Psychomotor Skills Checklist Objective: Demonstrate competence in performing basic nursing skills throughout the life span.

Topic Critical Elements Pass/Fail Vital Signs: The identification and accurate measurement of vital signs. Blood Pressure 1. Chose appropriate size blood pressure cuff for patient/client. 2. Palpate the brachial artery. 3. Position the stethoscope. 4. Auscultate patient/clients blood pressure. Respiratory Rate 1. Observe the patient/client respiration 2. Count respirations. 3. Assess for depth, rhythm, and character of respiration. Radial Pulse 1. Select correct pulse point. 2. Palpate and count the pulse. 3. Assess pulse rhythm and volume. Apical Pulse 1. Locate the apical impulse (PMI). 2. Place stethoscope over the apical impulse. 3. Listen and count the apical pulse for 1 minute. 4. Assess pulse rhythm and strength. Pain Scale 1. Assess location, intensity, quality, onset, duration and recurrence, manner of expressing pain, precipitating factors, alleviating factors of patient/client pain. 2. Demonstrate use of 10 point pain intensity scale. 3. Demonstrate use of Wong-Baker FACES Rating Scale. Oxygen Saturation 1. Apply the sensor and attach to pulse oximeter. 2. If client has nail polish or acrylic nails, place sensor to pad of finger. Infection Control: The prevention of the introduction or transfer or organisms. Standard Precautions 1. Wash hands before initiating direct contact with patient/client and whenever hands are
Competency Transcript Midwestern State University December 2006

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contaminated by patient/clients body secretions or substances. 2. Wear gloves whenever coming in contact with human secretions. 3. Protect patient/client from contamination. 4. Protect self and others from contamination. 5. Confine contaminated material to contaminated areas. 6. Dispose of contaminated materials in designated containers, according to agency protocols. 7. Implement any designated special precautions as required by agency protocols. Isolation Technique 1. Don isolation attire in proper order. 2. Remove isolation attire in proper sequence. 3. Identify types of isolation and special equipment required. Hand Washing 1. Differentiate need for soap/water or alcohol no-rinse handwashing. 2. Remove all jewelry. 3. Turn on water, apply soap. 4. Wash hands for 10 secs using firm, rubbing and circular movements to the palm, back of hand, between fingers, and wrist of each hand. 5. Thoroughly dry the hands and arms. 6. Turn off faucet with a new paper towel. Sterile Application of gloves 1. Open package of sterile gloves. 2. Apply the first glove on the dominant hand touching only the inside of the glove. 3. Apply the second glove on the nondominant hand by inserting the gloved fingers under the cuff. Establishing and Maintaining a 1. Remove cover to package. Sterile Field 2. Initially open package away from provider. 3. Does not reach over sterile field. Activities of Daily Living: To provide maximum independence and decrease infections in the patient/client.
Competency Transcript Midwestern State University December 2006

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Bathing

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2. 3. 4. 1. 2. 3. 1. 2. 3. 1. 2. 1. 2. 1. 2. 3. 4. 5. 6. Application of Restraints 1. 2. 3. 4. 1.

Back Rub

Foot Care

Ear, Eye & Nose Care

Oral Care Mobility

Bed Making

Describe various types and indications for use of baths (complete, self-help, partial, towel, tub, and shower). Provides patient/client with privacy and draping. Cleanses patient/client from cleanest area and works downward to feet. Assess condition of skin Warm lotion or solution. Massage in circular motion over back. Assess condition of skin. Wash and soak the foot. Dry thoroughly. Assess for condition of skin. Use water only. Use separate areas of the washcloth for each eye. Describes the indications for mouth care. Demonstrates brushing of teeth and dentures. Position client correctly (Fowlers, SemiFowlers, Lateral, Supine, Prone, Sims) Perform selected ROM Exercises Perform assistive device teaching demonstration (crutches, cane, walker Perform transfer from bed to chair or wheelchair. Assist patient/client to sitting position at side of bed. Demonstrate moving and turning patients in bed. Verbalize directives needed. Perform pre/post neurovascular/skin assessments. Apply restraint correctly. Document procedure and assessments. Verbalizes the difference in an occupied and
Competency Transcript Midwestern State University December 2006

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unoccupied bed. Demonstrates correct handling of contaminated linens. 3. Demonstrates making an occupied bed. Elimination 1. Verbalizes positioning of patient/client in comfortable position for elimination. 2. Demonstrates standard precautions in the use of a bedpan and urinal. 3. Provides patient/client with supplies to wash hands after elimination. Medication Administration: Provide for safe administration of medications. Safety 1. Follow the Five Rights of medication administration. 2. Identify the patient/client using identifiers. 3. Calculate and prepare dose. 4. Takes Medication Administration Record to the bedside with the medication. 5. Checks for medication expiration. Oral 1. Assesses patient for ability to take oral medications. 2. Unit dose medications are opened at the bedside. Topical 1. Inspect skin for areas of lesions, rashes, erythema, and breakdown. 2. Removed and disposed the old medication patch correctly. Intramuscular 1. Demonstrates correct reconstitution and mixing of medications. 2. Identify IM sites. 3. Chooses appropriate size and length of syringe and needle for medication. Cleanse site with correct technique. 4. Aspirate before administering medication dose. 5. Activates needle safe system prior to disposal. Intradermal 1. Identify the proper site. 2.
Competency Transcript Midwestern State University December 2006

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Cleanse site with correct technique. Inserts the needle with the bevel up and a 15 degree angle. 4. No massage of injection site. 5. Activates needle safe system prior to disposal. Subcutaneous 1. Identify the proper site. 2. Cleanse site with correct technique. 3. Insert the needle at a 45-90 degree angle. 4. Activates needle safe system prior to disposal Enteral or Nasogastric Tube 1. Assess tube placement. 2. Demonstrate crushing of medications. 3. Flush the tube prior to administration and after administration of medication. Insulin Administration 1. Demonstrate proper mixing of intermediate insulin. 2. Withdraw insulins utilizing correct sequence. 3. Verbalize peer validation. 4. Administer insulin using subcutaneous technique. Respiratory Management: Provide safe oxygen administration and support of respiratory effort. Airway Management 1. Describe four types and indication for use of artificial airways (oral, nasal, endotrachial, tracheostomy) 2. Demonstrates the insertion of an oral and nasal airway. Oxygen Delivery 1. Identifies assessment data required during oxygen therapy. 2. Verbalizes correct selection of an oxygen delivery system for the patient/client condition. 3. Demonstrates the insertion and proper use of an oxygen flow meter. 4. Describes safety precautions during oxygen therapy. Suctioning 1. Position patient/client for suctioning. Oropharyngeal 2. Set designated pressure on suction gauge.
Competency Transcript Midwestern State University December 2006

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Hyperoxygenate and hyper ventilate prior to suctioning. 2. Suction only on catheter removal. 3. Maintain sterility of catheter. 4. Suction for no more than 10 seconds. 5. Remove equipment appropriately. Tracheostomy Care 1. Position patient/client. 2. Suction tracheostomy. 3. Establish sterile field. 4. Maintain sterility of inner cannula. 5. Cleanse skin utilizing medical asepsis. 6. Apply trach ties or securing device and gauze dressing safely. Circulatory Management: Provide support of circulatory system. IV Insertion 1. Demonstrates proper selection of vein and size of intravenous catheter for venipuncture. 2. Applies tourniquet properly. 3. Insert the intravenous catheter at a 15-30 degree angle. 4. Release tourniquet prior to infusion of solution. 5. Attach prepared IV solution/saline lock. 6. Correctly dress the site according to protocols. 7. Verbalizes the management of an intravenous site. 8. Demonstrates the discontinuation of an intravenous catheter. IV Fluid Administration 1. Verbalizes the common types and use of intravenous solutions. 2. Demonstrates priming the primary tubing. 3. Calculates the proper infusion rate and sets the drip rate for the solution. Calculation of Intake and Output 1. Demonstrates the correct measurement of output (urine, stool, NG drainage, or other body substances). 2. Demonstrates the calculation of intake
Competency Transcript Midwestern State University December 2006

Nasopharyngeal Tracheostomy

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(intravenous, oral intake, tube feedings). Elimination Management: Assist with proper elimination body substances. Urinary Catheterization 1. Establish sterile field. Male/Female 2. Check indwelling catheter balloon. 3. Cleanse perineum correctly. 4. Insert catheter maintaining sterile technique. 5. Inflate balloon at appropriate location. Nasogastric Tube Insertion 1. Assess tube measurement 2. Position patient/client correctly. 3. Assess for nasal patency. 4. Insert tube utilizing clean technique. 5. Verify tube placement by three methods. 6. Secure tube appropriately. Nasogastric Tube Removal 1. Flush tube with air. 2. Use appropriate barriers. 3. Instruct patient/client to take a deep breath and to hold it. 4. Quickly and smoothly withdraw the tube. 5. Identify proper disposal. Enema Administration 1. Prepare solution correctly. 2. Position patient/client appropriately. 3. Insert tube safely with bag at correct height. 4. Remove and discard equipment in proper receptacle. Ostomy application and 1. Empty and remove appliance. management 2. Provide skin/stoma care. 3. Measure stoma correctly. 4. Reapply new appliance utilizing appropriate products. 5. Maintain proper barrier/universal precautions. Nutrition: Provide adequate calories for energy, strength and healing. Feeding 1. Verbalizes assessment data necessary to determine the amount of assistance is required for the patient/client. 2. Place head of bed at 90 degrees to assist with eating and swallowing.
Competency Transcript Midwestern State University December 2006

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Prepares food and drinks as required by the patient/client. Enteral Feeding 1. Position patient/client appropriately. 2. Verify tube placement. 3. Check gastric residual. 4. Flush tube with tap water before and after formula. 5. Instill formula without entry of excess air. 6. Verbalize patient/clients position postprocedure. Wound Management: Perform appropriate wound care. Central Line Dressing 1. Remove old dressing. 2. Don mask. 3. Establish sterile field. 4. Clean site from center outwards. 5. Apply transparent dressing. 6. Replace sterile caps properly. Sterile Wound Dressing Change 1. Remove soiled dressing using appropriate barrier. 2. Cleanse incision as ordered. 3. Apply appropriate dressing as ordered. 4. Tape dressing securely. 5. Dispose of soiled equipment in appropriate container. Removal of Sutures 1. Demonstrate proper procedure for using suture removal scissors. 2. Removes the suture without pulling exposed suture under skin. Removal of Staples 1. Demonstrates proper procedure for using the staple remover. 2. Disposes of staple in correct container. Application of Steri-strips 1. Demonstrates attachment of steri-strip to one side of wound. 2. Attaches other side of steri-strip to other side of wound pressing the wound sides together. Application of Abdominal 3. Select appropriate size binder for
Competency Transcript Midwestern State University December 2006

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Binder 4. 5. 1. 2. 3. 4. 1. 2. 3.

Application of Bandages

Application of Hot and Cold Compresses

patient/client. Place patient/client in correct position. Overlap the ends and secure with Velcro. Place limb to be bandaged in normal position or joint slightly flexed. Apply from distal end to proximal end. Demonstrates even pressure when applying bandage. Demonstrates neuro-vascular checks. Demonstrates proper filling of compresses. Provides for padding between skin surface and compress. Verbalizes when to remove the compress at the specified time.

Competency Transcript Midwestern State University December 2006