Licensed Vocational Nurse Skills Checklist

Level Of Proficiency:
By accurately filling out this checklist, you will help us match your skills and interests with available 1. Can function independently
assignments. Please place an “X” in the column that best describes your experience level with each skill. 2. Experienced but may need review
3. Limited experience
Applicants Name: ____________________ Date: _______________ 4. No experience
Applicants Signature: __________________

Safety Infection Control 1 2 3 IV Accesses 1 2 3 4 Oxygen/Airway 1 2

4 Management 3 4
Hand Washing Procedures Tunneled Catheters Nasal Airway suctioning
Standard Precautions Port-a-Caths Oximetry
TB Precautions Nontunneled Catheters Tracheostomy Care
MRSA Precautions Care & Flushing Use of ambu bag
Electrical Safety Peripheral Line Dressing Sputum Collection
Preventing Falls Central Line Dressing Assist with airway establishment
Fire Safety Wound Care /Maintenance 1 2 3 4 Ventilator Management
Medication Safety Dry Sterile dressing change Ventilators models used
Sharps Disposal Wet to Dry sterile dressing Care of the Patient 1 2 3 4
change
Assessment 1 2 3 4 Irrigation Care of Cardiac Patient
ENT Obtain wound culture Acute MI
Neurological Wound Care Products Congestive Heart Failure
Cardiovascular Pressure Sores Cardiac Arrest
Abn. Heart Sounds/ murmurs Staged Decubitus Ulcers AAA Repair
Auscultation ( rate, rhythm) Surgical Wounds with drain(s) Care of Respiratory Patient
Doppler Use of low air loss beds Care of Oncology Patient
Respiratory Ace Wraps & pressure drugs Care of the Post-Op Patient
GI/Nutrition Routine Skin Care Care of the Open Heart Surgery Patient
GU Other Procedures 1 2 3 4 Care of the Organ Transplant Patient
Integumentary Male Catheterization Care of the Neurological Patient
Pain Female Catheterization Care of the GI Patient
Epidural anesthesia/analgesia GU Irrigation Care of the GU Patient
PCA NG Tube Insertion Care of the Diabetic Patient
Endocrine NG Tube Irrigation IV Therapies 1 2 3 4
Vital Signs Hemovac Drain Antibiotics
Height and Weight Jackson Pratt Drain First Dose/Anaphylaxis
Cardiac Monitoring 1 2 3 4 Miller Abbott Cardiac Drips
Lead Placement Levine Chemotherapy
Telemetry- arrhythmia interpretation Tubes to Suction Vesicant
Set up and run a 12 lead EKG Tube Feedings-gravity Non Vesicant
12 lead EKG Interpretation Management of Gastrostomy Chemo Spill Kit
Tube
Management of Jejunostomy
Holter Monitoring IgG
Tube
Hemodynamic Monitoring 1 2 3 4 Hemodialysis Hydration
Pacemakers Peritoneal Dialysis Enteral
External Medication Administration 1 2 3 4 Inoptropics
Permanent Oral Pain Management
Temporary Subcutaneous Pumps 1 2 3 4
Transthoric (epicardial) IM Ambulatory
Cardiac Index Ocular Pole Mounted
Arterial Lines Aerosolized Insulin Pump
PA/Swan-Ganz IV Enteral
Intracranial pressure monitoring Gravity General Knowledge 1 2 3 4
Bolt Add-vantage Advanced Cardiac Life Support
Ventriculostomy Rate Controlled tubing Defibrillation
Venipunture/Labwork 1 2 3 4 TPN and lipids administration Cardioversion
Peripheral Venous Draw PPN administration Admin of cardiac drugs
Arterial Blood Draw Blood product administration CPR
Drawing from a central line Oxygen/Airway Management 1 2 3 4 Advanced Directives
Interpretation of arterial blood gases Nasal Cannula Set-up HIPPA
Interpretation of Lab Results Nebulizer treatments Care of the Patient w/ Septic Shock
Care of the Patient w/ Anaphylactic
Finger Stick Venti Masks
Shock
Care of the Patient w/ Hypovolemic
Blood Glucose Monitoring Trach Collars
Shock
IV Accesses 1 2 3 4 Endotracheal Tube/sunctioning Care of the Patient w/ DIC
Care of the Patient w/ Multi-System
Peripheral Insertion Extubation
Organ
PICC Care Nasal Airway Sunctioning Failure

9/08ED
 Licensed Vocational Nurse Skills Checklist
Level Of Proficiency:
By accurately filling out this checklist, you will help us match your skills and interests with available 1. Can function independently
assignments. Please place an “X” in the column that best describes your experience level with each skill. 2. Experienced but may need review
3. Limited experience
Applicants Name: ____________________ Date: _______________ 4. No experience
Applicants Signature: __________________

Midline Care Extubation

Age Specific Criteria: 1 2 3 4

Newborn/Neonate ( birth-
30 days )
Infant ( 30 days- 1 year )
Toddler ( 1-3 years )
Preschooler ( 3-5 years )
School age Children ( 5-12
years )
Adolescents ( 12-18 years )
Young Adults ( 18-39
years
Middle) Adults ( 39-64 years
)
Older Adults ( 64+ )

9/08ED