Hospice RN Skills Checklist

Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1-2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only

1 = Limited Experience / Rarely Done (<6 times/year)

2 = May Need Some Review / Occasionally Done (1-2 times/month)

3 = Experienced / Frequently Done (daily or weekly)

Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1-2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

Age Of Patients Cared For

Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler/Preschool (13 months to 5 years)
School Age Child/adolescent (6 years to 18 years)
Young Adults/Middle Adult (19 years to 64 years)
Older Adults/Elderly (65+ years)

General Skills

Care of Patient in Restraints
Automated Med Dispensing Systems
Electronic Documentation
IV Pumps
Peripheral IV Insertion, Care and Maintenance
Access/Management of Implanted Ports
Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, etc.)
Blood draws from PICC line, Central line
PCA/Epidural pumps
Administration of Blood/Blood Products
Occluded ports or catheters
NG tube insertion
Enterostomy/ostomy care
Knowledge of "Do Not Use Abbreviations"
Do you have charge/supervisor experience?
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores

Hospice Care

Admit and Initial Assessment
Infection control
Universal precautions
Isolation
Reverse Isolation
Minimize fall risks
Restraints
Lift/transfer devices
Interpretation and communication of lab values
Non-pharmacologic interventions
Blood Glucose monitoring

Plan Of Care

Advanced directives
Set Goals with Pt/family
Resources for Pt/family
Pt teaching self care
Quality of life issues
Death and dying counseling
Stages of grieving
Pt care after death
Facilitate family/cultural rituals/rites
Spiritual Care
Pronouncement of death
Coordinate mortuary services

Compliance

Scope and frequency of services
Medicare/State regulations for hospice
Document progression of decline
DME authorization and documentation of need/order
OASIS-C

Pain Management

Pain assessment/management
Moderate sedation
Administration of narcotics/sedatives
PAINAD Scale for nonverbal patients
Continuous narcotic infusion
Transdermal agents
TENS units
Alternative therapies
Titration of opioids
Family management of medications
Disposal of Medications
Equianalgesic Conversion Formula

Wound Care

Speciality beds
Prevention of pressure ulcers
Staging and care of pressure ulcers
Wound care
Use of Woundvac
Positioning Techniques
Educate Pt/Family on positioning/shearing

Medications

Bar coding for medication administration
Insulin administration
Anticoagulation therapy
Medication reconciliation
Oral Medication
Topical Medication
Opthalmic/Otic Medication
Rectal/vaginal medication
IM/SQ medication
IV push medications
IVPB medications
Continuous infusions
PPN
TPN
J-tube/G-tube feedings

Physical Assessment

Cardiovascular assessment
Respiratory assessment
Use of oxygen
Use of Incentive Spirometer
Nasal cannula/face mask
Nebulizers
Use of ambu bag
Pulse oximetry
Oral and nasotracheal suctioning
Tracheostomy care
Neuro assessment
Sleep assessment
Seizure precautions
Gastrointestional assessment
Nutrition assessment
NG tube insertion/management
Feeding tube insertion/management
PEG/gastrostomy/ jejunostomy management
Ostomy care
Foley catheters
Suprapublic tube
Nephrostomy
Shunts/fistulas

Pediatrics

Developmentally appropriate assessment
parent/sibling support
pediatric support team collaboration
Fatigue
Constipation
Nausea/vomiting

Certifications

CHPN
ACHPN
CHPPN