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Date
* Applicant's Name: Last
Middle Initial
* First
To ArdorHealthSolutions Healthcare Professionals:
The following checklist is a The following checklist is a profile used to assess your clinical proficiency and assist in matching your skills with available assignments. Your employment is not dependent upon responses given in this checklist. Please rate your ability as accurately as possible by checking the appropriate box.
The information I have given here is true and accurate to the best of my knowledge. In addition, I also authorize ArdorHealthSolutions to release this skills checklist to client institutions of ArdorHealthSolutions in relation to my employment with that institution.
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* Date
Please Mark Your Level of Experience 1 - No Experience: Theory / Observed Only 2 - Intermittent Experience: < 5 Times Per Year; Needs Review 3 - Moderate Experience: > 5 Times Per Year; May Need Minimal Resource 4 - Competent: Performs on Daily or Weekly Basis; Proficient
Care of Patient with
1
2
3
4
Asthma
Bone Marrow Transplant
Bowel Obstruction
Broncho-Pulmonary Dysplasia
CHP
Cystic Fibrosis
Diabetes Mellitus
Drug Addiction/Withdrawl
Endotracheal Tube Care and Suctioning
Epiglottitis
Failure to Thrive
HIV
Intracranial Hemorrhage
Leukemia
Low Birth Weight Infants
Meconium Aspiration
Meningitis
Near Drowning
NEC
Neuromuscular Disease
NG Tube Feeding
Overdose/Poison Ingestion
PDA Ligation
Pneumonia
Post Harrington Rod Insertion
Pre/Post Cardiac Surgery
Pre/Post Cardiac Cath
Pre/Post Neuro Surgery
Pre/Post Thoracic Surgery
Pulmonary Edema
RDS
Seizure Activity
Sickle Cell Disease
Spina Bifida
Systemic Infection
Tetralogy of Fallot
Tracheosophogeal Fistula
Tracheostomy Care and Suctioning
Transposition of Great Vessles
Cardiovascular
Administration of Cardiac Drugs
Apnea Monitor
Assessment of:
Chest Exam and Auscultation
Abnormal Chest Sounds
Chest Circumference
Pattern of Breathing
Presence of Deformity
Prolonged Inspiratory/Expiratory Phases
Rales, Rhonci, Wheezing
Retractions
Intercostal
Subcostal
Supraclavicular
Tachypnea
Extremities
Clubbing of Fingers and Toes
Edema
Eyes
Periorbital Edema
Activity Level
Apprehensive and Agitates
Height, Weight, Head Circumference
Skin
Cyanosis
Diaphroesis
Duskiness
Pallor
Vital Signs
Apical Pulse
Blood Pressure
Peripheral Pulse
Respirations
Cardiac Monitor
Cardio-Pulmonary Resuscitation
of Child
of Infant
Care of Child/Infant in Shock
Cardiogenic
Hypovolemic
Septic
Care of Child/Infant with:
Acyanotic Heart Disease
Care of CV Patient
Congestive Heart Failure
Cyanotic Heart Disease
Disseminated Intravascular Congestion (DIC)
Digital Scales
Interpretation of EKG Rhythm Strips
Interpretation of Normal HCT Values
Pre/Post Surgical Care
Preparation of Emergency Drugs
Use of Automatic BP Monitor
Use of Doppler
Use of Infant Scales
Endocrine
Assessment
General Appearance
Headache
Hunger
Impaired Healing
Irritability
Mood
Shakiness
Assessment of GI Status
Bowel Sounds -Presence and Type
Measurement of Abdominal
Girth
Cramping
Pain
Rigidity
Tenesmus
Vomiting
Assessment of Hydration
L&Q
Moistness of Mucous Membranes
Skin Turgor
Stool Output
Stool Testing
