STUDENT NAME: student Name: Des\yee, LUA Instructions for Students: Take a ical day. Ensure lab/simulation demonstration or observation of skills by signing and dating in the appropriate box. Scan a copy of the signed Psychomotor Skills Checklist and upload it into the approf te drop box in LoudCloud at the end of every didactic course with skills lab experiences and every clinical course. Note: Students are responsible for maintaining the original signed copy of this checklist throughout the duration of the program. Uploading the. document into the appropriate courses is required to advance from semester to semester and to graduate. Students are not required to demonstrate ar observe eter stil on ts form Inthe cinkal etre. faculty verify Instructions for Lab Faculty: Print, sign, and date below each skill to acknowledge the student's successful demonstration in the lab setting. Students must be signed off by lab faculty for all required jor to demonstration in clinical Instructions for Clinicians: Sign and date in the appropriate box next to each skill to acknowledge the student's successful demonstration/ observation of the skill. Students must be signed off by lab faculty on a required skills prior to demonstration in clinical. Students are not expected to observe or demonstrate all listed skills in clinical, however, clinicians should look for opportunities for students to observe and demonstrate as many skills as ee and ate ame ; i me aes Daw A $)2112014 ent Pan WiAl20 ——— ree — N peeinlperos ‘Skill checklists can be found in the textbook Clinical Nursing Skills and Techniques, 8th ed., by Per tter, and Ostendorf3 57201 wea ORB) BB z 7 : "Ton A nee Py Z ‘ainssaid poojg jenuew Sussassy, e +7) 8201 , eee Updelg NepRROKUIH27% eee SI 12|/o) OD PEAMU A ee suonestdsas Buy [eS ai : asind jeoide Suissassy, ° Lhele (eRe nul 4) i t Mhale Corre eu Yomi | a at 2[o, OF cies OM PF) ‘asind erpes Bu\ssassy, 3 = S855) WIPE HLT 2 F é a ta ror “tele Nelira nul 277 ae or PCM 7k) | aumesadwiar Apog Bunsen, ‘suBIS [EA 3 bife/e na" re nklu Yon x i ‘Bunuodas quaplour/quana asienpy, oO DOR GAS NA TAN TIS : sajou ssasSoid sasinu Sunuawno0g, oO a &1/72/6 narre-neu 27%) ——e | odas opuey e Buin, {9AEUHOjU, puE UOReWweUInDe io woREATCONMNR oa eI UI Yo pauls aq asnu SUIS aSaNN6-S]]PYS QE] T [BAB] pasinbay pansasqo, a ” ava pe : ae] ur wots ypee porernsuowsep Ayrysseaons sey tuepms paowag 9 rae 'ouneudis 1UN Pewiid UerAUED 48ye mojaq apnyout) aeq pue ‘ssmeusis ‘oweN payuid AYN2e4 GET wapmis ‘Bunras (e21U11) = Sumas ae1 purr 21\7C] SARSAssessing blood pressure electronically = ommerarin “Ivleasuring oxygen saturation (pulse oximet eGo mvcte dogs (Gree, merken fails LS Cree ets. fala ral Signs (Level 1) al" Gu memtdutr, [ze Ny Gece. meareidstss 'fes|e4 Head and neck assessment Bee. meres lei) ‘esl *PBA - Head-to-Toe Assessment (Level 1) wo as an seseat \iasiz0 | Al Dian wasn ore [zsiz0 LEE aa) 5 5 ev er, “a A !fro] eg a ees 8. ee BL (28 eae ff Dp AO ai 4120UP) RH bY s]e Morrencio-r)——F | oulsiy "? life. 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Urine specimen from D Ve-Buen "2/19 3 *Collecting a timed urine specimen Dd = Goce, nem @hly 3 *Blood glucose monitoring ae: a TBiaen MSN RIE (ns i20 D LS Gucci ed fe [ep Puen MSMR 219120 0 D ° == Gee mara irsa suoynesaid aunzias 5 Ee @ quresysay jeaisAyd e BulAiddy ~ qwauranosduyy Ayjend pue Kayes 0 a aq pazipinyy-se 40 uo|suadsns-s/e ue UO wal} e Busse|d ° bis], NelRR-weu 4zony @ saoeyins yoddns Burn spag leipeds pue saoejins woddns oO wy, UP FJ ~ pe a ‘7° Naz vay 2D —*4 Yt OPPHEIE cwrusanieienrccnvumucit oO L1)8/p, wneaseit ty e o1Aap vo|ssasdwo9 jenuanbas pue sfuny201s anseja Suididdy ° 87 eT o, OREM 2 FZ ae, biel poyeneau'27762 a befor NA Reet SF sasiouaxa uonow4o-28ues Buiwoyssq = Sie uoneinquiy pue asiasaxq : eee a quaussasse wnyDa1 pue ele yUaD quauissassy aesH T [a9] s0yy 40 Sung awyAuy Jea]Uy19 UL ayessuoUIag 0 s|IpIs |EUONIppY [eUoNdO py) 2A\ o>) SeNTNEMSsrupewrnawe: De VOC Lind Pain Management and Basic Comfort Measures 1cologic pain management 24 pain relict ZA NON Care of the Eye and Ear Eye care for nonresponsive clients o Care of hearing aids io Jo jo ‘Airway Management Performing oropharyngeal suctioning 2 Qreecnem-teuen “Yoln ° ° Dressings and Bandages ‘Applying a dressing = Gee, MIAN Yr] q ‘Applying a pressure bandage © |o Jo Jo ‘Applying @ transparent bandage lo Applying gauze and elastic bandages © |o Jowoneuquiy Aeuun (z j9n97) uonensiupupy UoneripaW~ vad, ] oe -9-4 i SS A (12121) uoyasuy snouanenyl jeroydtiad - Vd ocitut UIUSHE meg | otlhilg PWS UMPCS 1d NSity HA oy A sduind uorsnyur-quiw pur J quaniuayut ‘y2eqA88id Aq uoNes!paus snovanesaul Giwpy. ot jst qeusne mngc CUS) a] 0} a] QUIT wyUsue ~mgg eae) estos ‘SUOeDIPAW [e18IUaIed Zona] uw jeuondo se moy weed ppy-uoRDes (paxinbas ayy Ul-aqny. 9 Ue Jo Uo}J2sul UO- fequIp UW} oReNsUOWAP o> 1OKd Gel Ul yo pauls aq ysnus sipIs e59N.-S|[IYS QE] Z [BAB] pasinbay ° ° Si] ifor Nar PAIS ergy Seq Aworso jo Bufidarg woneuruia uonsajoo winds Lifton Nel pa-cpsius' 2 72) ZB |00%5 w pooja yn200 Buunseswy wo2a||09 uaui|saqs pat nd a| Skills to be Demonstrated in Clinical After Level 2 lar Access Therapy raver n 118120 Discontinuing short peripheral intravenous access : YP et 136}2020 Mba : as angen Ate 113120 | 0 Regulating intravenous flow rate toes peeves F114 120 D Ku sates M3 pad Breen ET aIA(20 | o | Pre oe ai (20 | B. oa asec pat) Gree pO 3[iH4(20 | 0 Changing infusion tubing Goer Ae ee lid (20 D P a Mgnt only GREASE Byldi o > oO DOL Murs) ashore é PSN RIL 218120 Wows PB tas SN RIC 21 6/20 moving a small-bore nasogastric/nasoenteric a 5 aE haf. - (Pp ee eS angi | irrigating 9 feeding tube : peop Vefro Checking feeding tube residuals jb rseat-Drt os hey oe o |o Jo |o Jo Jo Jo JoOTIPIIG DoS tS a Pe, PGF V 423429 Buyjamput ue Jo jenowias pue are Vey OPO G7Y 4ajayje> Aseuiin Suljiampul 10 YsIe.9S e yo LONLASU voneuuta Aeuun suresp punom SuiSeueyy ones punom quawissasse punom e BuIMO}ed ‘bab punom ‘Aua8iuns 404 qualp) e Buedaig ‘a1e9 annesedouied ‘Awsoysoajt ue 40 Ausoysoj09 e Suiyanod ‘aie Au0IsO Prk, ry UY 40 ‘Awoysonses ‘sua}us0seN :uONLINU jeJaIUa SUUaISIUIIpY PM) IQ aSsrunamame TYs\ee Lund Required Level 3 Lab S| -*these skills must be signed off in lab prior to demonstration in clinical Medication Administration *PBA - Medication Administration (Level 3) Intravenous and Vascular Access Therapy *PBA - Central line dressing change ‘Airway Management *Performing tracheostomy care Closed Chest Drainage Systems “* Managing closed-chest drainage system Specimen Collection Blood glucose monitoring *(Level 1 and 3) Antepartum/Intrapartum/Postpartum Gestational assessment *Fundus check *Lochia evaluationyuayp> 2ueIpad Jo JaLUSsasse 90]-O1-PEIH, ° qUaWIssasse xayay. quawissasse a8e jeuonersay, oe} alo o (yun jeunuopge “souasaywinaui ysa4p 940) siuawiainseaW, 1ya19H pue wysIaM, ° 2 (Anawino asind ‘uowa8euew ured ‘da ‘Uel) SUBS JeUA. qUaUssasse a0} 0} Peay WOGMAN, SuneIpad/woqMoN quauussasse punom, quawissasse seas, quauissasse wnauLad, uyr) WA2C\ saAuRNAENATORSr srupewmnaME Diver Lund Optional Skills to be Demonstrated in Clinical Anytime During or After Level 3 ‘Oxygen Therapy ‘Administering oxygen to a client with an artificial airway lo lo Using a peak flow meter ° Care of a client on a mechanical ventilator ° ‘Airway Management ‘Airway suctioning. ° Performing endotracheal tube care ololo Parenteral Nutrition ‘Administering parenteral nutrition through a central line ‘Administering parenteral nutrition through a peripheral line ololole Newborn/Pediatric Medication administration to pediatric client - parenteral ‘Medication administration to pediatric client - oral jo|clolo Required Level 4 Lab Skills-*these skills must be signed off in lab prior to demonstration in clinical Medication Administration *PBA - Medication Administration (Level 4)ee a ee ecfife petorsel repre (eI VALPDGI| WIUSE eng ry eed helyp 2bsisurd! pang ves | sw’ ~PYWw osama bss angus Om wr? NO RPTAVMLK LCOS WAU I> m0 1 WE VP S818 PIPING omnes NAOKI 42D IPT) GF ND NWN TOTTI ITA SHYSQ RLY vealhy porary | odes nadby pe nadcy eorssap - Neral 22) x STUNLVNDIS BOLNEISN pun yi? eet