Hudson Staffing Travel Nurses & Allied Health Careers
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Phone: 1-866-25-NURSE (68773)
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Hudson Staffing Travel Nurses| Home Health Online Checklist
Home Health Online Checklist

Thank you for your decision to apply for a travel nursing position with Hudson Staffing! Before we can offer you a nursing employment opportunity in the Home Health field, an electronic skills assessment must be completed. Please, complete the nursing skills checklist below, and be sure to review your information thoroughly before clicking the submit button.

GENERAL INFORMATION        
Note: * Denotes a required field.
Please enter your full name as it appears on your Social Security Card:

First Name
 
Middle Name
 
Last Name
 *


Please enter the Last Four digits of your Social Security Number:

 -   -   *       Please check here if you do not hold a valid social security card.


Please provide your contact information:

Phone Number
 *
E-mail Address
 *
Confirm E-mail Address
 *
Type your e-mail address again above.
       
This profile is for use by healthcare professionals in the Home Health discipline and specialty.
It will not be a determining factor for the program.
CHECKLIST INSTRUCTIONS        
Please mark your level of experience

     1. No theory and/or experience
     2. Limited experience/need supervision and/or support
     3. Experienced/minimal support needed to perform
     4. Proficient/can perform independently

CARDIOVASCULAR 1 2 3 4
     ACS/Post MI
     Heart Failure
     Post Cardiac Surgery
     Cardiac Auscultation (Rate/Rhythm)
     Peripheral Pulse/Circulation Checks
PULMONARY 1 2 3 4
     Asthma
     COPD
     Pneumonia
     Lung Cancer
     Pulmonary Emboli
     Auscultate Lung Sounds
     Oxygen Administration
     Oxygen Safety
     Oro/Nasotracheal Suctioning
     CPAP/BiPAP
     Ventilator Management (Specify):
NEUROLOGICAL 1 2 3 4
     CVA
     Alzheimer's Disease/Dementia
     Parkinson's
     Degenerative Neurologic Disorders (ALS, MS, etc.)
     Brain Tumor
     Brain Injury
     Para/Quadriplegia
     Seizure Disorder
     Level of Consciousness/Neuro Changes
ORTHOPEDICS 1 2 3 4
     Joint Replacement
     DVT Prophylaxis/Recognition
     Incision Checks
     Staple Removal
     Fractures
     Cast/Brace
     Amputation
     Arthritis
     Assistive Equipment/Lift Devices
     In Home PT/INR
GASTROINTESTINAL 1 2 3 4
     Nutritional Assessment
     Colostomy/Ileostomy Management
     Fecal Incontinence/Diarrhea
     Bowel Obstruction
     GI Bleed
     Post GI Surgery
     Hepatitis Liver Failure
     NG Tubes
     Feeding Tubes
     Feeding Pumps
     Drainage Devices
RENAL/GENITOURINARY 1 2 3 4
     Hemodialysis
     AV Fistula/Shunt
     Peritoneal Dialysis
     Post Bladder Surgery
     Post Prostate Surgery
     Urostomy
     Urinary Incontinence
     Bladder Catheter Insertion/Maintenance
     Suprapubic Catheter Insertion/Maintenance
ENDOCRINE/METABOLIC 1 2 3 4
     Diabetes
     Hyper/Hypoglycemia
     Diabetic Skin Assessment
     Cushing's / Addison's Disease
     Thyroid Disease
     Insulin Pumps
     Glucometers
WOUND/SKIN CARE 1 2 3 4
     Braden Scale
     Pressure Ulcer Prevention
     Pressure Ulcer Staging
     Pressure Ulcer Management
     Burns
     Wound Care
     Wound Cultures
     Wound Vac
ONCOLOGY 1 2 3 4
     Risk for Infection
     Symptom Management
     Side Effects of Treatment
     Terminal Disease
INFECTIOUS DISEASE 1 2 3 4
     MRSA
     VRE
     C. Difficile
     HIV
     Tuberculosis
     Isolation Precautions
PHLEBOTOMY/IV THERAPY 1 2 3 4
     Peripheral Venipuncture for Labs
     Start IVs
     Peripheral IVs
     PICC/CVP Lines
     Venous Access Ports
     Infusion Pump Set up and Management
     Specify Infusion Pump Type:
PSYCHIATRIC 1 2 3 4
     Cognitive Disorders
     Mood Disorders
     Schizophrenia/Psychotic Disorders
     Medication Compliance
WOMEN'S HEALTH/MATERNAL-INFANT CARE 1 2 3 4
     Pregnancy Related Complications
     Fetal Heart Tones
     Contractions
     Post Partum Mother/Baby Visit
     Newborn Care
     Phototherapy
     Breast Feeding Support
PEDIATRICS 1 2 3 4
     Growth and Development
     Respiratory Distress Syndrome
     Bronchopulmonary Dysplasia
     Cystic Fibrosis
     Muscular Dystrophy
     Spina Bifida
     Spinal Surgery
     Sickle Cell Disease
     Trach Care/Suctioning
     Ventilator Management
     Ventilator Type (Specify):
PAIN MANAGEMENT 1 2 3 4
     Verbal/Nonverbal Pain Scales
     Response to Pain Management Interventions
     PCA Pump
     Epidural Cath/Site Monitoring/Pump
     Non-Pharmacologic Pain Measures
PALLIATIVE AND END OF LIFE CARE 1 2 3 4
     Palliative Symptom Management
     Pain Management/Response
     Family Support/Teaching
     After Death Protocols
MEDICATIONS 1 2 3 4
     Alzheimer's Medications
     Antiarrhythmics
     Antibiotics/Antivirals
     Anti-Depressants
     Anti-Hypertensives
     Anti-Psychotics
     Anti-Seizure Medications
     Benzodiazepines
     Calculation of Pediatric Dosages
     Coumadin
     Diuretics
     Enoxaparin
     Inhaled Medications
     Nebulizer Medications
     Insulin
     Opioid and Non-Opioid Analgesics
     Oral Chemotherapy
     Oral Hypoglycemics
     Oral & Topics Nitrates
     Rivaroxaban
     Sedative/Hypnotics
     Steroids
HOME HEALTH 1 2 3 4
     Intake/Admissions
     Case Manager
     Case Load - Pts/Day(specify)
     Supervise LVNs/HHAs
     Medicare/Medicaid
     Long/Short Term Disability
     Private Insurance
     Telephonic Assessments
     Management of Complaints
     APS Reports
     OASIS
     Diagnosis Coding
     Document Plan of Care
     Clinical Assessment Documentation
PROFESSIONAL KNOWLEDGE AND SKILLS 1 2 3 4
     National Patient Safety Goals/Core Measures
     Safety Assessment
     Fall Assessment and Prevention
     Patient/Family Teaching
     Age Specific/Population Based Care
EMR 1 2 3 4
     Allscripts
     Cerner
     EPIC
     HomeCare Home Base
     McKesson
     Meditech
     Other Computerized Documentation System
1 2 3 4
     EMR Conversion Yes No
Certifications 1 2 3 4
     BLS
     ACLS
     PALS
     OASIS Training
     Coding Training
     IV Certification
     Wound Care
Please read and agree to the statements below by marking the checkbox. You will not be able to submit until you have marked the checkbox.

* I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize Hudson Staffing to release this Home Health Skills Checklist to the client facilities in relation to consideration of employment as a healthcare professional with those facilities.




Privacy Note: Hudson Staffing will record anonymous electronic information about your connection when you click on the submit button. This information is used for security purposes only. This information will include your IP Address (44.192.65.228) which will be used as a digital signature.



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Hudson Staffing
Phone: 1(866)256-8773
E-mail: info@hudsonstaffing.net

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