Licensed Practical Nurse Skill Checklist

Personal Information

Please fill the Recruiter Email correctly for successful application submission.

Candidate Name

Email of Recruiter / POC

Select Submission Date

SSN (Last 4 digits)

Proficiency Scale & Legend

1 No experience

2 Need Training

3 Able to perform with supervision

4 Able to perform independently

Able To Perform Independently

Activities of daily living

Admission of patient

Administration of medication

Ambulation

Application of heat and cold

Aseptic Technique

Assist with medical examination

Bathing: Sitz, tub, bed, shower

Bandaging

Binders

Body Alignment

Provide crisis intervention

Body Systems Review (Head to Toe data collection)

Cast care

Catheterization / Foley catheter care

Charting

Colostomy Care and irrigation

CPR

Crutch walking

Decubitus Care

Diabetic tests and preparation forms

Diabetic blood glucose testing

Discharge patients

Dosage computation

Draping

Dressing (sterile)

Ear drops

Elimination needs

Enemas, cleansing, retention, Harris flush

Restraints

Infection Control: Standard Universal Precautions

Infection Control: Reverse Isolation

Infection Control: TB/ Airborne Precautions

Infections Control: MRSA/ VRE Precautions

Isolation procedure for specimen collection

IVs: Monitor rate and infusion site

Medications: Oral, IM, SQ

Mouth care

Nail Care

Neurological Check

Nutritional check

Observations: Response to treatments/ meds

Observations: Signs of significant body system changes

Observations: Signs of shock

Observations: Signs of pain

Observes safety procedures

O2 administration

Pain assessment

Patient care plans (revise and update)

Positioning patient

Postural drainage

Pre-op and post-op care

Provide comfort, safety and privacy

Pulse oxymetry

Range of motion

Report observations/ changes

Hand hygiene

Skin care

Specimen collection: routine urine

Specimen collection: clean catch

Specimen collection: 12 & 24 hour specimen

Specimen collection: stool

Specimen collection: culture

Specimen collection: sputum

Specimen collection: from foley catheter

Suppositories

Suction-oral

Surgical Preps

Computerized charting

Trach care/suctioning

Telephone manners

Topical Medication Application

Traction

Transfer/ transport patients: wheelchair

Transfer/ transport patients: gurney

Transfer/ transport patients: to chair

Urine test for glucose/ acetone

Vital Signs

Weight: Bed scales and standing scales

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct, and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from the agency.