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.
SKILL: Communication | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Organize written and oral communication in a logical manner |
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Question other health care professionals to collect pertinent patient information |
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Communicate appropriately with the level of understanding of one's audience |
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Use good listening skills in all aspects of job |
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Interested in improving self and asks questions |
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Other by site: |
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Other by site: |
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SKILL: Patient Interaction / Staff Relations | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Greets patient and introduces self |
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Puts others at ease |
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Interview patient or caregiver to collect pertinent patient information |
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Use different strategies for communicating with non-English speakers or patients who are impaired i.e. deaf, cognitively impaired, etc |
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Exhibit empathy and compassion |
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Cooperation / Diplomacy and Tact with Staff |
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Emotional Maturity to Function Under Stress |
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Appropriate Conversation with Staff/Patients |
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Use of Correct Terminology |
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Sensitivity to Patient Comfort |
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Other by site: |
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SKILL: Personal Characteristics | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Problem solve in the workplace to better a situation i.e. coworker conflict, workflow mechanics, etc. |
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Adaptable to change; industrious |
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Ability to learn and retain information |
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Sufficent speed in completing tasks |
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Ability to adapt to new procedures |
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Displays initiative |
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Demonstrate ethical behavior with emphasis on confidentiality, realization of professional liability, and importance of following protocol |
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Maintain emotional stability to withstand the stresses, uncertainties, and changing circumstances that characterize patient/client care responsibilities |
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Accept direction and guidance from a supervisor or faculty member |
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Understands that each facility has some procedures that may differ from others and easily adapts to yours |
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Arrives for shift on time / punctual |
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Undertaking of appropriate & additional duties |
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Maintains impeccable personal hygiene & professional personal appearance |
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Anticipates Doctor’s / Co-worker needs |
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Neatness in accomplishing work |
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Other by site: |
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SKILL: Essential Job Functions | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Collect pertinent patient information for use by the pharmacist from the chart or patient profile with efficiency and accuracy |
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Be able to locate specific information from a medical record, profile, or electronic medical device |
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Understand what is needed by the pharmacist to efficiently and accurately manage pharmacy services |
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Demonstrate proficiency with word processing and database software |
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Be able to use the internet, e-mail and computerized medication information databases |
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Follow an established procedure for purchasing and pharmaceuticals, devices and supplies |
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Understand, observe, and comply with State/Federal laws at practice site |
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Be able to compound a sterile and non-sterile product |
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Prepare an IV admixture |
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Observe or prepare a T.P.N. order |
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Suggest alternative avenues for procuring a product which is unavailable |
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Understand alternative avenues for pricing and products available |
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Know proper storage conditions for pharmaceutical items |
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Know how to return expired, damaged or recalled pharmaceuticals |
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Understand how to deter theft and/or medication diversion |
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Inventory and maintain records for controlled substances |
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Screen medication orders/prescriptions for completeness |
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Create new patient profile |
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Enter information accurately into computer to obtain label and MAR |
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Accurately prepare medication order/prescription |
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Know how to dispose of hazardous materials/waste |
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Know how to prepare and label repackaged products |
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Process reimbursement claim forms |
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Sterilize a laminar or horizontal air flow hood |
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Efficiently deliver the correct medication to the correct patient/representative |
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Know the Pertinent policies and procedures for distribution of medications/controlled substances |
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Know the facets of patient consultation a technician can/can’t perform |
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Know how to handle 3rd party rejection claims |
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Understand how to prevent and report medication errors |
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Be able to work a cash register |
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Reconstitute a granular antibiotic into suspension form |
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Know how to prepare, store and distribute investigational drug products |
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Know how to obtain technician licensure and certification |
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Determine patient eligibility and co-pay |
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Calibrate a device |
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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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