PSYCHIATRIC KNOWLEDGE &

SKILLS CHECKLIST___________
NAME:       b. One-to-one
ID #:      
DATE:       DIRECTIONS: Please indicate your level of
experience by placing a check (√) in the
box. Experience level:
This Skills Checklist is for use by nurses 1 NO EXPERIENCE
with more than one year experience in 2 MINIMAL EXPERIENCE-requires
their discipline and specialty. Please be supervision/assistance
accurate with your assessment. 3 MODERATELY EXPERIENCED-requires
initial review, then performs
DESCRIPTION 1 2 3 4 independently
ASSESSMENT 4 VERY EXPERIENCED- proficient
1. Admission
2. Initial nursing assessment &
care plan DESCRIPTION 1 2 3 4
3. Initial treatment plan 24. Tracheostomy
4. Neurological vital signs 25. With tube feedings
5. Nursing diagnoses EQUIPMENT & SKILLS
6. Nursing reassessment & care 1. Insertion & care of straight and Foley
planning catheter
update a. Female
7. Suicide risk assessment b. Male
CARE OF THE PATIENT 2. O2 therapy and medication delivery systems
1. Care of child a. Bag and mask
2. Care of adolescent b. External CPAP
3. Care of adult c. Face masks
4. Abused Children d. Inhalers
5. Alcoholic e. Nasal cannula
6. Alzheimer’s f. Portable O2 tank
7. Assaultive/combative g. Trach Collar
8. Bipolar disorder 3. Oro-naso-pharynx suctioning
9. Drug-dependent 4. Restraints, application and assessment of:
10. Eating disorder a. Ambulatory cuffs
11. Forensic b. Full restraints
12. Geriatric c. Wrist restraints
13. Hallucinatory 5. Starting IV’s
14. Homicidal a. Angiocath
15. Manic-depressive b. Butterfly
16. Medically-compromised c. Heparin lock
17. Mentally retarded d. Inhalers
18. MRDD e. Nasal cannula
19. Organic disorder IV THERAPY
20. Schizophrenic patient 1. Hanging blood & blood
21. Seclusions and restraints products
22. Seizure disorder 2. Hyperalimentation
23. Suicidal patient maintenance &
a. Suicide precautions precautions
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 PSYCHIATRIC KNOWLEDGE &
SKILLS CHECKLIST___________
3. Infusion pumps
4. Venipuncture
MEDICATIONS
1. Administration for 1-20
patients
2. Administration of Heparin

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 PSYCHIATRIC KNOWLEDGE &
SKILLS CHECKLIST___________
NAME:       14. Multi-disciplinary treatment
ID #:       team
DATE:       participation
15. Nonviolent Crisis Intervention
16. Patients’ rights
DESCRIPTION 1 2 3 4 17. Patient teaching
MEDICATIONS (CONT) DESCRIPTION 1 2 3 4
3. Administration of oral 18. Participation in Milieu therapy
psychotropic 19. Preceptor
medications 20. Psychiatric emergency
4. Calculation of safe dosage response team
range 21. Rapid tranquilization
5. Intramuscular 22. Telephone crisis intervention
6. Knowledge of methods, 23. Therapeutic communication
incompatibilities, and side skills
affects 24. Universal precautions
7. Knowledge of drug 25. Voluntary admissions
interactions UNIT TYPES
8. Reconstitution of powdered 1. Acute psychiatric
medications facilities/units
9. Oral 2. Crisis intervention unit
10. Rectal 3. Cottage and/or independent
11. Unit dose living
12. Z-technique facilities
PROCEDURES 4. ER triage - psychiatric
1. Active participation in multi- 5. Locked Units
disciplinary staffing 6. Long-term psychiatric care
2. Assist with lumbar puncture 7. Open Units
3. Behavior Modification – 8. Outpatient clinic
implementation/participation 9. Psychiatric Home Health
4. Cardiopulmonary resuscitation 10. Transport/accompany patient
5. Charge nurse experience COMPUTERIZED CHARTING
6. Charting: 1. Cerner
a. Behavioristic 2. Eclipsys
b. Treatment/goal oriented 3. Epic
7. Discharge planning 4. McKesson
8. Group therapy leader 5. Meditech
9. Assist physician in 6. Other:
administration of
electroconvulsive therapy
10. Electroconvulsive therapy
11. Involuntary admissions
12. Management of drug/alcohol
detox
symptoms
13. Management of assaultive
behavior
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 PSYCHIATRIC KNOWLEDGE &
SKILLS CHECKLIST___________

Name:      
MY EXPERIENCE IS PRIMARILY IN:
Please check the boxes below for each
age group for which you have expertise in NEUROLOGY       years
providing age-appropriate nursing care. PULMONARY       years
SURGICAL       years
A. Newborn/Neonatal (birth – 30 days) MEDICAL       years
B. Infant (30 days – 1 year) CARDIAC CARE       years
C. Toddler (1 – 3 years) TELEMETRY       years
D. Preschool (3 – 5 years)
E. School Age Children (5 – 12 years) I HAVE CURRENT CERTIFICATIONS FOR:
F. Adolescent (12 – 18 years)
G. Young Adults (18 – 39 years) TYPE COURSE
H. Middle Adults (40 – 64 years) DATE (MM/DD/YY)
I. Older Adults (64 + years) ARRHYTHMIA      
CRITICAL CARE      
EXPERIENCE WITH AGE GROUPS: ACLS      
1. Able to assess age appropriate BLS      
behavior, motor skills and physiological TNCC      
norms. NRP      
PALS      
A B C D E F G H I NALS      
CCRN      
Other            
2. Able to adapt care according to normal Other            
growth and development.

A B C D E F G H I The information I have provided in this

knowledge and skills checklist it true and
accurate to the best of my knowledge.
3. Able to communicate and instruct
patient according to their age, maturity            
and comprehension ability. Signature Date
(Written/Electronic)
A B C D E F G H I ID #:      

This skills checklist has been reviewed

4. Able to provide a safe environment and approved by Nicole Bloxham, RN.
according to the specific needs of various
age groups.            
Signature Date
A B C D E F G H I (Written/Electronic)
ID #:      

Please return to: Northwest Nurse Staffing

Company, PA
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 PSYCHIATRIC KNOWLEDGE &
SKILLS CHECKLIST___________
ATTN: Records Dept.
Fax: (866) 352-4338

Email: records@nns-ic.com

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