VIRGINIA MASON MEDICAL CENTER



|St. James Healthcare ~ Medical Surgical Nursing |

|NURSING BASIC SKILLS INVENTORY |

|[Preceptor Review of Skills] |

Name: __________________________ Milestone Meeting (Date): __________

New Grad: Y □ N □

Preceptor: _______________________ Submitted To HR (Date): __________

The Nursing Basic Skills Inventory is to assist you and your preceptor to early identify basic skills that you have or do not have for the purpose of developing a continuing learning plan.

This Nursing Basic Skills Inventory is first completed by you during general nursing orientation with an assigned preceptor. It consists of four basic areas: 1) Physical Assessment Skills (theory / critical thinking), 2) Psychomotor Skills (technical),

3) Medication Administration Skills, and 4) Care Management & Documentation Skills.

Instructions: Complete the Skills Inventory for each category with your preceptor. Preceptors reviewing a skill should initial in the “INITIAL” section for each item. Milestone meeting(s) will be scheduled with your Clinical Director and / or Supervisor prior to transition to night shift or at the end of unit orientation where opportunity will be given to review the skills inventory checklist and your individual learning plan.

Verification Level Codes:

Competency Method Codes

| CERTIFICATION(S) |Verification |Date |COMMENTS / INITIALS |

| |

|Milestone Meeting Date: |

| |Verification |Week # |Competency |

| |

|I. Cardiovascular |

|Physical Assessment (auscultation) |

|Telemetry equipment and application |

| |

|Physical Assessment (auscultation) |

|Head Tilt/Chin Lift/Jaw Thrust |

|Nasal Cannula |

|Non-Invasive Oximetry Monitor |

| |

|Physical Assessment (auscultation / palpation) |

|Core Pak Tube |

| |

|Physical Assessment |

|GU Basket |

| |

|Physical Assessment |

|Throat Swabs |

| |

|Physical Assessment |

|Prevalon Turn & Position System |

| |

|Physical Assessment |

|Assistive Devices (walker / cane / crutches) |

| |

|Physical Assessment |

|Physical Assessment |

| |

|Assessment and Treatment – Acute / Chronic | |

| |

|Age Specific (pediatric / adult / geriatric) |

| |

|Fall Risk Assessment |

| |

|Vital Signs |

|Portable Philips Vital Sign Monitor |

|I. Ambulation |

|Gait Belt |

| |

|Ace wrap |

| |

|Bed bath / Shower / Sitz |

| |

|White Boards |

| |

|Fingerstick (glucose testing) |

| |

|Positioning of Patient: |

|Lifting, Moving and Turning |

|Active |

| |

|Set-up / management CT drain set |

| |

|Exam for Stool Impaction |

| |

|Cannula Application |

|Simple Mask |

| |

|Wrist (soft) |

| |

|Surgical Drains (JP and Hemovac): Monitor, Empty and Document |

| |

|Hand Hygiene - Demonstrate before/after patient care |

|I. Medication Administration |

|Five Rights |

|Care Everywhere – Vaccination History |

|Administer fluids |

| |

|Bag change |

| |

|Patient Controlled Analgesia (PCA) |

| |

|I. Care Planning |

|Hourly Rounding |

|Assessment/Reassessment | |

| |

|Color Code system | |

| |

|Email - SJH |

| |

|Medication Room |

|Pre-Op Checklist |

| | |

|Preceptor Name: |Initials: |

|Preceptor Name: |Initials: |

|Preceptor Name: |Initials: |

-----------------------

M = Met

U = Unmet

E = Exceeded

C – Course/Class RW – Review of Written Materials

I – Inservice AV – Audio Visual

T – Testing SR – Standard of Care Review

D – Demonstration NA – Not Applicable

V – Verbalizes NDE – No Documented Exceptions

Knowledge

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