Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.
| ADULT | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Neck Injuries / Surgeries |
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| Back Injuries / Surgeries |
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| Hip Fractures / Injuries |
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| Total Hip Replacement |
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| Knee Injuries |
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| Total Knee Replacement |
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| Upper Extrem Joint Replacements |
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| Shoulder Injuries |
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| Degen. Joint Disease / Arthritis |
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| Hand Injuries |
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| Temporomandibular Joint (TMJ) |
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| Post Operative Care |
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| Amputations |
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| Stroke Rehabilitation |
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| Cognitive Disorders |
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| Head Trauma |
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| Spinal Cord Injury |
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| Functional Splinting |
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| Adaptive Equipment-Wheelchair |
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| Neuromuscular Diseases |
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| Multiple Sclerosis |
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| ADULT | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Upper Extremity Prosthetics |
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| Above Knee Prosthetics |
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| Below Knee Prosthetics |
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| Sports Medicine | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| LIDO |
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| Nautilus / Eagle |
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| Taping |
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| Other |
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| Chest PT |
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| Cardiac Rehab |
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| ICU Procedures |
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| CCU Procedures |
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| SICU Procedures |
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| Burn Management |
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| Work Hardening - Work Site Eval |
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| Work Capacity Eval |
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| Procedures / Treatments: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Ankle / Foot Orthosis |
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| Slings |
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| Splints - Wrist / Hand |
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| CPM Machine |
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| Hydrotherapy |
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| Whirlpool |
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| Hubbard Tank |
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| Therapeutic Pool |
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| TENS |
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| Electrical Stimulation |
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| Ultrasound |
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| Cryotherapy |
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| Massage |
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| Diathermy |
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| Acupressure |
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| Spinal Mobilization |
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| Extremity Mobilization |
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| Myofacial Release |
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| Craniosacral Techniques |
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| Cervical Traction |
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| Lumbar Traction |
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| Activities of Daily Living |
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| Gait Training |
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| transfers |
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| Sports Medecine |
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| Athletic Injuries |
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| Biodex |
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| Cybex |
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| Orthotron |
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| Other | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Functional Capacity Eval |
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| Muscle Energy Techniques |
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| Activities of Daily Living |
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| Universal Precautions |
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| Skilled Nursing Documentation |
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| Medicare A |
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| Medicare B |
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| State Healthcare |
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| Skilled Nursing Documentation |
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| AGE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Newborn (birth-30 days) |
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| Infant (30 days - 1 year) |
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| Toddler (1 - 3 years) |
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| Preschooler (3 - 5 years) |
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| School Age (5 - 12 years) |
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| AGE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Adolescents (12 - 18 years) |
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| Young Adults (18 - 39 years) |
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| Middle Adults (39 - 64 years) |
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| Older Adults (64+ years) |
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