Learning and Development,

Departments & Programs,UW Health,Ambulatory Education,Ambulatory Orientation,Checklists - Core and Department Specific,Resources


Orthopedics - Departments & Programs, UW Health, Ambulatory Education, Ambulatory Orientation, Checklists - Core and Department Specific, Resources


ORTHOPEDICS - CLINICAL TRAINING CHECKLIST ----- This is due three months from hire date------

Employee Name: __________________________________ Employee Credentials:________ Hire Date: ____________

Clinic Location/ number: _______________________ Employee Number ________________________

*refer to appropriate UWMF policy *** N/A on checklist indicates that it is not indicated for the employee***
***Each area should either be discussed or observed by preceptor***

AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Employee is able to gather data relevant to the following:
Signs & Symptoms of:
Compartment syndrome ie: edema,
DVT ie: pain, redness, swelling, edema
Wound infection ie; redness, induration, swelling, fever, drainage
Delayed nonunion ie: motion at the fracture
Strains, sprains, fractures
Dislocations and subluxations
Herniated Disc ie: low back/sciatic pain
Osteomyelitis ie: swelling, fever, redness, weakness, fatigue

Types of Pain: Superficial, Referred, and Phantom (with expressions of pain)
History of Pain intensity (0-10 scale), onset, duration, medications, etc.

Able to gather data on patient ’s perception of problem
Able to elicit patient’s expectations in medical care
Able to determine patient’s knowledge level/deficit, ability to understand
Able to identify cultural practices related to care
Able to elicit information regarding relationships with significant others

Patient Education- Employee participates in patient/family teaching
Health Education - Employee demonstrates knowledge & can discuss with

Post op complications
Wound care*
Drain care

AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Pre op teaching related to specific surgery
Ace wrap
Clavicle immobilizer, Shoulder immobilizer
Knee immobilizer
Posterior mold
Finger splint, Traction splint
Velcro wrist splint, Air splints
Ring cutter
Buddy splinting

Is able to understand use terminology in musculoskeletal assessment:
abduction- away from midline, atrophy-wasting away, causalgia-burning,
circumduction-moving 360 θ, contracture-absence of motion in joints,
dorsiflexion–moving up, eversion–sole of foot facing away from the opposite foot,
flexion-decrease of the angle, kyphosis-convexity of thoracic column, lordosis-
concavity of vertebral column, subluxation- trauma to joint structure (see below) #

Provides URGENT Patient Care – Employee is able to:
Initiates AED Defibrillation (if indicated)*
Appropriately cares for patient in parking lot/front lobby requiring emergency

Initiate Emergency Protocols appropriately ( Emergency Procedures Manual)*
Appropriately cares for patient in cardiac arrest (until crash cart help arrives)*

Employee is able to perform Sterilization of Instruments/Autoclaving
Assures instrument cleaning and autoclaving is properly completed
Assures proper putting of instruments into sleeve protectors and marking of packs

Consults/referrals to other departments (nutrition) or specialists.
Understands that secretaries set up all outside consults
Demonstrate competence in counseling and provide appropriate resources
Smoking Cessation
Exercise prescription – referral to exercise Physiologist
Be able to speak with drug representatives
Fill out forms for ordering medications for those who need financial assistance

AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Employee is competent with Equipment/ Supplies
Assure all equipment/supplies are available based on patient needs
Assure all equipment functions before use
Assure all emergency equipment/supplies are current and available at all times
Demonstrate competence in the care of cast saw

Procedures- Demonstrate competence to assist/set-up/patient care/follow-up
Staple removal, suture removal, *
Incision and drainage, dressing changes
Pin removal, Nail Care (rarely done)
Assist with casting, cast removal*
Jones Dressing
Assist with injecting joint or Hematoma block

Proper and complete labeling of specimens and paperwork (in needed)

Diagnostic tests- Demonstrate competence to assist/set-up/patient care/follow-

Radiograph, CT, MRI, EMG’s, LESI, MRAs, Intra articular
Steroid Injections, Doppler ultrasound

Surgery: Employee understand that secretaries do the following:
Scheduling and Pre-authorizations
Different Surgery Packets, Patient education on surgery
Information required for the Surgery Packets

Administration of Medications – has general understanding of drug

Verbalizes appropriate dose, mechanism, side effects of the following

Analgesics: (pain) aspirin, anacin, ibuprofen, acetaminophen, ecotrin, excedrin,
Demerol, ketorolac, midol, morphine, percocet, vicodin)

Antibiotics: (infection) amoxicillin, ceftriaxone, cefazolin, bactracin ointment,
gentamicin, penicillin, tobramycin, vancomycin

Anti-pyretic: (fever) acetaminophen, ibuprofen, sumatriptin, dexamethasone
Anti-rejection: cyclosporine, Immunosuppression Prednisone
Nonsteroidals: Celebrex, Vioxx

Properly disposes of expired medications & unused or discarded or refused


I, _________________________________________ (employee name) have completed the Orthopedics Training Checklist and attest the
information is true and valid. I have demonstrated or discussed these skills and I am responsible for performing patient care as a Certified Medical
Assistant / Licensed Practical Nurse / Registered Nurse (circle one).

__________________________________________________ ___________________
Preceptor Date

____________________________________________________ ___________________
Supervisor Date

__________________________________________________ ___________________
Provider Date

Additional Preceptor Signatures/initials:
1. _________________________________________________
2. _________________________________________________
3. _________________________________________________
4. _________________________________________________

Initially Completed 8-14-03, Updated 8-2-05, 8/07, 9/2011, 3/2012, 8/2014, 3/2017

 Send the original signed Orthopedics Training Checklist to Clinical Staff Education – 1035.
 One copy of the signed Orthopedics Training Checklist should be placed in the clinic’s staff employee’s file, and a copy given to the

Core Curriculum for Orthopaedic Nursing (1996) National Association of Orthopaedic Nursing, Rutherford NJ.
Brener, T., Doyle, R.M. (Ed.). (2008). Nursing 2008 drug handbook. Philadelphia, PA: Lippincott Williams & Wilkins.
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby Elsevier.