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REGISTERED NURSE
ADMIN
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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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Administrative Duties
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1
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2
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3
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4
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Data Entry
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Medical Records - Entry
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Medical Records -
Maintenance
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Electronic Medical Records
- Entry
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Electronic Medical Records
- Maintenance
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Gathers data and runs
reports
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Patient Files - Set up,
report and record
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Completion and
filing/distribution of reports
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Schedules
appointments/tests
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Takes, distributes and
prioritizes messages
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Assists physicians with
procedures
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Assists nursing staff
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Prepares patients for
appointments and exams
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Gathers patient history and
VS
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Gives injections as
directed
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Performs phlebotomy skills
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Collects lab. Specimens
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Administer EKGs
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Completes specimen testing,
i.e. glucose, strep, mono, flu
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Prepares and maintains
supplies and equipment
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Knows utilization of
patient care equipment/instruments
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Develops patient, physician
and peer relationships
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Maintains/protects patient
confidentiality
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Adheres to facility
policies and procedures
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Adheres to OSHA, HIPPA,
legal and ethical guidelines
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Adheres to quality protocol
and standards
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Attends and participates in
required meetings
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Schedules appointments,
tests and treatments
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Responds to emergencies in
a calm organized manner
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Understands/follows the
reporting process acording to the chain of command
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Rating Stars
(Click)
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Computer 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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Medic, Medic Soft
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Centricity
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Medical Manager
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HIS
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Word, Word Perfect
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Soft
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Windows
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IDX
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Meditech
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Rating Stars
(Click)
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EMR
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1
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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 (birth to 30 days)
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Infant (31 days to 1 year)
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Toddler (ages 2-3 years)
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Preschooler (ages 4-5
years)
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Childhood (ages 6-12 years)
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Adolescents (ages 13-21
years)
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Young Adults (ages 22-39
years)
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Adults (ages 40-64 years)
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Older Adults (ages 65 -79
years)
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Elderly (ages 80+ years)
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