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PINECONE HEALTH LLC

CNA SKILLS CHECKLIST

Name *

First

Last

This self-evaluation is for assessing your experience in specific clinical areas. This self-evaluation will not be a determining factor in accepting your application to become an employee of Pinecone Health LLC.

1 = No Experience 2 = Limited Experience 3 = Experienced 4 = Highly Skilled

GENERAL NURSING

Admit & Orient Patients *

1
2
3
4

Discharge Patients *

1
2
3
4

Vital Sign Monitoring *

1
2
3
4

Pulse Oximetry *

1
2
3
4

Urine Dipstick *

1
2
3
4

Blood Glucose Monitoring *

1
2
3
4

Wound Care *

1
2
3
4

Dressing Changes *

1
2
3
4

Positioning / Transferring *

1
2
3
4

Pre-Operative Care / Preparation *

1
2
3
4

Post-Anesthesia Care:

General *

1
2
3
4

Spinal *

1
2
3
4

Block *

1
2
3
4

Restraints - Apply/Monitor *

1
2
3
4

Isolation Techniques *

1
2
3
4

Advance Directives *

1
2
3
4

Postmortem Care

1
2
3
4

Assist / Perform Bathing *

1
2
3
4

Complete Bed Bath / Total Assist *

1
2
3
4

Assist with Oral Hygiene *

1
2
3
4

Documentation *

1
2
3
4

Reporting to Supervisor *

1
2
3
4

CARDIAC

Use of Cardiac Monitors *

1
2
3
4

Telemetry *

1
2
3
4

Perform 12-lead EKG *

1
2
3
4

Assist with Code *

1
2
3
4

Assist Care of Patient With:

Acute MI *

1
2
3
4

Congestive Heart Failure *

1
2
3
4

Pre / Post Cardiac Cath *

1
2
3
4

Pre / Post Cardiac Surgery *

1
2
3
4

Aneurysm *

1
2
3
4

Permanent Pacemaker

1
2
3
4

Temporary Pacemaker *

1
2
3
4

ORTHOPEDIC

Crutch Walking *

1
2
3
4

Cast Care *

1
2
3
4

Traction *

1
2
3
4

Assist Care of Patient With:

Amputation *

1
2
3
4

Skeletal Traction *

1
2
3
4

Arthroscopy / Arthrotomy

1
2
3
4

Total Hip Replacement *

1
2
3
4

Total Knee Replacement

1
2
3
4

VASCULAR

Apply Noninvasive BP Monitor *

1
2
3
4

Monitor Noninvasive BP Monitor *

1
2
3
4

Draw Blood for Lab Studies *

1
2
3
4

Discontinue Peripheral IVs *

1
2
3
4

Intake and Output *

1
2
3
4

Peripheral Pulses *

1
2
3
4

Ultrasonic Doppler *

1
2
3
4

Apply Antiembolism Stockings *

1
2
3
4

RESPIRATORY

Open / Monitor Airway *

1
2
3
4

Assist with Intubation (ETT) *

1
2
3
4

Assist with Extubation *

1
2
3
4

O2 Saturation Spot Checks *

1
2
3
4

O2 Saturation Monitors *

1
2
3
4

Incentive Spirometry *

1
2
3
4

Nasal Cannula *

1
2
3
4

Face Masks *

1
2
3
4

Assist Care of Patient With

Asthma / COPD *

1
2
3
4

Pre / Post Thoracic Surgery *

1
2
3
4

Tracheostomy *

1
2
3
4

Chest Tubes *

1
2
3
4

NEUROLOGY

Neurological Evaluation *

1
2
3
4

Seizure Precautions *

1
2
3
4

Assist with Lumbar Puncture *

1
2
3
4

Assist Care of Patient With

Open / Closed Head Injury *

1
2
3
4

Spinal Cord Injury *

1
2
3
4

Drug Overdose / DTs *

1
2
3
4

GASTROINTESTINAL

Assist with Nutritional Evaluation *

1
2
3
4

Assist with Feedings *

1
2
3
4

Gastrostomy Tube Monitor / Feed *

1
2
3
4

GI Bleed *

1
2
3
4

Abdominal Wounds *

1
2
3
4

Drains *

1
2
3
4

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