| Name |
|
| Date |
|
| Please choose your level of experience in each of the following. |
| |
| GENERAL SKILLS |
| Advanced directives |
|
| End of life care |
|
| Emergency codes |
|
| Disaster protocols |
|
| Universal precautions |
|
| Infection control |
|
| Blood Glucose Monitoring (BGM) |
|
| Insulin administration |
|
| Diabetes mellitus |
|
| Isolation |
|
| Airway management |
|
| Wound care/dressing changes |
|
| Minimize risk for falls |
|
| Patient family teaching |
|
| Restraints |
|
| O2 therapy and delivery |
|
| Cardiac arrest/CPR |
|
| Administration of blood/blood products |
|
| Management of fluid/electrolyte balance |
|
| Seizure precautions |
|
| NG tub insertion/maintenance |
|
| Intake & output |
|
| Oral/nasotracheal suctioning |
|
| Pulse oximetry |
|
| Venipuncture |
|
| Saline lock/peripheral intravenous insertion |
|
| Assessment of circulation/peripheral pulses |
|
| Foley catheter insertion/maintenance |
|
| |
|
| 2024 NATIONAL PATIENT SAFETY GOALS |
NPSG.01.01.01
• Identify patients correctly |
|
| • Use patients name and date of birth |
|
| • Make sure correct patient gets the correct medicine and treatment |
|
Improve staff communication
|
|
NPSG.02.03.01
Get important test results to the right staff person on time. |
|
Use medicines safely
|
|
NPSG.03.04.01
Before a proceedure, label medicines that are not labeled. For example, medicines in syringes, cups and basins. Do this in the area where medicines and supplies are set up. |
|
NPSG.03.05.01
Take extra care with patients who take medicines to thin their blood. |
|
NPSG.03.06.01
Record and pass along correct information about a patient’s medicines. Find out what medicines the patient is taking. Compare those medicines to new medicines given to the patient. Give the patient written information about the medicines they need to take. Tell the patient it is important to bring their up-to-date list of medicines every time they visit their doctor. |
|
| Use Alarms Safely |
|
NPSG.06.01.01
Make improvements to ensure that alarms on medical equipment are heard and responded to on time. |
|
| Prevent infection
|
|
NPSG.07.01.01
Use the hand cleaning guidelines from the Centers of Disease Control and Prevention or the World Health Organization. Set goals for improving hand cleaning |
|
| Identify patient safety risks |
|
NPSG.15.01.01
Reduce the risk for suicide. |
|
| Improve health care equity |
|
NPSG.16.01.01
Improving health care equity is a quality and patient safety priority. For example, health care disparities in the patient population are identified and a written plan describes ways to improve health care equity. |
|
| Prevent mistakes in surgery |
|
UP.01.01.01
Make sure that the correct surgery is done on the correct patient and at the correct place on the patient’s body. |
|
UP.01.02.01
Mark the correct place on the patients body where the surgery is to be done. |
|
UP.01.03.01
Pause before the surgery to make sure that a mistake is not being made. |
|
| |
| COMPUTERIZED CHARTING |
| Health Connect |
|
| Meditech |
|
| Cerner |
|
| McKesson |
|
| EPIC |
|
| Camis |
|
| Affinity |
|
| Wellsoft – ER |
|
| T–System – ER |
|
| Automated medication dispensing |
|
| Bar coding for medication administration |
|
| |
TREATMENT SETTINGS |
| Inpatient hospital psychiatric unit |
|
| Inpatient acute psychiatric facility |
|
| Chronic psychiatric facility |
|
| Outpatient clinic/community setting |
|
| Forensic unit (prison) |
|
| Eating disorder unit |
|
| Substance abuse/rehab unit |
|
| Locked unit/ward |
|
| Alzsheimers unit |
|
| |
|
PSYCHIATRIC |
|
Assessment |
|
| Admission |
|
| Initial nursing assessment/care plan |
|
| Mental status |
|
| Personality assessment |
|
| Initial treatment plan |
|
| Neurological vital signs |
|
| Nursing diagnoses |
|
| Nursing reassessment/care planning update |
|
| Suicide risk assessment |
|
Communication techniques |
|
| Active listening |
|
| Questioning |
|
| Restatement/reflection |
|
| Clarification |
|
| Focusing |
|
| Confronting |
|
| Summarizing |
|
| Limit setting |
|
| Positive reinforcement |
|
| Reality orientation |
|
Equipment/procedures |
|
| Active participation in multi-disciplinary staffing |
|
| Assist physician in administration of electroconvulsive therapy |
|
| Assist with lumbar puncture |
|
| Charge nurse experience |
|
| Charting |
|
| Behavioristic |
|
| Treatment/goal oriented |
|
| Discharge planning |
|
| Electroconvulsive therapy |
|
| Group therapy leader |
|
| Insertion/care of straight/Foley catheter |
|
| Female |
|
| Male |
|
| Management of drug/alcohol detox symptoms |
|
| Management of assaultive behavior |
|
| Multi-disciplinary treatment team participation |
|
| Participation in milieu therapy |
|
| Patient teaching |
|
| Psychiatric emergency response team |
|
| Psychiatric home health |
|
| Rapid tranquilization |
|
| Telephone crisis intervention |
|
| Therapeutic communication skills |
|
Care of patient with |
|
| Alcohol/drug dependency |
|
| Mood disorders |
|
| Electroconvulsive therapy |
|
| Hallucinations |
|
| Manic behavior |
|
| Med-psych patient |
|
| Organic disorder |
|
| Partial hospital/intensive outpatient program patient |
|
| Seclusion and restraints |
|
| Seizure disorder |
|
| Suicidal disorder |
|
| Tracheostomy |
|
Medications |
|
| Administration of oral psychotropic medications |
|
| Heparin |
|
| Intramuscular |
|
| Management of extrapyramidal symptoms (EPS) |
|
| Oral |
|
| Rectal |
|
| Sub-q |
|
| Unit dose |
|
| Z-technique |
|
| |
|
| AGE SPECIFIC COMPETENCIES |
| Adolescents (ages 12 – 21 years) |
|
| Young Adults (ages 21 – 39 years) |
|
| Adults (ages 40 – 64 years) |
|
| Older Adults (ages 65 – 79 years) |
|
| Elderly (ages 80+ years) |
|
| |
|
EXPERIENCE WITH AGE GROUPS |
|
| Able to adapt care to incorporate normal growth and development |
|
| Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level |
|
| Can ensure a safe environment reflecting specific needs of various age groups |
|
|
MY EXPERIENCE IS PRIMARILY IN: (Please indicate number of years) |
| Adolescent |
years |
| Adult |
years |
| Chemical |
years |
| Dependency/detox |
years |
| |
All the information on this page is true and accurate to the best of my knowledge. By completing this form, I am authorizing
Professional Staffing to release this information to the appropriate client facilities in consideration of employment as a registry, local traveler of full traveler. |
| |
Please Enter Your Name and Date and then click the Submit Button
|
