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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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