Patient Care Technician

Patient Care Technician

Name

LAST 4 OF SSN

This checklist was electronically signed on (Today’s date)

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.

Proficiency Scale:

1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

OBTAINING AND RECORDING:

Assessing Pulse

Assessing Temperature

Medication Administration

Weighing the Client

Use of Electronic VS Equipment:

Administering Edemas:

Nutrition:

Specimens:

Collecting Urine:

Hygiene/Skin:

Bathing/Daisy Hygiene:

Use of Pressure and Friction Reduction Services:

Infection Control:

Proper Use of Specific Barrier, Methods:

Safety and Activity:

Application of Restraints:

AGE SPECIFIC COMPETENCIES

I hereby certify that ALL information I have provided on this skills checklist and all other documentation is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

BP, including Orthostatic		1 2 3 4
VITAL SIGNS AND WEIGHTS		1 2 3 4
Administering an Enema		1 2 3 4
Applying Ted Hose		1 2 3 4
Asssessing Respirations		1 2 3 4
Assisting with Ambulation		1 2 3 4
Assist with Dressing		1 2 3 4
Colostomy Care		1 2 3 4
Denture Care		1 2 3 4
EKG		1 2 3 4
Incentive Spirometer		1 2 3 4
Isolation Techniques		1 2 3 4
Making an Unoccupied Bed		1 2 3 4
Making an Occupied Bed		1 2 3 4
Massaging		1 2 3 4
Measuring Height		1 2 3 4
Measuring Intake and Output		1 2 3 4
Moving the Patient		1 2 3 4
Mouth Care		1 2 3 4
Perineal Care		1 2 3 4
Phlebotomy		1 2 3 4
Placing Restraints		1 2 3 4
Positioning the Patient		1 2 3 4
Postmortem Care		1 2 3 4
Range of Motion		1 2 3 4
Sterile Technique		1 2 3 4
Transferring the Client		1 2 3 4
Universal Precautions		1 2 3 4
Using a Mechanical Lift		1 2 3 4
Recognizing Cardiac Arrest		1 2 3 4
Activating Code Team		1 2 3 4
Bringing Emergency Equipment to Room		1 2 3 4
Providing Appropriate Code Support		1 2 3 4
GI/GU		1 2 3 4
Report Abnormal Findings		1 2 3 4
Bowel Function		1 2 3 4
Bladder Function		1 2 3 4
Placing and Removing Bed Pan		1 2 3 4
Clamping Catheter		1 2 3 4
Emptying Foley Bag		1 2 3 4
Placing Condom Catheter		1 2 3 4
Emptying and Replacing Ostomy Bag (Established Ostomy)		1 2 3 4

Axillary		1 2 3 4
Oral		1 2 3 4
Rectal		1 2 3 4
Tympanic		1 2 3 4

Buccal		1 2 3 4
Oral		1 2 3 4
Rectal		1 2 3 4
Topical		1 2 3 4
Vaginal		1 2 3 4

Estimating Intake		1 2 3 4
Setting up for Meals		1 2 3 4
Feeding Patients		1 2 3 4
Aspiration Precautions		1 2 3 4
Nourishments		1 2 3 4
Counting Calories		1 2 3 4
Fluid Restriction		1 2 3 4
NPO		1 2 3 4

Bathing (Shower/Tub/Arjo)		1 2 3 4
Oral Care, including Patients who are NPO, Comatose		1 2 3 4
Pen Care		1 2 3 4
Foot Care for Patients with Impaired Circulation or Sensation		1 2 3 4
Incontinence Care		1 2 3 4
Shaving and Precautions		1 2 3 4
Reducing Pressure and Friction		1 2 3 4