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
Working with patients in isolation
Working with patients in restraints
End of life care/palliative care
Knowledge of "Do Not Use Abbreviations"
Do you have charge/supervisor experience?
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores
Durable Medical Equipment (DME)
Understanding of health care economics and health care policies as it applies to delivery of patient care
Concepts of capital budgeting
Department/unit budgeting
Labor Laws pertaining to hiring
Orientation of new employees
Knowledge of quality improvement/performance improvement tools
Promotion of interdepartmental communication
Developing Strategic plans
Developing operational plans
Personal growth and development
Ethical behavior and practice
Professional association involvement
Risk Management/Service Utilization
Local Department of Health
State Department of Health
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)