Home Health – unizon

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Recruiter Email ID *

First Name *

Last Name *

Phone Number *

Today's Date *

Your Email Address *

GENERAL SKILLS:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Advanced directives *

Patient / family teaching *

Lift / transfer devices *

Specialty beds *

Restrictive devices (restraints) *

End of life care / palliative care *

Skin / wound assessment & care *

Diabetic care & education *

Blood Glucose Monitoring (BGM) *

General nursing assessment *

Recognizing failure to thrive across the lifespan *

Monitoring of vital signs *

Monitoring of intake / output *

Monitoring of weight *

Cardiac / respiratory arrest / CPR adult *

Cardiac / respiratory arrest / CPR pediatric or infant *

Documentation of skilled care (written) or computerized *

Medicare 485 / 486 forms *

National Patient Safety Goals *

Accurate patient identification *

Effective communication *

Interpretation & communication of lab values *

Medication administration *

Medication reconciliation *

Anticoagulation therapy *

Pain assessment & management *

Infection control (nosocomial / community-acquired) *

Anti-infective therapy (antibiotics, antivirals, antifungals) *

Universal precautions *

Awareness of HCAHPS *

General Skills - cont. Experience *

Isolation *

Minimize risk falls *

Prevention of pressure ulcers *

RESPIRATORY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Assessment / auscultation of lung sounds *

Incentive spirometry *

Principles of chest percussion *

Establishing an airway *

THERAPY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Starting & maintaining peripheral IVs *

Blood draw: venous *

Central line care (includes PICC / Groshong / Hickman) *

Blood draw: central line *

Care & management of ports *

Care & management of nonvascular devices (epidural, intrathecal) *

TPN & lipids *

Administration of blood and blood products *

Administration of chemotherapy *

Monitoring of chemotherapy (does not initiate) *

Infusion pumps *

CARDIAC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Cardiovascular assessment *

Clinical identification of dysrhythmias (AP check for rate & rhythm) *

CARE OF PATIENTS WITH:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Coronary Artery Disease (CAD) *

Acute MI *

Post Coronary Artery Bypass Graft (CABG) / valve *

CHF *

Aneurysm (thoracic or abdominal) *

Pre-post surgery *

MEDICATION ADMINISTRATION / PATIENT TEACHING:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Antidysrhythmics (i.e., betablockers, calcium channel blockers & cardiac glycosides) *

Antihypertensives *

Vasoactive drugs (NTG) *

Diuretics (i.e., lasix, dyazide) *

RESPIRATORY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Assessment / auscultation of lung sounds *

Incentive spirometry *

Principles of chest percussion *

Establishing an airway *

RESPIRATORY EXPERIENCE - CARE OF PATIENT WITH:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Asthma *

COPD *

Pulmonary hypertension *

Tracheostomy *

Lung cancer *

Pulmonary emboli *

MEDICATION ADMINISTRATION / PATIENT TEACHING:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Aminophylline *

Bronchodilators (Bronkosol / Brethine) *

Expectorants *

Inhaled medications (proventil / anticholinergics / steroids / mucolytics) *

NEUROLOGY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Assessment of neuro signs *

Seizure precautions *

CARE OF PATIENT WITH:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Coma *

Cerebral tumors *

Seizure activity *

Spinal cord injury / paralysis (para / quad) *

TBI (Traumatic Brain Injury) *

TIA’s *

Stroke (CVA) hemiparesis *

Alzheimer’s Disease *

Meningitis *

Multiple sclerosis *

Parkinson’s disease *

ALS (Amyotrophic Lateral Sclerosis) *

MEDICATION ADMINISTRATION / PATIENT TEACHING:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Corticosteroids *

Anticonvulsant *

MAOIs *

Antidyskinetics *

Skeletal muscle relaxants *

Dopamine (blockers & stimulants) *

GI / GU EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

NG tube *

Long term feeding tube (Keofeed, Dobhoff) *

PEG / gastrostomy tube *

Tube feeding *

Drainage tubes (surgical & non-surgical) *

G.I. bleed *

Colostomy / ileostomy care *

Ileal conduit *

G.U. irrigations *

Suprapubic catheter *

CARE OF PATIENTS WITH:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Shunts & fistulas *

Straight catheterization *

Self catheterization *

Incontinence *

Peritoneal dialysis *

Hemodialysis *

GYNECOLOGY EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Endometriosis *

Self breast exam *

Mastectomy *

Hysterectomy *

ORTHOPEDIC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Total joint replacements (knee / hip / shoulder) *

Crutch walking *

Assistive devices *

Arthroscopy / arthrotomy *

TENS unit *

CARE OF PATIENT WITH:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Arthritis *

Amputation *

Casts *

Fractures *

MATERNAL - CHILD CARE EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Assessment & care of complicated pregnancy *

Breast feeding *

Homecare of postpartum mother *

Healthy baby *

NEWBORN CARE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Bulb suctioning *

NEWBORN CARE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Cord & circumcision care *

Phototherapy *

NG feedings *

PEDIATRICS:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Medication calculation for pedi dosing *

Use of croup tent *

Oxyhood *

CARE OF PEDIATRIC PATIENT WITH:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Asthma *

Bone marrow transplant *

Bronco-pulmonary dysplasia *

Cardiac surgery *

Cystic fibrosis *

Epiglottiditis *

Near drowning *

Overdose / poison ingestion *

Post harrington rod insertion *

Respiratory Distress Syndrome (RDS) *

Reye’s syndrome *

Sickle cell disease *

Spina bifida *

USE OF EQUIPMENT FOR ALL AGE GROUPS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Cardiac monitors *

Wound VAC *

Apnea monitors *

O2 administration (NC / mask) *

Ultrasonic nebulizer *

Ventilators *

SOFTWARE PROGRAMS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

MeDecision *

TILE *

OASIS *

AGE-SPECIFIC COMPETENCIES EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

Limited or no experience
Experienced, but may need review or supervision
Able to function independently *

Newborn / neonate (birth-30 days) *

Infant (31 days-1 year) *

Toddler (ages 2-3 years) *

Preschool (ages 4-5 years) *

School age (ages 6-12 years) *

Adolescent (ages 13-21 years) *

Young adult (ages 22-39 years) *

Adult (ages 40-64 years) *

Older adult (ages 65-79 years) *

Elderly (ages 80+ years) *