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.
| Work Settings | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Acute care |
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| Children’s hospital |
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| Daily treatment center |
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| Home health care |
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| Inpatient acute rehab |
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| Neonatal intensive care |
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| Outpatient/outpatient community re-entry |
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| Pediatrics |
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| Psychiatric hospital |
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| Private practice |
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| School setting |
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| Early intervention |
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| Skilled nursing facility |
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| Patient Populations | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Geriatrics |
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| Hearing impaired |
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| Learning disabilities |
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| Pediatrics/school age |
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| Progressive neurologic disease |
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| Trachs/ventilators |
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| Transient Ischemic Attach (TIA) |
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| Traumatic brain injury |
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| Voice/laryngectomy |
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| Assessment Tools | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Boston assessment of severe aphasia |
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| Boston diagnostic aphasia examination |
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| Minnesota test for differential diagnosis of aphasia |
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| Informal testing |
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| Porch index of communicative abilities |
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| Reading comprehension battery for aphasia |
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| Ross information processing assessment-geriatric |
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| Western aphasia battery |
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| Bedside swallow evaluation |
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| Blue dye test |
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| Cervical auscultation |
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| Fiber endoscopic evaluation study |
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| Modified barium swallow study |
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| Rehab Institute of Chicago evaluation of communication |
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| Augmentative devices |
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| Pure tone screening |
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| Types of Disorders | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Aphasia |
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| Apraxia |
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| Autism |
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| Cleft palate |
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| CVA/stroke |
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| Fluency |
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| Dementia/alzheimers |
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| Dysarthria |
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| Dysphagia |
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| Hearing loss |
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| Learning disabilities |
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| Traumatic brain injury |
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| Treatment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Augmentative devices |
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| Behavior modification |
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| Cognitive training |
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| Community re-entry |
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| Computer |
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| Co-treatment |
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| Treatment - cont. | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Group |
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| Individual |
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| Safety awareness |
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| Total communication |
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| Vital stimulation |
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| Dysphagia across the age-spectrum |
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| Regulations | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| FIMS |
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| Medi-Cal |
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| Medicare |
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| Omnibus budget reconciliation |
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| RUG levels |
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| General Skills | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Patient/family teaching |
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| Patients in isolation |
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| Patients in restraints |
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| Initial evaluation |
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| Lift/transfer devices |
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| Specialty beds |
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| End of life care/palliative care |
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| Cerner |
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| EPIC |
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| McKesson |
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| Meditech |
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| Accurate patient identification |
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| Effective communication |
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| Pain assessment & management |
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| Infection control |
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| Universal precautions |
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| Care of patients in isolation |
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| Minimize risk of falls |
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| Prevention of pressure ulcers |
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| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Infant (birth to 1 year) |
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| Toddler (ages 1-3 years) |
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| Preschooler (ages 3-5 years) |
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| Childhood (ages 6-12 years) |
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| Adolescents (ages 12-21 years) |
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| Young Adults (ages 21-39 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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