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VisionQwest Healthcare Group
Emergency Room – Skills Checklist
Name: ______________________________Date:__________ Years of Experience: _________________________________
Directions for completing skills checklist:
The following is a list of equipment and/or procedures performed in rendering care to patients. Please
indicate your level of experience/proficiency with each area and, where applicable, the types of
equipment and/or systems you are familiar with. Use the following key as a guideline:
A) Theory Only/No Experience--Didactic instruction only, no hands on experience
B) Limited Experience--Knows procedure/has used equipment, but has done so infrequently or not
within the last six months.
C) Moderate Experience--Able to demonstrate equipment/procedure, performs the task/skill
independently with only resource assistance needed.
D) Proficient/Competent--Able to demonstrate/perform the task/skill proficiently without any
assistance and can instruct/teach.

A. CARDIOVASCULAR
c. Interpretation of waveforms & values A. CARDIOVASCULAR

B. PULMONARY

1. Assessment
B. PULMONARY

3. Equipment & procedures
f. Care of the patient with a chest tube i. O2 therapy & medication delivery systems k. Trouble shooting high pressure alarms
B. PULMONARY
b. Bronkosol (Isoetharine hydrochloride) d. Isuprel (Isoproterenol hydrochloride)
C. NEUROLOGICAL

1. Assessment

C. NEUROLOGICAL
e. Solu-Medrol (Methylprednisolone sodium succinate)
D. ORTHOPEDICS

1. Assessment

D. ORTHOPEDICS

E. GASTROINTESTINAL

1. Assessment

F. RENAL/GENITOURINARY

F. RENAL/GENITOURINARY
a. Insertion & care of straight and Foley catheter
G. ENDOCRINE/METABOLIC

1. Assessment

H. WOUND MANAGEMENT/SURGICAL

1. Equipment & procedures

J. TRAUMA/SHOCK

1. Assessment
J. TRAUMA/SHOCK

K. INFECTIOUS DISEASES

1. Interpretation of lab values - CBC, SMA 7
L. PHLEBOTOMY/IV THERAPY/INVASIVE PROCEDURES

1. Equipment & procedures
a. Administration of blood/blood products
M. PAIN MANAGEMENT

N. PEDIATRICS

1. Equipment & procedures

O. WOMEN'S HEALTH

P. MISCELLANEOUS

AGE SPECIFIC PRACTICE

A. Newborn/Neonate (birth - 30 days)
B. Infant (30 days - 1 year)
C.Toddler (1 - 3 years)
D. Preschooler (3 - 5 years)
E. School age children (5 - 12 years)
F. Adolescents (12 - 18 years)
G. Young adults (18 - 39 years)
H. Middle adults (39 - 64 years)
I. Older adults (64+)
EXPERIENCE WITH AGE GROUPS
A B C D E F G H I
Able to adapt care to incorporate normal growth Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level. Can ensure a safe environment reflecting specific needs of various age groups. My experience is primarily in: (Please indicate number of years) ○ Medical year(s) The information I have given is true and accurate to the best of my knowledge. I hereby authorize VisionQwest Healthcare Group to release Emergency Room Skills Checklist to client facilities of VQHG in relations to consideration of employment as a Per Diem with hose facilities. Signature Date: ________________________________________________

Source: http://www.vqstaff.com/uploads/2/8/1/5/2815653/skills_check_emergency_room.pdf