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LPN Skills Competency
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LPN Skills Competency

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Name *

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Select one of the following for each section – 1: No Experience, 2: Need Training, 3: Able To Perform With Supervision, 4: Able To Perform Independently *

I Agree

Admission of patient *

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2
3
4

Administration of medication *

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2
3
4

Ambulation *

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3
4

Application of heat and cold *

1
2
3
4

Aseptic Technique *

1
2
3
4

Assist with medical examination *

1
2
3
4

Bathing: Sitz, tub, bed, shower *

1
2
3
4

Bandaging *

1
2
3
4

Binders *

1
2
3
4

Body Alignment *

1
2
3
4

Body Systems Review (Head to Toe data collection) *

1
2
3
4

Cast care *

1
2
3
4

Catheterization / Foley catheter care *

1
2
3
4

Charting *

1
2
3
4

Colostomy Care and irrigation *

1
2
3
4

CPR *

1
2
3
4

Crutch walking *

1
2
3
4

Decubitus Care *

1
2
3
4

Diabetic tests and preparation forms *

1
2
3
4

Diabetic blood glucose testing *

1
2
3
4

Discharge patients *

1
2
3
4

Dosage computation *

1
2
3
4

Draping *

1
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3
4

Dressing (sterile) *

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3
4

Ear drops *

1
2
3
4

Elimination needs *

1
2
3
4

Enemas, cleansing, retention, harris flush *

1
2
3
4

Restraints *

1
2
3
4

Infection Control: Standard Universal Precautions *

1
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3
4

Infection Control: Reverse Isolation *

1
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3
4

Infection Control: TB/ Airborne Precautions *

1
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3
4

Infections Control: MRSA/ VRE Precautions *

1
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3
4

Isolation procedure for specimen collection *

1
2
3
4

IVs: Monitor rate and infusion site *

1
2
3
4

Medications: Oral, IM, SQ *

1
2
3
4

Mouth care *

1
2
3
4

Nail care *

1
2
3
4

Neurological Check *

1
2
3
4

Nutritional check *

1
2
3
4

Observations: Response to treatments/ meds *

1
2
3
4

Observations: Signs of significant body system changes *

1
2
3
4

Observations: Signs of shock *

1
2
3
4

Observations: Signs of pain *

1
2
3
4

O2 administration *

1
2
3
4

Pain assessment *

1
2
3
4

Patient care plans (revise and update) *

1
2
3
4

Patient safety standards/ precautions *

1
2
3
4

Positioning patient *

1
2
3
4

Postural drainage *

1
2
3
4

Pre-op and post-op care *

1
2
3
4

Provide comfort, safety and privacy *

1
2
3
4

Pulse oxymetry *

1
2
3
4

Range of motion *

1
2
3
4

Report observations/ changes *

1
2
3
4

Hand hygiene *

1
2
3
4

Skin care *

1
2
3
4

Specimen collection: routine urine *

1
2
3
4

Specimen collection: clean catch *

1
2
3
4

Specimen collection: 12 & 24 hour specimen *

1
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3
4

Specimen collection: stool *

1
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3
4

Specimen collection: culture *

1
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4

Specimen collection: sputum *

1
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4

Specimen collection: from foley catheter *

1
2
3
4

Suppositories *

1
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3
4

Suction-oral *

1
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3
4

Surgical Preps *

1
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3
4

Computerized charting *

1
2
3
4

Trach care/suctioning *

1
2
3
4

Topical Medication Application *

1
2
3
4

Traction *

1
2
3
4

Transfer/ transport patients: wheelchair *

1
2
3
4

Transfer/ transport patients: to chair *

1
2
3
4

Vital Signs *

1
2
3
4

Weight: Bed scales and standing scales *

1
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4

IV therapy certified *

1
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3
4

Infant (Birth – 1 year) *

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4

Preschool (ages 2-5 years) *

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4

Childhood (ages 6-12 years) *

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4

Adolescents (ages 13-21 years) *

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Young Adults (ages 22-39 years) *

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Adults (ages 40-64 years) *

1
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4

Older Adults (ages 65-79 years) *

1
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4

Elderly (ages 80+ years) *

1
2
3
4

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