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
Practice Settings/Experience
Correctional Facility (Jail)
Pharmacy Benefits Management (PBM)
Psychiatric Patient Management
Pharmacy Software Systems
Baxter– AUTOMIX Compounder
Baxter– MICROMIX Compounder
McKesson– IntelliShelf-Rx
PharmASSIST– SmartCabinet
Hormone Replacement Therapy
Clinical and Job Related Experience
Computerized Physician Order Entry
Drug Rehabilitation Programs
Enteral Nutrition Products
Hyperalimentation Calculation
Infusion Pumps and Systems
Neonatal Intensive Care (NICU)
OTC selection and recommendations
P&T committee participant
Age Specific Competencies
Preschooler (ages 2-5 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)
Pharmacokinetic Dosing of