LPN ORIENTATION SKILLS CHECKLIST
Date ______
______has completed the following skills under the supervision of ______.
q PPD administration
q EKG administration and performance
q Properly obtaining blood and spinning blood specimens
q Properly obtaining a blood specimen and operating a glucometer
q Collecting the proper equipment in order to obtain a 24-hour urine and reviewing the directions with the patient.
q Reviewed the dermatology, suture, I.V., ear wash, and procedure trays
q Reviewed and demonstrated the audiometer
q Reviewed how to operate the I.V. pump
q Reviewed colposcopy equipment, procedure, follow-up and paperwork.
q Reviewed cleansing procedure of surgical instruments, including colposcopy, wrapping instruments and autoclaving instruments. Discussed dating the autoclave tape on the autoclave.
q Reviewed proper procedure for obtaining a HCT specimen, spinning a specimen and reading a specimen.
q Reviewed specimen collection for Ova and Parasites and proper containers and equipment to obtain them.
q Reviewed occult blood specimens and how to read result.
q Reviewed how to draw up a urine culture.
q Discussed the importance of zeroing out the infant and adult scales after weighing each Pt. Also, relayed that if the scale is unable to be zeroed out that the Clinical Coordinator should be notified.
q Wall vision screening reviewed along with the distance that should be used and the amount that can be missed on each line and be considered as a passing result.
q Reviewed how to properly dispense meds from the pharmacy per provider’s orders.
q Reviewed all immunization forms, along with the multi-dose immunization consent form, immunization documentation form, and immunization record for the patients. Discussed appropriate needle sizes, gauges and sites that are acceptable with the State and FHC
q Reviewed preemie and full-term infant growth charts, along with plotting them
q Reviewed and demonstrated proper technique of how to perform a PKU on an infant
q All forms that will possibly be used by any physician in our clinic at any given time.
q EKG
q Office Spirometery
q Autoclave
q Hemocue
q Hemoglobin A1c
q Urinetek
q Forms
q Medications programs/IDP
q PapRx
q Billing
q Front Office
q Phelbotomy
q Satellite Clinic site
q Fetal alcohol syndrome presentation
q Shaken baby syndrome video
q Using vanish-point devices
q Mantoux (PPD) video
q http://www.cdc.gov/nip/ed/youcalltheshotshtm.
q Health Literacy Video/DVD
______
I acknowledge that I have demonstrated competency with the above listed procedures and equipment.
Employee Signature Date
Clinical Coordinator Date
AC-21-1.2