Southville International School and Colleges

COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
A. Vital Signs
1 Pulse rates and sites
2 Respiratory rate and quality
3 Blood pressure: manual, palpation, electronic
4 Temperature: axilla, oral, rectal, tympanic
5 Pain Scale
Physical Assessment:
B. The student will perform examination using inspection, auscultation,
palpation and percussion.
1 Skin, hair, nails
2 Eyes, vision
3 Ears
4 Nose and sinuses
5 Mouth and throat
6 Neck
7 Neck vessels
8 Lungs
9 Heart
10 Breast and axillae
11 Abdomen
12 Muscoskeletal
13 Peripheral vascular
14 Neurologic
15 Health history interview
C. Pain Management and Assessment
1 Qualitative and quantitative assessment
2 Patient controlled analgesia
3 Relaxation techniques
4 Body positioning in pain control
D. Infection Control
1 Medical Asepsis
2 Medical Hand washing
3 Hand Rubbing
4 Clean gloving
5 Use of Mask/N95/Eyewear/Face Shield
6 Surgical Asepsis
7 Surgical Hand washing

Revised: 9/2/2022
 Southville International School and Colleges
COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
8 Sterile gloving
9 Gowning
10 Sterile technique/Sterile field
11 Others
12 Sharps disposal
13 Contaminated material disposal
14 Cleaning bodily fluid spills
E. Personal Hygiene and Skin Care
1 Oral Care
Mouth Care
Care of dentures, retainers, bridges
Dental Flossing
Oral irrigation
Trache care
2 Nasal Care
Nasal Irrigation
Ear Care
3 Ear Irrigation
Nail care (fingers and toes)
4 Hair Care/Shampooing
Pedicolosis Treatment
5 Bath
Tub bath
Bed bath
Partial bed bath
Therapeutic bath
Shower
6 Perineal Care
7 Scrotal Care
8 Foot care
9 Care of prosthetics (eyeglasses, contacts, eye prosthesis,
hearing aid, artificial limbs)
10 Back care
11 Shaving - Facial hair, pubic hair, body hair
F. Toileting
1 Use of bedpan
2 Use of urinal

Revised: 9/2/2022
 Southville International School and Colleges
COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
3 Commode
G. Mobility, Immobility and Positioning
1 Body mechanics
2 Body alignment
3 Turning patient
4 Transferring patient: bed, stretcher, chair
5 Use of safety devices
6 Use of restraints
7 Use of devices to relieve pressure sores
8 Active range of motion
9 Passive range of motion
10 Restrictive Exercises
11 Leg Exercises
H. Ambulation
1 Use of wheelchair
2 Use of crutches: walking, upstairs, downstairs
Swing-through gait
Two-point gait
Three-point gait
Four-point gait
3 Use of cane
4 Use of walker
5 Parallel Bar
I. Positioning for Examination & Treatment
1 Supine
2 Prone
3 Dorsal Recumbent
4 Lithotomy
5 Trendelenburg
6 Proctologic
7 Fowler's
8 Sim's
9 Sitting
10 Knee Chest
J. Draping of patient
K. Bedmaking and Comfort Measures
1 Bed stripping

Revised: 9/2/2022
 Southville International School and Colleges
COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
2 Making occupied bed
3 Making unoccupied bed
4 Egg-crate (Inflatable/Alternating Pressure Mattress)
L. Comfort Measures
1 Offering bed pan/urinal
2 Providing comfort, rest and sleep
3 Back rub/massage
4 Applying external warming device
5 - Bear hugger- warmer
M. Use of supportive devices
1 Pillows
2 Foot rest
3 Back rest
4 Sand bags
5 Handy rolls
6 Rubber rings
7 Arm Sling
8 Trapeze Bar
9 Use of the call bell
10 Transporting a patient
11 ID and allergy bands
N. I & O Calculation and Recording
1 Net balance calculation
O. Genitourinary
1 Straight catheter insertion/removal
2 Indwelling catheter insertion
3 Bladder Instillation
4 Continuous bladder irrigation
5 Bladder Training
6 Catheter removal
7 Catheter care: indwelling, condom
8 Assist with pap smear
9 Assist with pelvic examination
P. Bowel Elimination
1 Enema - cleansing, retention, soap suds, carminative, fleet
2 Selection/Application of ostomy appliances
3 Ostomy pouch care

Revised: 9/2/2022
 Southville International School and Colleges
COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
4 Stoma/Peristomal skin care
5 Ostomy irrigation
6 Removal of impactions
Q. Nutrition
1 Nutritional Assessment
2 Residual Check
3 Gravity feedings: enteral , gastrostomy
4 Insertion/Maintenance of enteral feeding tube
5 Removal of feeding tube (not gastrostomy tube)
6 Feeding pumps
R. Wound Management
1 Clean dressing change
2 Superficial dressing change (dry, gauze, topical wound products,
3 with drainage tube.)
4 Deep wound packing
5 Wet to dry dressing change
6 Sterile dressing change
7 Wound irrigation
8 Incision and drainage
9 Suture/Staple removal
10 Application of binders (abdominal, T-binder, breast)
S. Heat and Cold Therapy
1 Care of a patient with fever
2 Heat Application/Hot Soak
3 Warm Compress
4 Cold Application
5 Tepid Sponge
6 Sitz Bath
T. Safe Medication Preparation and Administration
1 Oral (tablets, capsules, and liquids)
2 Topicals, intradermal and transdermal
3 Eye drops, ointment
4 Ear drops
5 Nose drops
6 Nasal sprays
7 Nasal inhalers
8 Nebulization

Revised: 9/2/2022
 Southville International School and Colleges
COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
9 Metered-dose-device; w/ spacer
10 Oxygenation
11 Rectal
12 Vaginal
13 Subcutaneous
14 Mixing insulins in 1 syringe
15 Intramuscular
16 Nasogastric/Gastrostomy
U. IV Therapy
1 Tube priming
2 Set up single and multi IV line configurations
3 Peripheral IV maintenance
4 Peripheral IV insertion
5 Peripheral IV site care
6 Peripheral IV removal
7 Central line management
8 Central venous catheter care
9 IV tube and bag changes
10 Use of infusion devices
11 Regulate flow rate
12 Heplock flush
13 IV medication push
14 IV piggyback medication
15 IV meds via soluset
16 IV meds via saline lock/heplock
17 IV meds thru central line
18 IV meds thru portha catheter
19 Assessment for inflammation/infiltration
20 Blood Transfusion:
Peparing forms, cross-checking
Monitoring of transfusion reaction
Whole Blood Cells/Packed cells/ Plasma
21 Total parenteral nutrition (TPN) administration
22 Assist in Cut down
V. Immunization
1 BCG
2 DPT

Revised: 9/2/2022
 Southville International School and Colleges
COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
3 Polio
4 Measles
5 Tetanus Toxoid
6 Hepa B
7 Anti- rabies
8 Hypersensitivity test
W. Specimen Collection
1 Blood specimen/phlebotomy
2 Sputum specimen (oral/tracheostomy)
3 Stool specimen
4 Urine Specimen
5 Gastric specimen from nasogastric tubes (gastrocult)
6 Wound culture
7 Glucose testing/fingerstick
8 Central line/ intravenous catheter
9 Porta catheter/subcutaneous
X. Tubes and Drains
1 Insertion of nasogastric tube
2 Nasogastric tube maintenance
3 Gastrostomy tube maintenance
4 Care of drainage collection device(s): JP drains, hemovacs, Penrose
5 Care of dialysis tubes: IJ Cath, AV Cath, peritoneal
Y. Respiratory Care
1 Pulse oximeters
2 Use of ambu bag/mask
3 Turn, cough, and deep breathe
4 Postural drainage/chest physiotherapy
5 Incentive spirometry
6 Oxygen therapy:
Nasal cannula
O2 mask
O2 tent
Re-breathable mask
Croupette
7 Assisted ventillation
IPPB
Bennet's respirator

Revised: 9/2/2022
 Southville International School and Colleges
COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
Emerson's respirator
Bird's respirator
8 Suctioning
Nasal
Oral
Endotracheal
Tracheal
9 Closed chest tube drainage system care
10 Chest tube insertion site care/Thoracostomy Care
11 Tracheostomy care
Z. Mental Health
1 Self-awareness and appropriate self-disclosure
2 Mental status examination:
Apperance and behavior
Mood and affect
Thought processes & perception
Cognitive functions & sensorium
3 Therapeutic communication skills
4 Evaluate risk for suicide
5 Evaluate risk for violence
AA. Care of the Dying & Post-mortem Care
1 Care for the Dying
2 Care after Death
AB. Patient Safety (International Patient Safety Goals) JCI
1 Correct patient identification (full name and date of birth) (IPSG 1)
2 Improvement of safety of high alert medications (IPSG 3)
3 Ensuring safe surgery (Surgical Safety Checklist) (IPSG 4)
Risk of health care associated infections assessment (IPSG 5)
- Pressure injury
- CLABSI
4
- CAUTI
- SSI
- VAP
5 Risk for falls assessment and management (IPSG 6)
AC. Communication with Patient and Family (IPSG 2)
1 Orientation to room (during admission)
Use of call button
Patient’s rights and responsibilities
Information board (nurse for the shift, diet, important reminders, etc)

Revised: 9/2/2022
 Southville International School and Colleges
COLLEGE OF NURSING

CI's Signature
Simulated Observed Performed
BASIC NURSING CLINICAL SKILLS CHECKLIST
Skills Lab RLE RLE
Discharge plan (take home meds, ff up check up, etc)
AD. Communication among Health Practitioners (IPSG 2)
1 Charting
Narrative
POMR - SOAP
FDAR
2 Discharge of patients
3 Transfer of patients
4 Referrals-SBAR
Relaying critical results
Read back for telephone and verbal orders
5 Self-reporting of errors and near-misses
6 Endorsement/Handover communication

Revised: 9/2/2022