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FLOAT RN CHECKLIST
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NAME
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LAST 4 OF SSN
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DATE
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I hereby certify that
ALL information I have provided to IMCS Group on this skills checklist and
all other documentation, is true and accurate. I understand and acknowledge
that any misrepresentation or omission may result in disqualification from
employment and/or immediate termination.
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Instructions: This checklist is
meant to serve as a general guideline for our client facilities as to the
level of your skills within your nursing specialty. Please use the scale
below to describe your experience/expertise in each area listed below.
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Proficiency Scale:
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1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
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Rating Stars (Click)
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Medication Administration
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1
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2
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3
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4
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Documentation on M.A.R.
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Dose calculation
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Generic equivalents
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Usage of PDR
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Knowledge of drug
actions/interactions
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Verification of narcotic
wastage
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Oral medications
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Sublingual medications
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Intradermal medications
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Parenteral medications
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Subcutaneous medications
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Intramuscular medications
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Topical medications
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Eye drops
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Ear drops
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Swallowing precautions
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Inventory and storage
control
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Rating Stars
(Click)
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Infectious Control
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1
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2
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3
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4
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AIDS/HIV interaction
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Hepatitis interaction
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Hospice
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MRSA
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VRE
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Fever management
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Interpretation of labs
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Decubitus/Wound care
(Contaminated)
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Linen -Transporting,
storing, & Handling
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Cleaned
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Soiled
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Proper disposal of sharpes
and waste
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Personal clothing
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Standard precautions
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Rating Stars
(Click)
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Pain Management
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1
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2
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3
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4
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Documentation and
assessment of site, character, & frequency of pain
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Documentation of response
to pain medications
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Assessment of pain levels
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Rating Stars
(Click)
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Intraveneous Therapy
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1
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2
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3
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4
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I.V. certified (Check
"4")
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Administration of I.V.
antibiotics
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Administration of I.V. pain
medications
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Administration of I.V.
cardiac meds
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Blood draws - peripheral
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Blood draws - central line
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Blood draws - implanted
catheter
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Care of I.V. site -
peripheral
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Care of I.V. site -
implanted catheter
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I.V. dose calculations
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I.V. insertion - peripheral
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Use of infusion pumps
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Rating Stars
(Click)
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Diabetic Care
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1
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2
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3
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4
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Diabetic monitoring
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S/S hyper/hypoglycemia
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Diabetic patient teaching
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Performing fingersticks
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Use of glucometers
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Insulin infusions
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Regular, long-acting
insulin
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Rating Stars
(Click)
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Psychosocial Problems
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1
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2
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3
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4
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Assessment and
documentation of behavioral problems (target behaviors)
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Assessment and
documentation of s/s of depression
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Assessment and
documentation of patient response to psychotropic medications
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Parameters for use of
restraints in long-term care settings
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Assessment and
documentation of effectiveness of preventive medicine medications
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Rating Stars
(Click)
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Orthopedics
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1
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2
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3
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4
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Assessment of circulation
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Assessment of gait
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Assessment of range of
motion
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Amputation care
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Post-arthroscopy care
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Casts and related care
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Osteoporosis
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Pinned fractures
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Total hip replacement
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Total knee replacement
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Continuous passive motion
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Canes
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Cervical collars
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Gait belts
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Prostheses
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Total knee replacement
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Slings
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Transfer board
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Rating Stars
(Click)
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Cardiovascular Problems
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1
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2
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3
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4
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Auscultation of rate/rythym
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Blood pressure
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Doppler
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Pulses
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Circulation checks
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CPR
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Post-abdominal aortic
bypass
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Aneurysm
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Post carotic endarterectomy
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Fem-pop bypass
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Permanent pacemaker
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DVT
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Congestive heart failure
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Permanent pacemaker
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Post cardiac surgery
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Administration of post-op
cardiac meds
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Rating Stars
(Click)
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Gastrointestinal Problems
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1
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2
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3
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4
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Administration of tube
feedings
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Administration of
medications via tube
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Inflammatory bowel disease
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Bowel prep
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G.I. bleeding
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Gualac
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Nutritional status
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Colostomy care
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Post
abdominal surgery
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NG tube placement and care
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Nasointestinal tube care
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Assessment of bowel tones
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Assessment of abdomen
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Enema administration
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Assessment of bowel
incontinence
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Signs and symptoms of fecal
impaction
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Rating Stars
(Click)
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Neurological Problems
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1
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2
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3
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4
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Post-Op anticonvulsant
medications
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Assessing levels of
consciousness
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Dementias
(Re-direction/Validation)
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Neuromuscular disease
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CVA
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Pupil check
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A.I.M.S.
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Seizure precautions
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Administration of
anticonvulsant
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Medications
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Aneurysm precautions
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Spinal cord injuries - long
term
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Rating Stars
(Click)
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Urinary Problems
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1
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2
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3
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4
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Assessment and care of AV
shunt
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Post renal surgery
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Renal failure
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Assessment of urinary
incontinence
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Assessment of I and O data
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Use of bladder scanne
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Signs and symptoms of UTI
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Indwelling
catheter insertion
Screening for UTI via urine dipstick
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Indwelling catheter care
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Suprapubic catheter care
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Rating Stars
(Click)
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Wounds, Pressure Sores, and
Skin Impairments
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1
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2
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3
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4
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Assessment and care of
post-surgical wounds
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Assessment, prevention, and
care of pressure ulcers
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Assessment and
documentation of skin conditions/wounds
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Dressing changes - asceptic
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Dressing changes - sterile
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Wound irrigation
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Application of wound care
products
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Use of air fluidized, low
air-loss beds
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Use of pressure-relieving
seat cushions
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Staple and suture removal
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Rating Stars
(Click)
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Other Skills
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1
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2
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3
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4
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Alert charting system
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Use of 24-hour written and
verbal reporting systems
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Use of "911" in
LTC setting
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Regulatory guidelines
related to the prevention of abuse and neglect of residents
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Regulatory guidelines
related to resident rights in LTC setting
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Discerning code status
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Incident and accident
reporting
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Rating Stars
(Click)
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EMR
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2
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3
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4
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Epic
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Cerner
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Eclipsys
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McKesson
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Meditech
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Other Computerized System
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Computerized Physician
Order Entry
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Bar Coding for Medication
Administration
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MY EXPERIENCE IS
PRIMARILY IN:
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Unit
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No. of Years
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Unit
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No. of Years
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BURN
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POST PARTUM
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CRITICAL UNIT
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LABOR & DELIVERY
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PACU
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NEWBORN NURSERY
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NEUROLOGY
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LEVEL II NICU
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TELEMETRY
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LEVEL III NICU
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MEDICAL
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PICU
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SURGICAL
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PEDIATRICS
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ONCOLOGY
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OB/GYN
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ORTHOPEDICS
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PSYCHIATRY
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OPERATING ROOM
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RRT
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EMERGENCY ROOM
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CRT
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TRAUMA CENTER
LEVEL 1
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COMMUNITY ER
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RURAL ER
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Rating Stars
(Click)
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Age Specific Competencies
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1
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2
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3
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4
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Newborn/Neonatal (birth –
30 days)
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Infant (30 days-1 year)
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Toddler (1-3 years)
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Preschool (3-5 years)
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School Age Children (5-12
years)
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Adolescent (12-17 years)
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Young Adults (18-44 years)
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Middle Adults (45-64 years)
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Older Adults (>65 years)
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