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 below to describe your experience/expertise in each area listed below.
| RADIATION THERAPY: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Skin Assessment |
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| Total Body Irradiation |
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| Side Effect Management |
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| External Radiotherapy |
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| Brachytherapy |
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| Radiation Safety Precautions |
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| Intraoperative Radiation |
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| ONCOLOGY PATIENT CARE: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Renal Failure |
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| Fever |
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| Pneumonia |
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| Cqrdiac Arrhymias |
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| Hypercalcemia |
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| Hyperkalemia |
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| Pancreatitis |
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| Pulmonary Embolism |
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| Bowel Obstruction |
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| Diabetes |
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| Pneumothorax |
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| Stress Fractures |
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| RespiratoryDistress |
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| Spinal Cord Compression |
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| GI Bleed |
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| Pleural Effusion |
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| Infection |
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| Hypokalemia |
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| DIC |
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| Atlelectasis |
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| Lymphedema |
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| VASCULAR DEVICES: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Flush Catheter |
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| Punctured Catheter |
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| Chemo Port |
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| Omega-Port |
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| S.E.A. Port |
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| Port-A-Cath |
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| Opti-Port |
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| PICC Lines |
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| Obtain Blood Specimens |
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| Line Insertion Assistance |
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| De-Clotting Ports |
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| Groshong Catheters |
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| Catheter Port |
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| Site Care |
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| Broviac Catheters |
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| Patient/Teaching |
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| Hickan Catheters |
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| CARE OF PATIENTS WITH: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Foley Catheter Irrigations |
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| CVP Line Insertion |
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| Jejunostomy Tubes |
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| Wound Care |
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| Colostomy Care |
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| TURP |
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| Reverse Isolation |
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| Liver Biopsy |
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| Platelet Precautions |
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| Accucheck |
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| NG Tube Insertion |
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| Suprapubic Catheter |
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| Ileostomy |
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| Thoracentesis |
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| Isolation |
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| Foley Catheter Irrigations |
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| Bone Marrow Biopsy |
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| Enterostomal Care |
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| Chest Tube Care |
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| Paracentesis |
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| Gastrostomy Tube |
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| Narcotic Infusion |
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| Hemodialysis |
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| Nephrostomy Tube |
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| Pain Management |
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| Pulse Oximetry |
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| Fistulas/Shunts |
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| Seizure Precautions |
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| Peritoneal Dialysis |
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| Nasotracheal Suctioning |
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| PCA Pumps |
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| CARDIOVASCULAR: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Hyperalimentation |
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| Peripheral Blood Stem Cells |
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| Packed RBC’s |
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| IV Fluid Hydration |
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| Venoclusive Disease |
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| Fresh Frozen Plasma |
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| Infections |
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| Pneumonitis |
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| Graft Rejection |
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| Platelets |
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| WBC/Lukocytes |
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| Blood /Byproducts |
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| Antivirals |
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| Donor Education |
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| Allogeneic BMT |
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| Antibiotics |
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| GVHD Graft |
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| Autologous BMT |
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| Antifungals |
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| Implantable Infusion Pumps |
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| Medtronic |
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| Infusaid |
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| Ambulatory Infusion Pumps |
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| Synchormed |
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| Cormed |
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| Pharmacia |
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| Auto Syringe |
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| Pancretec |
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| Patency Maintenance |
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| Patient Teaching |
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| PSYCHO & SOCIAL CARE: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Palliative Care |
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| Hospice Care |
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| Family Support |
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| Counseling/Death/Dying |
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| Identifying Support Groups |
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| Advance Directives |
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| Identifying Resources |
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| Health Care Proxy |
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| PHARMACOLOGY: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Floxuridine/FUDR |
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| Doxorubicin/Adrianycin |
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| Heparin/Coumadin |
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| Carmustine/BiCNU |
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| Dopamine |
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| Cistplatin |
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| Mitonycin/Mutanycin |
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| Dilantin |
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| Fluorouracil/-FU |
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| Usulfan/Myleran |
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| Neupogen/Epogen |
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| Hydroxyurea/Hydrea |
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| Corticosteroids |
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| Vincristine/Oncovin |
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| Methotrexate/Amethopterin |
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| Morphine |
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| Etoposide/VP-6- |
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| Cyclophosphamide/Cytoxan |
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| Decadron |
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| Belomycin/Blenoxane |
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| Vinblastine/Velban |
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| Melphalan/Alkeran |
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| IV Care/Skills |
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| Chemotherapy Adm |
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| IM/SQ |
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| IVPB |
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| IV Push/Intrathecal |
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| ONCOLOGY & GENERAL CARE: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Thrombocytopenia |
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| Stomatitis |
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| Hemorrhabe |
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| Oncology PCU |
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| Neuropathy |
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| Bone Marrow Transplant |
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| Death /Dying |
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| Venous Access Devices |
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| Electrolyte Imbalance |
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| Palliative/Hospice Care |
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| Neutropenia |
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| Pain Management |
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| Telemetry |
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| Nutritional Needs |
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| Immunosuppression |
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| IV Maintenance |
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| Septic Shock |
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| Vomiting/Diarrhea/Nausea |
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| Skin Care |
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| Blood/Blood Byproducts |
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| Normal Serum Labs Values |
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| Radiation Therapy |
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| Surgical Patient Care |
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| Chemotherapy Protocols |
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| Implantable Vascular Ports |
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| Patient Teaching |
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| Implantable Infusion Pumps |
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| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Infant (Birth - 1 year) |
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| Preschooler (ages 2-5 years) |
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| Childhood (ages 6-12 years) |
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| Adolescents (ages 13-21 years) |
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| Young Adults (ages 22-39 years) |
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| Adults (ages 40-64 years) |
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| Older Adults (ages 65-79 years) |
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| Elderly (ages 80+ years) |
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