Licensed Nurse Competency Checklist Name:______________________________ Title: ___________________________ Hire Date:_______________ Method of Evaluation Evaluation (Check One) (Check One) D = Skills Demonstration O = Performance Observation Verification Skill Area W = Written Test Competency (Initials/Date) Needs V = Verbal Test Demonstrated/ Additional Meets Training D O W V Standards Admission History and Physical Nursing Assessment Adjustment Charting Admission Readmission Room Change Catheters Catheterization Female – Catheterization Male – Foley Insertion/Removal Change of Condition Assessment
Licensed Nurse Competency Checklist Name:______________________________ Title: ___________________________ Hire Date:_______________ Skill Area Evaluation (Check One) Method of Evaluation (Check One) D = Skills Demonstration O = Performance Observation W = Written Test V = Verbal Test Verification (Initials/Date) Competency Demonstrated/ Meets Standards Needs Additional Training D O W V Admission History and Physical Nursing Assessment Adjustment Charting Admission Readmission Room Change Catheters Catheterization – Female Catheterization – Male Foley Insertion/Removal Change of Condition Assessment
3b-Licensed-Nurse-Competency-Checklist.docx