| Skills Checklist
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > Middle Adults (39 - 64 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > Young Adults (18 - 39 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > Adolescents (12 - 18 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > School Age Children (5 - 12 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > Preschooler (3 - 5 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > Toddler (1 - 3 years) > No
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > Infant (30 days - 1 year) > No
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > Newborn / neonate (birth - 30 days) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > Middle Adults (39 - 64 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > Young Adults (18 - 39 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > Adolescents (12 - 18 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > School Age Children (5 - 12 years) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > Preschooler (3 - 5 years) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > Toddler (1 - 3 years) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > Infant (30 days - 1 year) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > Newborn / neonate (birth - 30 days) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > Middle Adults (39 - 64 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > Young Adults (18 - 39 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > Adolescents (12 - 18 years) > Yes
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > School Age Children (5 - 12 years) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > Preschooler (3 - 5 years) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > Toddler (1 - 3 years) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > Infant (30 days - 1 year) > No
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > Newborn / neonate (birth - 30 days) > No
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| INFECTION CONTROL > Disposal of Hazardous Waste > No Experience (theory only)
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| INFECTION CONTROL > Bloodbourne Pathogens > No Experience (theory only)
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| INFECTION CONTROL > TB Precautions > No Experience (theory only)
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| INFECTION CONTROL > Universal Precautions > No Experience (theory only)
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| OTHER > Positioning > No Experience (theory only)
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| OTHER > Postural Drainage > No Experience (theory only)
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| OTHER > Breathing Exercises > No Experience (theory only)
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| OTHER > Cardiopulmonary Conditioning > No Experience (theory only)
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| OTHER > Pulmonary Physical Therapy > No Experience (theory only)
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| OTHER > Back Protection > No Experience (theory only)
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| OTHER > Proper Posture > No Experience (theory only)
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| ADMINISTER > Paraffin Wax Dip > No Experience (theory only)
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| ADMINISTER > Ultrasound > Expert (competent to supervise)
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| ADMINISTER > Electrostimulation > Expert (competent to supervise)
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| ADMINISTER > TNS Setting > Expert (competent to supervise)
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| ADMINISTER > Cold > Expert (competent to supervise)
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| ADMINISTER > Heat > Expert (competent to supervise)
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| EXERCISE > Tactile Stimulation > Expert (competent to supervise)
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| EXERCISE > Muscle Re-Education > No Experience (theory only)
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| EXERCISE > Home Program > No Experience (theory only)
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| EXERCISE > Balance > No Experience (theory only)
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| EXERCISE > Pre-Gait Coordination > No Experience (theory only)
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| EXERCISE > PNF > No Experience (theory only)
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| EXERCISE > Mobilization > No Experience (theory only)
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| EXERCISE > Resistive > No Experience (theory only)
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| EXERCISE > Active Assist > Somewhat Experienced (performs infrequently)
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| EXERCISE > Active > Very Experienced (performs frequently)
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| EXERCISE > Passive > Very Experienced (performs frequently)
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| TRANSFERS > With Hemovac > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Rapid tranquilization > No Experience (theory only)
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| TRANSFERS > Hoyer > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Psychiatric home health > No Experience (theory only)
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| TRANSFERS > Commode/Toilet > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Psychiatric emergency response team > No Experience (theory only)
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| TRANSFERS > Tub/Shower > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Patient teaching > No Experience (theory only)
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| TRANSFERS > Low Surfaces > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Participation in milieu therapy > No Experience (theory only)
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| TRANSFERS > W/C > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Oro-naso-pharynx suctioning > No Experience (theory only)
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| TRANSFERS > Chair > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > O2 therapy & medication delivery systems > Trach collar > No Experience (theory only)
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| TRANSFERS > Elevated Surfaces > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > O2 therapy & medication delivery systems > Portable O2 tank > No Experience (theory only)
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| TRANSFERS > Bed > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > O2 therapy & medication delivery systems > Nasal cannula > No Experience (theory only)
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| EXPERIENCE WITH AGE GROUPS > Able to ensure a safe environment reflecting specific needs of various age groups. > Older Adults (64 + ) > Yes
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| BED MOBILITY > Prone > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > O2 therapy & medication delivery systems > Inhalers > No Experience (theory only)
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| BED MOBILITY > Supine To/From Sit > Very Experienced (performs frequently)
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| PSYCHIATRIC > Equipment and Procedures > O2 therapy & medication delivery systems > Face masks > No Experience (theory only)
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| BED MOBILITY > Scoot Supine > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > O2 therapy & medication delivery systems > External CPAP > No Experience (theory only)
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| BED MOBILITY > Rolling > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > O2 therapy & medication delivery systems > Bag and mask > No Experience (theory only)
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| GAIT TRAINING > Measuring Endurance > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Multi-disciplinary treatment team participation > No Experience (theory only)
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| GAIT TRAINING > Measuring Distance > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Management of assaultive behavior > No Experience (theory only)
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| GAIT TRAINING > Wt. Bearing > Experienced (can function independently)
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| PSYCHIATRIC > Equipment and Procedures > Management of drug/alcohol detox symptoms > No Experience (theory only)
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| GAIT TRAINING > Level of Assistance > Experienced (can function independently)
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| PSYCHIATRIC > Equipment and Procedures > Insertion & care of straight and Foley catheter > Male > No Experience (theory only)
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| GAIT TRAINING > Stairs > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Insertion & care of straight and Foley catheter > Female > No Experience (theory only)
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| EXPERIENCE WITH AGE GROUPS > Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level > Older Adults (64 + ) > Yes
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| GAIT TRAINING > Ramps > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Group therapy leader > No Experience (theory only)
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| GAIT TRAINING > Uneven Surfaces > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Electroconvulsive therapy > No Experience (theory only)
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| GAIT TRAINING > Even Surfaces > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Discharge planning > No Experience (theory only)
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| GAIT TRAINING > Gait Belt > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Charting > Treatment / goal oriented > Very Experienced (performs frequently)
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| GAIT TRAINING > Prosthesis > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Charting > Behavioristic > No Experience (theory only)
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| GAIT TRAINING > Str. Cane > Very Experienced (performs frequently)
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| PSYCHIATRIC > Equipment and Procedures > Charge nurse experience > No Experience (theory only)
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| GAIT TRAINING > Quad Cane > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Cardiopulmonary resuscitation > No Experience (theory only)
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| GAIT TRAINING > Crutches > Somewhat Experienced (performs infrequently)
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| PSYCHIATRIC > Equipment and Procedures > Assist with lumbar puncture > No Experience (theory only)
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| GAIT TRAINING > O2 > No Experience (theory only)
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| PSYCHIATRIC > Equipment and Procedures > Assist physician in administration of electroconvulsive therapy > No Experience (theory only)
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| EXPERIENCE WITH AGE GROUPS > Able to adapt care to incorporate normal growth and development > Older Adults (64 + ) > Yes
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| GAIT TRAINING > Manual Assist > Very Experienced (performs frequently)
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| PSYCHIATRIC > Equipment and Procedures > Active participation in multi-disciplinary staffing > No Experience (theory only)
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| GAIT TRAINING > Orthosis > No Experience (theory only)
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| PSYCHIATRIC > Assessment > Suicide risk assessment > No Experience (theory only)
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| GAIT TRAINING > Hemi Walker/3 Point Cane > No Experience (theory only)
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| PSYCHIATRIC > Assessment > Nursing reassessment and care planning update > No Experience (theory only)
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| GAIT TRAINING > Walker (PU/FW) > No Experience (theory only)
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| PSYCHIATRIC > Assessment > Nursing diagnoses > No Experience (theory only)
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| DOCUMENTATION > Discharge Summary > No Experience (theory only)
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| PSYCHIATRIC > Assessment > Neurological vital signs > No Experience (theory only)
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| DOCUMENTATION > Multidisciplinary Team Case Conference Note > No Experience (theory only)
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| PSYCHIATRIC > Assessment > Initial treatment plan > No Experience (theory only)
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| DOCUMENTATION > Therapy Care Plan > Experienced (can function independently)
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| PSYCHIATRIC > Assessment > Initial nursing assessment and care plan > No Experience (theory only)
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| DOCUMENTATION > Therapy Assessment > Experienced (can function independently)
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| PRIMARY EXPERIENCE > Physical Therapy > Years > 0-1
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| PSYCHIATRIC > Assessment > Admission > No Experience (theory only)
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