ee senna Sih Name JeVWVVO Jil instructions for Stusents Take a printed copy ofthis checklist to every ab, simulation and clinical day. Ensure lb/simulaton or clinical faculty verify Fee ere dah at ule bystrlog and dating nthe appropiate box. Seana copy ofthe siged Psychomotor his Ceca nd upload Fee reaser se aron borin LeudCcutat he endo every cdot ouse with skis lb experiences and every cial course. It oD oe ee msinuncg hc onal signed copy fs hel throughout the uration ofthe program Uploading the Te rN ered wr cavance rom semester to semester ano praduate Stent are ot requed o demonstrate sratrrve every atl on ts frm nthe cal etn instructions for Lab Faculty: Print, sign, and date below each skil to acknowledge the student's successful demonstration in the lab setting. Students ‘must be signed off by lab faculty forall equired skills prior to demonstration in clinical instructions fr lniclans: Sign and dat inthe appropriate box next to each sito acknowledge the student's sucessful emonstraton/obsenaton aaa nee ents ust be signed of by lab facity ona required sil prior to demonstration in inca. Students are not expected to obese oF aan erat tated sls inca, however, cnans should look for opportunites for students to observe and demonstrate 9s many sls 25 possible. ee aie seer nd ute: Vi \pe ub NSN eG yO aot Ne natinmecenenendermestesnis gama haan tte drone re wee Seer and ae -Lael3 ube age tba ood Wal Sully y signin, acknowledge that | have demonstrated or observed thesis By signing, lacknowledge that have demonstrated or re coe lees shi chads ca be found in the textbook nical Nursing Skil and Techniques, th ed, by Per, Potter and OnendortPore CMO frit, Lab Setting 5 ‘lineal Setting a ae aan - —=—= T Student demoed {ab Faculty Printed Name, Signature, and Date (Include below after Clinician Printed Name, Signature, and Date os Student has successfully demonstrated each skill in aby) Observed Required Level 1 Lab SI | trou [ Oocument these sills must be signed off in ab fon in clinical tion and Informatics I alg = ° *Documenting nurses’ progress notes = 7 o ; Yn WLM pall i - o “Adverse event/incident reporting 2 5 Eten pss ?(2eF afte Tae : e Vital Signs er * Measuring body temperature , Slavs 77 *bsgossing radial pulse TZ biy4 | “Assessing apical pulse eles ihe ge i214 “Assesfing manual blood pressure Se : aiciJeuna frit =Wessurng oygen saturdon (pulse oximetry) >_clemond ext ju xp fis, ZB Cc aie 6palo a) Dead el lo |o Jo Beg [SSL ‘PBA - Vital Signs (Level 1) z ie. Health Assessment General savey %|_ Olam) ew o fe. MHA (sal pr) E244 ° THead and neck assessment — 1 \ ie lala 2 ° Seer rc § ZBL el z ; G tae Zz o ‘Sein sob Zeer ee IL, Z =| Y sae N Zz Fal tas] ° Weal > ° be idntook og ZZ —) e Tees isl [ett ° “oestuENTNAME ew Medical Asepsis JENIN _Dritin dyaiene ~ @ 21\4 precautions tin S52 Re | Sterile Technique ‘Applying and removing cap, mask, and protective eyewear rece Anse re t// Ce Preparing a sterile field 4 On bn ly ju Rew kee | Sate Patient Handling, Transfer and Positioning sscng ste and elective transfer techngues Dip MEP? T3fca Jo Jo Jo Jo lo lo lo lo lo Io Oxygen Therapy _ a “Applying a nasal cannula or oxygen mask x | Deraard feat Lofor/ ani4 __L DaahLl sth. *Using incentive spifometdy lo |o Jo |o Llofov fois. BibleSbermawe ICU Smit \y Medication Administration . ae 2 cc B ZZ SOT ~TAminiterng medications trough an ener een ube Ge lols *Applving topical medications tothe skin | Aye lel Ke “instilling eye and ear medications ~Sadministering nasal instilations “Using metered-dose inhalers wee le “Administering rectal suppositories \(\e \ or Parenteral Medications “Preparing injections: Ampules and oar \< a ~~ ¥ Administering intradermal injections wh? As : ly ?P EBBS™S mW ult\ > Jtuna Jmith Mee cnmmarren Oe ce “Therapeutic Use of Heat and Cold “Applying, heat Ai eT I al 7 “Applying cold CZEZE Gigel mes Kustiny al sl UA /Specimen Collection Urine specimen collection: Midstream urine; Urine specimen from AP atanenccneal for pues Gel (tt *Collecting a timed urine specimen 2 mata ised had [0-1 “$biood glucose monitoring *{Level 1 and 3) EZ Oo 10/05/90 ine screening for flucose,Jenna Jinity ’ Optional Additional Skills to Demonstrate in Clinical Anytime During or After Level 1 Health Assessment Genitalia and rectum assessment Exercise and Ambulation Performing rt Emotion exercises Ml In Wir 1 (WWD. mre ber 2 “oping elas stockngs and sequential compression device al aa ONDE DA : Sai itiemeemark Tend PN i, 7 oe i | : Wa, We LO Nel Ad hak io Support Surfaces and Special Beds Utilizing support surfaces ° Oper Av 2° the a Tinangacient on ov utsuspetson or asada bed . I o Sahay ood Otay prone Toph phystal rest ; ° Sanaa peti :Jenna Srith ‘management and Basic Comfort Measures aa aCnn ane i Paioust cyeshey of U4 F ee - 7 ‘ \ Wr, - ars ta, bs) Vale a Ut the Eve and Eat a ea es : E Seealieceaa : : fees Seen catapedncee : soon 3 pee ‘Applying a dressing Than tr ‘Applying a pressure bandage “Applying a transparent bandage ‘Applying gauze and elastic bandages lo jo Jo Jo Jo |e Jo loSibeewne JEW 0 Jnik seen nec | Measusitig occult blood in stool LL? ‘Sputum collection | limination mptying of ostomy bag Wha me, Bo 1145 Required Level 2 Lab Skills nese sts mustbespredoffin sb ‘rior to demonstration in clinical -On Insertion ofan G Tube-in the required section-Add peak flow as optional in level 2 Parenteral Medications “Administering medications by intravenousbolus Blzne5 mim Administering intravenous medication by piggyback, intermittent infusion sets, and mini-infusion pumps $4 -2- lig Z, ripheral Intravenouf|nsertion (LeveF2) oy 19, OS A a [span Medication Adiglstration (Level 2) Queer MHZ) Ch 'eeleoz0 a Ufinary Elimination PBA - Foley Catheter insertion (Level 2) 2/26l2ne ouksoes ST RVYSII IS petersSaat CWO writin __ ditional Optional Skills to be Demonstrated in Clinical Anytime During or After Level 2 | intravenous and Vascular Access Therapy ating intravenous therapy ° CMY oor Me a 6 Teguletingmnravenous tpg Ss 5 L sl DEEP? OF ute ° Changing WY solutions Fn Cte, 2 (4 ‘ Car fir-¢ . angng Wihion bing p-to > i 0% o — D Me <— o Inserting and removing a small-bore nasogastric/nasoenteric feed ° PMs Wire : ° Verifying feeding tube placement ps, wrgas hi [tere a ° Irrigating aXgeding tube fame tu few D ° ‘Checking fobaing tube residuals ; o Ldn RS Hone ei ° bestb CMW Sniy ‘Administering enteral nution: Nasoentei,gaswoROmy oF Jejunostomy tube: D: unt PAMES Shui [r028 as ‘Ostomy Care Pouching a colostomy or an leostomy o ° Perioperative Care Preparing a cient for surgery D ° Wound Care Performing a wound assessment > ° Wound irrigation > ° ‘Managing wound drains . ° Urinary Elimination Insertion ofa straight or indweling urinary catheter Tu Gay en U)a}rer8 = ” ° Care and removal ofan indwelling catheter MA ORS rr le 3 °HONG Jini hy | Intravenous and Vascular Access Therapy “PBA Central ine dressing change Airway Management “Performing tracheostomy care Closed Chest Drainage Systems "Managing closed-chest drainage system | Specimen Collection “Blood glucose monitoring “Level and 3) ‘Antepartum/Intrapartum/Postpartum | “Gestational assessment “Fundus check “Lochia evaluationsuperna Jeng Jinit D 2 ° “Breast assessment 7 o : “ ° *Wound assessment : ne ° | Newborn/Pediatric "Newborn head to toe assessment 3 ° ital signs (TPR, BP, pain management, pulse oximetry) 3 “Weight and Height D De ° “Measurements (OFC, Chest circumference, abdominal girth) 2 ° “Gestational age assessment = 2. “Reflex assessment Ore D ° | __ *Head-to-Toe assessment of pediatric client :enna S Hit ‘to be Demonstrated in Clinical Anytime ‘after Level 3 saat pueingor sn Therapy ‘Administering oxygen to a client with an artificial airway 7 ° Using @ peak flow meter D ° Care of a cient on a mechanical ventilator D ° Airway Management ‘Airway suctioning ° ° Performing endotracheal tube care ° ° Parenteral Nutrition ‘Administering parenteral nutrition through a central line 2 ° ‘Administering parenteral nutrition through a peripheral line D ° Newborn/Pediatric “Medication administration to pediatric client - parenteral D ° ‘Medication administration to pediatric Client - oral a ° Required Level 4 Lab Skills-these skills must be signed off in lab prior to demonstration in clinical Medication Administration “PBA Medication Administration (Level 4) 5 °INSTRUCTOR SIGNATURES al Lud Sted WS, - porrame Ester o © Cree usw! Abocen MSHe7 I / ‘ PP ee J i Tre. Meg, Kil 6x, Le isecy GO pur fe CraseWacer Oameruaye MSMRV CL a 4 Man €d,Ba- @ [lttheds pyacte Whe, MY —Tanelle Stoplel ev Siaplhorr demond Bs denna. lemend Gig Bo Joes | Hee) Le ee Ss) WINGS, = ye CB : pp Melissa Geers