Patient Care Mid-Level

Candidate:

Discipline:

Checklist:

Date Signed:

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Maria Gilbert

LPN

Long Term Care LVN/LPN

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'Maria Gilbert 04/09/2024 2:07

PM

Limited Experience

Mid-level Experience

Advanced-level Experience

1

2

3

Assessment/ Patient Care

General 3.0

EMR Software 1.7

Cardiovascular 3.0

Endocrine/Metabolic 3.0

Gastrointestinal 3.0

Immunology/Hematology/Oncology 2.6

Musculoskeletal 2.7

Neurological 3.0

Pulmonary 3.0

Renal/ Genitourinary 2.7

Wounds/ Integument 2.9

Medication/ Therapeutic Interventions

Blood 1.0

IV Therapy 2.8

Medications

Administration

3.0

Nutritional Therapy 3.0

Oxygen Administration 2.8

Pain Management 2.5

Procedures/ Equipment

Perform 2.7

Specimen Collection 3.0

Isolation and Infection

Prevention

2.3

Age Group Experience

Age Groups 3.0

Clinical Settings 3.0

Maria Gilbert, LPN Long Term Care LVN/LPN

[1] Limited [2] Mid-level [3] Advanced-level

Assessment/ Patient Care

General

EMR Software

Admission 3

Advance Directives 3

Collect Appropriate Data 3

Long Term Care Plan 3

MDS Forms 3

Medicare Survey 3

Out of Hospital DNR 3

Patient and Family

Teaching

3

Allscripts 1

American HealthTech 1

Athenahealth 2

CareMatrix 1

CERNER 2

eClinicalWorks 2

EPIC 2

Meditech 1

EMR Software (cont.)

Cardiovascular

Endocrine/Metabolic

PointClickCare 3

Sorian 2

Abnormal Heart

Sounds/Murmurs

3

Auscultation (Rate,

Rhythm)

3

Capillary Refill 3

Color 3

Coagulation Studies 3

Vital Sign Monitoring 3

Acute MI 3

AICD (Automatic

Implanted

Cardioverter/Defibrillator)

3

Angina 3

Cardiac Arrest/ CPR 3

Cardiomyopathy 3

Congestive Heart Failure 3

Hypertension 3

Hypovolemic Shock 3

Pacemaker (Permanent) 3

Maria Gilbert, LPN Long Term Care LVN/LPN

[1] Limited [2] Mid-level [3] Advanced-level

Endocrine/Metabolic (cont.)

Gastrointestinal

Immunology/Hematology/Oncology

Blood Glucose 3

Diabetes 3

Diabetic Ketoacidosis 3

Drug Overdose 3

Bowel Sounds 3

G.I. Assessment 3

Nutritional Status 3

Bowel Obstruction 3

Colostomy 3

GI Bleeding 3

Hepatitis 3

Ileostomy 3

Liver Cancer 3

Liver Failure 3

Pancreatic Cancer 3

Pancreatitis 3

Blood Transfusions 2

Immunology/Hematology/Oncology (cont.)

Musculoskeletal

Neurological

Hematology 3

Acute Leukemia 3

Cancer 3

Chemo/ Radiation 1

HIV/ AIDS 3

Sepsis 3

Treatment Side Effects 3

Cast Care 3

Pulse/Circulation Checks 3

Traction 1

Amputation 3

External Fixation 3

Paraplegia/ Quadriplegia 3

Joint Replacement 3

Level of Consciousness 3

Neurological Assessment 3

Reflex/ Motor Deficits 3

Maria Gilbert, LPN Long Term Care LVN/LPN

[1] Limited [2] Mid-level [3] Advanced-level

Neurological (cont.)

Pulmonary

Renal/ Genitourinary

Alzheimer's Disease 3

Coma 3

CVA 3

Neuromuscular Disease 3

Seizure Disorder 3

Spinal Cord Injury 3

Assess Lung Sounds 3

Oxygenation Status 3

Rate and Work of

Breathing

3

Asthma 3

COPD 3

COVID 3

Pneumonia 3

Pulmonary Edema 3

Pulmonary Embolism 3

Tracheostomy 3

Tuberculosis 3

Renal/ Genitourinary (cont.)

Wounds/ Integument

Fluid Status 3

BUN and Creatine 3

Serum Electrolytes 3

Fluid Balance 3

Measurement of I & O 3

End Stage Renal Disease 3

Fistula/ Shunt 3

Hemodialysis 2

Peritoneal Dialysis 1

Suprapubic Catheter 3

Urinary Tract Infection 3

S/S Infection 3

Skin Assessment 3

Skin Breakdown 3

Burns 2

Staged Decubitus Ulcers 3

Stasis Ulcers 3

Surgical Wounds with

Drains

3

Maria Gilbert, LPN Long Term Care LVN/LPN

[1] Limited [2] Mid-level [3] Advanced-level

Wounds/ Integument (cont.)

Medication/ Therapeutic Interventions

Blood

IV Therapy

Medications Administration

Nutritional Therapy

Wounds 3

Administer Blood/ Blood

Products

1

Administer IV Medications 3

Assess/ Maintain IV Site 3

Infusion Pumps 3

IV Insertion 3

Vascular Access Devices

Care/ Maintenance

2

Administer IM and SQ

Medication

3

Administer Inhalation

Medication

3

Administer PO

Medications

3

Bladder Irrigation and

Instillation

3

Dobhoff Tube Insertion 3

Enteral Administration 3

Gravity/ Bolus Tube

Feedings

3

Nutritional Therapy (cont.)

Oxygen Administration

Pain Management

Procedures/ Equipment

Perform

J-tube 3

NGT Insertion 3

PEG 3

Tube Feeding Pumps 3

Nasal Cannula 3

Portable Oxygen 3

Tracheostomy Tube 3

External CPAP/BIPAP 3

High Flow Nasal Cannula

(HFNC)

3

Interpretation of ABGs 2

Assess Pain Level/

Tolerance

3

Patient Controlled

Analgesia

2

Doppler 2

Dressing Changes 3

Establish/ Protect Airway 1

Maria Gilbert, LPN Long Term Care LVN/LPN

[1] Limited [2] Mid-level [3] Advanced-level

Perform (cont.)

Specimen Collection

Foley (Female) 3

Foley (Male) 3

Isolation 3

Nerve Stimulators 2

Specialty Beds 3

Suctioning (Oral-

Nasopharynx)

3

Tracheostomy Care/

Suctioning

3

Wound Care 3

Wound Irrigations 3

Wound Vac 3

Central-Line Blood Draw 3

Clean Catch Urine 3

Cultures (Blood, Sputum) 3

Finger Stick 3

Sterile Urine 3

Stool 3

Throat Swab 3

Venipuncture 3

Isolation and Infection Prevention

Age Group Experience

Age Groups

Clinical Settings

CAPR Respirator 1

Contact Precautions 3

Droplet Precautions 3

N95 Masks 3

PAPR Respirators 1

Standard Precautions 3

18 - 39 Years 3

39 - 64 Years 3

64+ Years 3

Assisted Living 3

Memory Care Unit 3

Nursing Home 3

Skilled Nursing Unit 3

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