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
ADMIT / ORIENT VOLUNTARY CLIENTS
ADMIT / ORIENT INVOLUNTARY CLIENTS
INITIAL COMPREHENSIVE ASSESSMENT
INITIAL FOCUSED ASSESSMENT
INITIAL SCREENING ASSESSMENT
REASSESSMENT / UPDATE CARE PLAN
MULTI-DISCIPLINARY PLANNING
SUPERVISE UNLICENSED PERSONNEL
ADMIN / MONITOR TUBE FEEDINGS
INSERT / CARE OF FOLEY CATHETER
ASSIST WITH LUMBAR PUNCTURE
PARANOID PSYCHOTIC DISORDER
CATATONIC PSYCHOTIC DISORDER
SUICIDAL IDEATION / ATTEMPTS
OBSESSIVE / COMPULSIVE DISORDER
DISSOCIATIVE IDENTITY DISORDER
SURVIVOR OF ABUSE / VIOLENCE
POST TRAUMATIC STRESS DISORDER
SOMATOFORM DISORDERS (PAIN ETC.)
CARE OF DEVELOPMENTAL / AUTISTIC DISORDERS
DEVELOPMENTAL / AUTISTIC DISORDERS
CLUSTER A - PARANOID / SCHIZOID
CLUSTER B - ANTISOCIAL / BORDERLINE
CLUSTER C - ANXIOUS / FEARFUL
SUBSTANCE RELATED DISORDERS
INTERVENTIONS / THERAPIES
THERAPEUTIC COMMUNICATION
EDUCATION OR VOCATIONAL TRAINING
ELECTROCONVULSIVE THERAPY
EXPRESSIVE THERAPY (ART, MOVEMENT)
ADMINISTER PO MEDICATIONS
ADMINISTER RECTAL MEDICATIONS
USE OF HEPARIN / SALINE LOCKS
ADMINISTER IV MEDICATIONS
ADMIN OF HYPERALIMENTATION
ADMIN OF BLOOD / BLOOD PRODUCTS
DISCONTINUE PERIPHERAL IVS
PAIN ASSESSMENT / MANAGEMENT
ANTIDEPRESSANTS / MOOD ELEVATORS
ANTICHOLINERGICS / ANTIPARKINSONS
MEDS SIDE EFFECTS - RECOGNITION AND MANAGEMENT
HYPOTENSION / ORTHOSTATIC
AKATHISIA (MOTOR RESTLESSNESS)
NEUROLEPTIC MALIGNANT SYNDROME
INFANT (30 DAYS - 1 YEAR)
PRESCHOOLER (3 - 5 YEARS)
SCHOOL AGE (5 - 12 YEARS)
ADOLESCENTS (12 - 18 YEARS)
YOUNG ADULTS (18 - 39 YEARS)
MIDDLE ADULTS (39 - 64 YEARS)