Instructions: This checklist is
meant to serve as a general guideline for our client facilities as to the
level of your skills within your nursing specialty. Please use the scale
(PROFICIENCY)
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
(FREQUENCY)
1 = Never performed observed only
2 = Less than 6 times per year
3 = 1-2 times per month
4 = Daily or Weekly
PROFICIENCY / FREQUENCY
PROFICIENCY
FREQUENCY
Medical Records - Maintenance
Electronic Medical Records - Entry
Electronic Medical Records - Maintenance
Gathers data and runs reports
Patient Files - Set up, report and record
Completion and filing/distribution of reports
Schedules appointments/tests
Takes, distributes and prioritizes messages
Assists physicians with procedures
Prepares patients for appointments and exams
Gathers patient history and VS
Gives injections as directed
Performs phlebotomy skills
Completes specimen testing, i.e. glucose, strep, mono, flu
Prepares and maintains supplies and equipment
Knows utilization of patient care equipment/instruments
Develops patient, physician and peer relationships
Maintains/protects patient confidentiality
Adheres to facility policies and procedures
Adheres to OSHA, HIPPA, legal and ethical guidelines
Adheres to quality protocol and standards
Attends and participates in required meetings
Schedules appointments, tests and treatments
Responds to emergencies in a calm organized manner
Understands/follows the reporting process according to the chain of command
Age Specific Competencies
Newborn (birth to 30 days)
Infant (31 days to 1 year)
Preschooler (ages 4-5 years)
Childhood (ages 6-12 years)
Adolescents (ages 13-21 years)
Young Adults (ages 22-39 years)
Adults (ages 40-64 years)
Older Adults (ages 65 -79 years)