About PNI | Per Diem Nurses | Travel Nurses | Allied Health Professionals | Healthcare Facilities | Contact Us | Home | Apply

 
 


 
Skills Assessment - CNA
 
The following checklist will be used to match your skills and interests with available assignments. Please enter your information, and we will store this information with your application/profile. Please indicate your level of proficiency by marking the appropriate number.
 
First Name:
Middle Initial:
Last Name:
SSN: - -
E-mail Address:
Home Phone: - -
Work Phone: - -
Cell Phone: - -
City:
State:
 
 
0. Theory, no practice   1. Limited   2. Confident   3. Very Confident
 
Experience:
Provide AM care 0   1   2   3  
Provide PM care 0   1   2   3  
Assist patient with ambulation 0   1   2   3  
Provide back and skin care 0   1   2   3  
Give a bed bath 0   1   2   3  
Care for bedsores 0   1   2   3  
Care for Foley catheter 0   1   2   3  
Provide colostomy care 0   1   2   3  
Apply cold compresses 0   1   2   3  
Change non-sterile dressings 0   1   2   3  
Administer enema 0   1   2   3  
Assist with exercise/ROM 0   1   2   3  
Provide hair care 0   1   2   3  
Use correct hand washing technique 0   1   2   3  
Calculate and record intake and output 0   1   2   3  
Use correct isolation technique 0   1   2   3  
Complete menu with patient 0   1   2   3  
Provide oral hygiene 0   1   2   3  
Provide perineal care 0   1   2   3  
Provide post-mortem care 0   1   2   3  
Shave patient 0   1   2   3  
Transfer/transport patient 0   1   2   3  
Take vital signs: TPR & BP 0   1   2   3  
Apply restraints 0   1   2   3  
Universal precautions 0   1   2   3  
Feed patient 0   1   2   3  
Dispose of sharps 0   1   2   3  
Use of correct side rail position 0   1   2   3  
Specimen collection
(urine, stool, sputum)
0   1   2   3  
Follow fluid restrictions 0   1   2   3  
Use of special mattresses 0   1   2   3  
Provide ostomy care 0   1   2   3  
Administer sitz bath 0   1   2   3  
Weigh patient/use of scale 0   1   2   3  
Apply TED hose 0   1   2   3  
Use of aqua-K pads 0   1   2   3  
Complete admission paperwork 0   1   2   3  
Discharge a patient 0   1   2   3  
Stock supplies 0   1   2   3  
Clean equipment 0   1   2   3  
Answer phone 0   1   2   3  
Assist with care of the patient with alcoholism 0   1   2   3  
Assist with care of the patient with amputation 0   1   2   3  
Assist with care of the patient with arthritis 0   1   2   3  
Assist with care of the blind patient 0   1   2   3  
Assist with care of the patient with cancer 0   1   2   3  
Assist with care of the patient with cataracts 0   1   2   3  
Assist with care of the comatose patient 0   1   2   3  
Assist with care of the confused/disoriented patient 0   1   2   3  
Assist with care of the patient with convulsions 0   1   2   3  
Assist with care of the deaf patient 0   1   2   3  
Assist with care of the drug abuse patient 0   1   2   3  
Assist with care of the patient with diabetes 0   1   2   3  
Assist with care of the patient with fractures 0   1   2   3  
Assist with care of the patient with a gastrotomy 0   1   2   3  
Assist with care of the geriatric patient 0   1   2   3  
Assist with care of the patient with dementia 0   1   2   3  
Assist with care of the patient with heart condition 0   1   2   3  
Assist with care of the incontinent patient 0   1   2   3  
Assist with care of the infant 0   1   2   3  
Assist with care of the child 0   1   2   3  
Assist with care of the patient with multiple sclerosis 0   1   2   3  
Assist with care of the patient with a pacemaker 0   1   2   3  
Assist with care of the paraplegic patient 0   1   2   3  
Assist with care of the quadriplegic patient 0   1   2   3  
Assist with care of the patient with Parkinson's disease 0   1   2   3  
Assist with care of the retarded patient 0   1   2   3  
Assist with care of the senile patient 0   1   2   3  
Assist with care of the patient in shock 0   1   2   3  
Assist with care of the patient with stroke 0   1   2   3  
Assist with care of the terminally ill patient 0   1   2   3  
 
 
 
 


© professional nursing, inc.   

  About PNI | Per Diem Nurses | Travel Nurses | Allied Health Professionals | Healthcare Facilities | Contact Us | Home | Apply