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
                                            
                                         
                                        
                                                                                    
                                                                                                                                        
                                                    
                                                        Organize written and oral communication in a logical manner
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Question other health care professionals to collect pertinent patient information
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Communicate appropriately with the level of understanding of one's audience
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Use good listening skills in all aspects of job
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Interested in improving self and asks questions
                                                    
                                                    
                                                    
                                                 
                                                                                                                                
                                                
                                                    SKILL: Patient Interaction / Staff Relations
                                                
                                                
                                                
                                                
                                                
                                             
                                                                                                                                        
                                                    
                                                        Greets patient and introduces self
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                                                                                                        
                                                    
                                                        Interview patient or caregiver to collect pertinent patient information
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Use different strategies for communicating with non-English speakers or patients who are impaired i.e. deaf, cognitively impaired, etc
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Exhibit empathy and compassion
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Cooperation / Diplomacy and Tact with Staff
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Emotional Maturity to Function Under Stress
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Appropriate Conversation with Staff/Patients
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Use of Correct Terminology
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Sensitivity to Patient Comfort
                                                    
                                                    
                                                    
                                                 
                                                                                                                                
                                                
                                                    SKILL: Personal Characteristics
                                                
                                                
                                                
                                                
                                                
                                             
                                                                                                                                        
                                                    
                                                        Problem solve in the workplace to better a situation i.e. coworker conflict, workflow mechanics, etc.
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Adaptable to change; industrious
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Ability to learn and retain information
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Sufficient speed in completing tasks
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Ability to adapt to new procedures
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                                                                                                        
                                                    
                                                        Demonstrate ethical behavior with emphasis on confidentiality, realization of professional liability, and importance of following protocol
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Maintain emotional stability to withstand the stresses, uncertainties, and changing circumstances that characterize patient/client care responsibilities
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Accept direction and guidance from a supervisor or faculty member
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Understands that each facility has some procedures that may differ from others and easily adapts to yours
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Arrives for shift on time / punctual
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Undertaking of appropriate & additional duties
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Maintains impeccable personal hygiene & professional personal appearance
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Anticipates Doctor’s / Co-worker needs
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Neatness in accomplishing work
                                                    
                                                    
                                                    
                                                 
                                                                                                                                
                                                
                                                    SKILL: Essential Job Functions
                                                
                                                
                                                
                                                
                                                
                                             
                                                                                                                                        
                                                    
                                                        Collect pertinent patient information for use by the pharmacist from the chart or patient profile with efficiency and accuracy
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Be able to locate specific information from a medical record, profile, or electronic medical device
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Understand what is needed by the pharmacist to efficiently and accurately manage pharmacy services
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Demonstrate proficiency with word processing and database software
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Be able to use the internet, e-mail and computerized medication information databases
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Follow an established procedure for purchasing and pharmaceuticals, devices and supplies
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Understand, observe, and comply with State/Federal laws at practice site
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Be able to compound a sterile and non-sterile product
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                                                                                                        
                                                    
                                                        Observe or prepare a T.P.N. order
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Suggest alternative avenues for procuring a product which is unavailable
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Understand alternative avenues for pricing and products available
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know proper storage conditions for pharmaceutical items
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know how to return expired, damaged or recalled pharmaceuticals
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Understand how to deter theft and/or medication diversion
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Inventory and maintain records for controlled substances
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Screen medication orders/prescriptions for completeness
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Create new patient profile
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Enter information accurately into computer to obtain label and MAR
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Accurately prepare medication order/prescription
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know how to dispose of hazardous materials/waste
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know how to prepare and label repackaged products
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Process reimbursement claim forms
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Sterilize a laminar or horizontal air flow hood
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Efficiently deliver the correct medication to the correct patient/representative
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know the Pertinent policies and procedures for distribution of medications/controlled substances
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know the facets of patient consultation a technician can/can’t perform
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know how to handle 3rd party rejection claims
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Understand how to prevent and report medication errors
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Be able to work a cash register
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Reconstitute a granular antibiotic into suspension form
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know how to prepare, store and distribute investigational drug products
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Know how to obtain technician licensure and certification
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                    
                                                        Determine patient eligibility and co-pay
                                                    
                                                    
                                                    
                                                 
                                                                                                                                        
                                                                                                                                
                                                
                                                    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)