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Occupational Therapy Skills Checklist | ||||||
| NAME | |||||||
| LAST 4 OF SSN | |||||||
| DATE | |||||||
| I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination. | |||||||
| 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. | |||||||
| Proficiency Scale: |
1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently |
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| Rating Stars (Click) | Work Settings | 1 | 2 | 3 | 4 | ||
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General acute care | ||||||
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Adult/adult ICU | ||||||
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Pediatrics/PICU | ||||||
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Children’s hospital | ||||||
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Hand therapy | ||||||
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Home health care | ||||||
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Outpatient neuro | ||||||
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Outpatient ortho | ||||||
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Psychiatric hospital | ||||||
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Rehabilitation hospital/inpatient rehabilitation unit | ||||||
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Skilled care facility | ||||||
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School setting | ||||||
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Early intervention | ||||||
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Subacute | ||||||
| Rating Stars (Click) | Orthopedics | 1 | 2 | 3 | 4 | ||
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Hand injury | ||||||
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Total joint replacement/upper extremities | ||||||
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Lower back/spinal surgeries | ||||||
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Arthritis programs | ||||||
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Soft tissue injuries | ||||||
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Knee injuries & total knee replacement | ||||||
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Hip fractures & total hip replacement | ||||||
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Mobilization techniques | ||||||
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Prosthetics/amputations | ||||||
| Rating Stars (Click) | Neurologic | 1 | 2 | 3 | 4 | ||
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Alzheimers/dementia | ||||||
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Degenerative diseases of the CNS | ||||||
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Multiple sclerosis | ||||||
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Parkinson’s disease | ||||||
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Spinal cord injury | ||||||
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Adaptive equipment | ||||||
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Neurodevelopmental testing (NDT) | ||||||
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Wheelchair evaluation | ||||||
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Stroke acute | ||||||
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Stroke rehabilitation | ||||||
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Functional splinting | ||||||
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Traumatic brain injury | ||||||
| Rating Stars (Click) | Pediatric Assessments | 1 | 2 | 3 | 4 | ||
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Neurodevelopmental testing | ||||||
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Developmental screening | ||||||
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Sensory-motor testing | ||||||
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Visual perceptual testing | ||||||
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Feeding/swallowing/oral motor | ||||||
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Seating & positioning assessment (i.e. w/c) | ||||||
| Rating Stars (Click) | Other Assessments | 1 | 2 | 3 | 4 | ||
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Physical capacity evaluation | ||||||
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Home assessments/home accessibility | ||||||
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Activities of daily living | ||||||
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Driving evaluation | ||||||
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Cognitive/perception | ||||||
| Rating Stars (Click) | Treatment Approaches | 1 | 2 | 3 | 4 | ||
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ADL | ||||||
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Cognitive retraining | ||||||
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Community re-entry | ||||||
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Energy conservation/work simplification techniques | ||||||
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Functional transfer training | ||||||
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Home safety | ||||||
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Lymphedema management | ||||||
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Orthotics/Prosthetics training | ||||||
| Rating Stars (Click) | Treatment Approaches - cont. | 1 | 2 | 3 | 4 | ||
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Patient, family & staff training | ||||||
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PNF | ||||||
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SI | ||||||
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Therapeutic exercises/activities | ||||||
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Work hardening | ||||||
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Splinting | ||||||
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Neurodevelopmental testing (NDT) | ||||||
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Incontinence management | ||||||
| Rating Stars (Click) | Modalities | 1 | 2 | 3 | 4 | ||
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Anodyne | ||||||
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Biofeedback | ||||||
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Electrical stimulation | ||||||
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Feeding techniques | ||||||
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Fluidotherapy | ||||||
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Oral motor facilities | ||||||
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Paraffin bath | ||||||
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TENS | ||||||
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Therapeutic pool | ||||||
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Ultrasound | ||||||
| Rating Stars (Click) | Prosthetics/Orthotics | 1 | 2 | 3 | 4 | ||
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UE prosthetics | ||||||
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Static splints | ||||||
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Dynamic splints | ||||||
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Serial casting | ||||||
| Rating Stars (Click) | Other | 1 | 2 | 3 | 4 | ||
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Burn management | ||||||
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Cardiac rehabilitation | ||||||
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Cognitive retraining | ||||||
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Computer skills | ||||||
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FIM scoring | ||||||
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Geriatrics | ||||||
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Group dynamics | ||||||
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IEP skills | ||||||
| Rating Stars (Click) | Other - cont. | 1 | 2 | 3 | 4 | ||
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Inservice education | ||||||
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Job task analysis | ||||||
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Therapeutic media | ||||||
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Knowledge of payment sources | ||||||
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Medicare | ||||||
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Medicaid | ||||||
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MDS | ||||||
| Rating Stars (Click) | General Skills | 1 | 2 | 3 | 4 | ||
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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 | ||||||
| Computerized Charting: | |||||||
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Cerner | ||||||
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EPIC | ||||||
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McKesson | ||||||
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Meditech | ||||||
| National Patient Safety Goals: | |||||||
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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 | ||||||
| Rating Stars (Click) | Age Specific Competencies | 1 | 2 | 3 | 4 | ||
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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) | ||||||
| Rating Stars (Click) | Age Specific Competencies - cont. | 1 | 2 | 3 | 4 | ||
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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) | ||||||
| Please list any Additional Skills: | |||||||
| 1 | |||||||
| 2 | |||||||
| 3 | |||||||
| 4 | |||||||
| Additional training: | |||||||
| 1 | |||||||
| 2 | |||||||
| 3 | |||||||
| 4 | |||||||
| Additional equipment: | |||||||
| 1 | |||||||
| 2 | |||||||
| 3 | |||||||
| 4 | |||||||