+ years)*

General Skills

Standard Precautions*

Isolation Precautions*

Discontinue PIV*

Initiate Peripheral IV*

Lift/ Transfer Devices*

Pediatric Respiratory/Cardiac Arrest*

Adult Respiratory/Cardiac Arrest*

Crash Carts*

Defibrillators*

Use of Rapid Response Teams*

Care of Patients in Restraints*

Pain Management*

Automated Med Dispensing Systems*

Care Planning & Discharge Planning*

Organ/Tissue Donation*

Patient/Family Education*

Electronic Documentation*

Patient Head to Toe Assessment*

Knowledge of Normal Serum Lab Values*

Obtaining Cultures (Blood, Sputum, Swab, Urine)*

Calculate mcg/min and mcg/Kg/min*

Titrating Medications*

IV Conscious Sedation*

Interpretation of Dysrhythmia*

Management of Dysrhythmia*

Psychological

Overdose/ Withdrawal*

Suicidal Precautions*

Manic Disorder/ Behavior*

De-escalation techniques*

Depression*

Knowledge and Use of :

Anti-depressants*

Anti-anxiety Medications*

Psych Medications*

Medications

Anticoagulants*

Narcotics*

PCA for Pain Control*

Epidural for Pain Control*

Non-narcotic Analgesics*

Topical Medications*

IM Medications*

SQ Medications*

Oral Medications*

IV Push Medications*

IV Drip Medications*

Antibiotics*

Chemotherapy*

Neuro General Skills

Assessing Levels of Consciousness*

Glasgow Coma Scale*

Dysphagia Screen*

Pupil Checks*

Seizure Precautions*

Aneurysm Precautions*

Assisting with Lumbar Puncture*

Use of Hyper/Hypothermia Blanket*

Neuro - Care of Patients With

Stroke*

Seizure Activity*

Seizure Disorder*

Acute Head Injury*

Aneurysm*

Spinal Cord Injury - Acute*

Spinal Cord Injury – Long Term*

Neuromuscular Disease*

Multiple Sclerosis*

Alzheimer's Disease*

Encephalitis*

Meningitis*

Intracranial Hemorrhage*

Metastatic Tumor*

Hydrocephalus*

Knowledge and Use of :

Anticonvulsants*

IV Drip Steroids*

Cardiac General Skills

Cardiac Monitors*

Auscultation of Cardiac Sounds*

EKG- 12 Lead*

Recognizing Basic & Life-Threatening Dysrhythmias*

Cardioversion/ Defibrillation*

Pulse Checks*

Capillary Refill*

Permanent Pacemaker*

Temporary Pacemaker*

Interpretation of Cardiac Enzymes*

Use of Doppler*

Use of Automatic BP Cuff (ie Dinamap)*

Cardiac - Care Of Patients With

Angina*

CHF*

Chest Pain*

Abdominal Aortic Aneurysm*

Acute MI*

Pericarditis*

Post MI*

Knowledge and Use of:

Nitrates (Oral, Topical)*

Antiarrhythmics (Oral)*

Antihypertensives (Oral)*

Heparin Drip*

Respiratory General Skills

O2 Cannulas/Masks*

Nebulizer Set-up/Use*

Incentive Spirometry*

Chest PT*

Pulse Oximetry*

Trach Management*

Assessment of Lung Sounds*

Suctioning:

Oral*

Tracheostomy Tube*

Respiratory - Care of Patients With

SOB*

Pulmonary Embolism*

Pulmonary Edema*

Tracheostomy Tube*

COPD*

Emphysema*

ARDS*

Asthma Exacerbation*

Pneumonia*

Pneumothorax*

Pre/Post Thoracic Surgery*

Chest Tubes*

Tuberculosis*

Inhalation Injuries*

Knowledge and Use of:

O2 Therapy*

Bronchodilators*

Oral Steroids*

IV Steroids*

Inhaler*

Gastrointestinal General Skills

Insertion, Care & Maintenance of Nasogastric Tubes (ie Salem Pump, Levine)*

Nasointestinal Tubes (ie Cantor, Miller-Abbot)*

Jejunostomy, Gastrostomy, Cecostomy Tubes*

Auscultation of Bowel Sounds*

Tube Feedings via Flexible Tubes:

by Gravity Infusion*

by Feeding Pump*

Collection of Stool Specimens*

Bowel Preparation & Cleansing Procedures*

Gastrointestinal - Care of Patients With

Stoma*

Bowel Obstruction*

Pancreatitis*

Post Abdominal Surgery*

Ileostomy*

Colostomy*

Inflammatory Bowel Disease*

Hepatitis*

Liver Failure*

Esophageal Bleeding*

G.I. Bleed*

Paralytic Ileus*

Knowledge and Use of:

Total Parenteral Nutrition (TPN)*

Peripheral Parenteral Nutrition (PPN)*

Antiemetics*

Proton Pump Inhibitors*

Renal/GU Problems General Skills

Insertion of Catheter Straight*

Insertion of Catheter Foley*

Bladder Irrigation Continuous*

Bladder Irrigation Intermittent*

Peritoneal Dialysis*

Automatic Cycler Machine*

Collection of Urine Specimens*

Hemodialysis*

A-V Fistula/Shunt Care*

Pre- & Post- Dialysis Care*

Suprapubic Catheter*

Nephrostomy Tube*

Renal/GU - Care Of Patients With

Urinary Tract Infection*

Pyelonephritis*

Renal Calculi*

Urinary Retention/Incontinence*

Chronic/ Acute Renal Failure*

Shunts and Fistulas*

Endocrine General Skills

Performing Fingersticks*

Use of Blood Glucose Meter Device*

Use of Visual Blood Glucose Strips*

Endocrine- Care of Patient With:

Hyper/Hypoglycemia*

DKA*

Diabetes*

Thyroid Disorders*

Knowledge and Use of Insulin:

Single Type*

Dextrose*

Mixed Insulins*

Insulin Infusion*

Orthopedic General Skills

Cast Care*

C.M.S. Checks*

Traction – Skin*

Traction – Skeletal*

Range of Motion*

Use of Assistive Devices*

Applications of Splints Extremities*

Continuous Passive Motion Machine (CPM)*

Orthopedic - Care of Patients With

Total Joint Replacement*

Rheumatic/Arthritic Disease*

Amputation*

Paraplegia/Quadriplegia*

Spica Cast/ Body Cast*

External Fixation*

ORIF*

Multiple Trauma*

Compartment Syndrome*

Wound/Skin Care

Dressing Changes*

Air Fluidized, Low Airloss Beds*

Pressure Relief Mattress/Seat Cushion*

Pressure Sores*

Leg Ulcers*

Burns*

Braden Scale*

Wound VACs

Hemovacs*

Jackson-Pratt Tubes*

Penrose Drains*

T-Tubes*

Surgical Wound Irrigations & Dressings*

Vascular

Discontinue PICC*

Care of Patient with DVT*

Draw Blood from Arterial Line*

Draw Blood from Central Line*

Peripheral IV Insertion, Care & Maintenance*

Discontinue Peripheral IV*

IV Infusion Pumps*

CVP Lines – Measurement of CVP*

Central Line Care & Maintenance (including dressing changes)*

Blood/Blood Product Administration*

Multi-Lumen Central Catheters*

Port-A-Caths (Infusa-Ports)*

Continuous Subcutaneous Infusion Pumps*

Other

Care of Oncology Patient*

Chemotherapy Administration*

Care of Patient with Burns*

Care of Patient with HIV/AIDS*

Care of Patient with Sepsis*

Hyperbaric Oxygenation*

Suicide Precautions*

Post Mortem Cares*

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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