Emergency Department Skills Checklist
   NAME    
   LAST 4 OF SSN      
   DATE    
I hereby certify that ALL information I have provided 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.  
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.  
Proficiency Scale: 1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

 
       
Rating Stars (Click) WORK SETTINGS 1 2 3 4  
Level I Trauma Center  
Level II Trauma Center  
Non-Trauma Center Emergency Department  
Pediatric Emergency Department  
Emergency Department - Combined Adult/Pediatric  
Critical Care Transport  
Rating Stars (Click) CARDIAC 1 2 3 4  
Acute Coronary Syndrome  
Congestive Heart Failure/Pulmonary Edema  
Aneurysm  
Cardioversion  
Transcutaneous Pacemaker  
Heart Sound  
Rating Stars (Click) PULMONARY 1 2 3 4  
Respiratory Failure  
COPD/Asthma  
Aspiration  
Pneumonia  
Pneumo/Hemothorax  
Chest Tube Insertion/Management  
Pulmonary Embolism  
Tuberculosis  
External CPAP/BiPAP  
Intubation  
Ventilated Patients  
ABG Interpretation  
Rating Stars (Click) NEUROLOGICAL 1 2 3 4  
CVA  
Stroke Scale  
Brain Injury  
Glascow Coma Scale  
Spinal Cord Injury  
Meningitis  
Seizures  
Rating Stars (Click) ORTHOPEDICS 1 2 3 4  
Fractures/Casting  
Open/Complex Fractures  
Apply/Manage Splints  
Circulation Checks  
Rating Stars (Click) GASTROINTESTINAL 1 2 3 4  
GI Bleeding  
Liver Disease  
GI Obstruction  
Abdominal Pain/Distress  
Gastric Tubes  
Rating Stars (Click) RENAL/GU 1 2 3 4  
Acute Renal Failure  
Renal Calculi  
Renal Trauma  
Testicular Torsion  
Rating Stars (Click) ENDOCRINE 1 2 3 4  
Hypoglycemia  
Hyperglycemia  
DKA  
Rating Stars (Click) WOUND MANAGEMENT 1 2 3 4  
Skin Integrity Assessment  
Wound Repair  
Rating Stars (Click) SHOCK/TRAUMA 1 2 3 4  
Some items are covered in system specific areas.  
Injury Severity Score  
Trauma Code  
Trauma Team Member  
Major Trauma  
Traumatic Amputation  
Peritoneal Lavage  
Hypovolemic Shock  
Neurogenic Shock  
Anaphylactic Shock  
Septic Shock  
Cardiogenic Shock  
Burns - 2nd Degree  
Burns - 3rd Degree  
Rating Stars (Click) INFECTIOUS DISEASE/IMMUNOSUPPRESSED PATIENTS 1 2 3 4  
Contagious/Infectious Patients  
Isolation  
Neutropenia/Reverse Isolation  
Rating Stars (Click) WOMEN'S HEALTH 1 2 3 4  
Placenta Abruptio/Previa  
Precipitous Delivery  
Pregnancy Induced Hypertension  
Fetal Heart Tones  
Sexual Assault  
Reporting Acts of Violence  
Rating Stars (Click) PEDIATRICS 1 2 3 4  
Management of Pediatric Emergency Patients  
Identification/Reporting Abuse  
Abdominal Pain  
Epiglottitis  
Asthma/Reactive Airway Disease  
Fractures  
Head/Spinal Injury  
Poison Ingestion  
Seizures  
Sickle Cell Crisis  
Rating Stars (Click) PSYCHIATRIC 1 2 3 4  
Acute Psychotic Patient  
Managing Violent Behavior  
Drug /ETOH Overdose/Withdrawal  
Psychiatric Hold  
Suicidal Patient  
Rating Stars (Click) MISCELLANEOUS 1 2 3 4  
Bites- Animal/Snake/Human  
Hazardous Material Exposure  
Heat Exhaustion/Stroke  
Drowning  
Rating Stars (Click) IV THERAPY 1 2 3 4  
Starting IVs  
Central Line Placement  
Intraosseous Infusion  
Blood Product Administration  
Rating Stars (Click) MEDICATIONS 1 2 3 4  
Anti-Arrhythmics  
Anticoagulants (IV, oral, & injection)  
Anti-Hypertensives  
Anti-Psychotics  
Anti-Seizure Medications  
Benzodiazepines  
Continuous IV Paralytics  
Continuous IV Sedation  
Procedural Sedation - Administration  
Emergency Medications  
Inhaled Medications  
Insulin  
IV Vasopressors  
Narcotics/Opioid Analgesics (IV, oral, & injection)  
Nitrates (Oral & Topical)  
Non-Opioid Analgesics (IV, Oral, & Injection)  
Reversal Agents  
Thrombolytic Therapy  
Steroids (IV, Oral, Inhaled)  
Automated Medication Dispensing (i.e. Pyxis, Omnicell)  
Rating Stars (Click) CARDIAC MONITORING & EMERG. RESPONSE 1 2 3 4  
Dysrhythmia Interpretation  
Dysrhythmia Management  
Obtain 12 Lead EKG  
Interpret 12 Lead EKG  
Management of Cardiac Arrest  
Rating Stars (Click) PROFESSIONAL KNOWLEDGE AND SKILLS 1 2 3 4  
Triage  
Ambulance/Paramedic Radio  
Charge Experience  
AMA procedures  
EMTALA  
National Patient Safety Goals/Core Measures  
Fall Risk Assessment/Prevention  
Pressure Ulcer Risk Assessment/Prevention  
Restraints/Use of Least Restrictive Device  
Patient/Family Teaching  
Age Specific/Population-Based Care  
Isolation Precautions  
Infection Prevention  
Pain Assessment & Management  
Interpretation and Communication of Lab Values  
Rating Stars (Click) Age Specific Competencies 1 2 3 4  
Infant (Birth - 1 year)  
Preschooler (ages 2-5 years)  
Childhood (ages 6-12 years)  
Adolescents (ages 13-21 years)  
Young Adults (ages 22-39 years)  
Adults (ages 40-64 years)  
Older Adults (ages 65-79 years)  
Elderly (ages 80+ years)  
Rating Stars (Click) EMR 1 2 3 4  
Epic  
Cerner  
Eclipsys  
McKesson  
Meditech  
Allscripts  
Other Computerized System  
Computerized Physician Order Entry  
Bar Coding for Medication Administration  
  EMR Conversion
   
CERTIFICATIONS   Expiry Date :  
BLS  
ACLS  
PALS  
PEARS  
TNCC  
ENPC  
CEN  
  Other: Specify  
  Other: Specify