Soliant.com Skills Self Assessment

Pharm Tech
Skills Self Assessment

This skills assessment is designed to determine your level of competency in the areas listed below. By completing this checklist to the best of your ability, you will help us match your skills and areas of interest with our available assignments. Please indicate your appropriate level for each category as well as the date last performed.

Traveler Name:
Traveler Email:
Recruiter Name:
Date:

COMPETENCY LEVELS	DATE LAST PERFORMED
1 = Functionally Independent	Within 6 Months
2 = Some Experience	6 mo. - 12 mo. ago
3 = Minor or No Experience	Over 1 year ago
	Not Performed / Never Worked

Skills	Competency Level	Date Last Performed
PRACTICE SETTING
Independent Community
Retail/Chain
Hospital Inpatient (HIP)
Hospital Outpatient (HOP)
Home Infusion/HomeHealth (HI)
Long Term Care
Mail Order
Other(list):

GENERAL SKILLS
Computer Skills
Prescription Data Entery
Creating New Patient Profiles
Call Physicians for Refill Authorization
Interpret Prescriptions for Accuracy
Prepare and Fill Prescriptions
Third Party Billing/Adjudication
Brand/Generic Equivalence Knowledge
Compounding/Oral Suspension Reconstitution
Cart Fill
Unit Dose Preparation
Proper Storage of Medications
Ordering/Inventory Control
Knowledge of Controlled Substances
Pseudoeph/Ephedrine, etc Laws/Regulations
Disposal of Hazardous Waste/Materials
Parenteral Product Preparation (IVs)
Pharmaceutical Calculations
Other(list):

AUTOMATION
Compounding Systems
Baxa Rapid Fill (ASF)
Baxa Repeater Pump
Baxa ExactaMIX
Baxter AUTOMIX/MICROMIX
Other(list):

Dispensing Systems
Pyxis
Omnicell
Parata RDS
Parata MAX or Mini
McKesson PACMED
McKesson MedCarousel
McKesson PROmanager
Other(list):

Tablet Counting System
Kirby Lester
TORBAL Rx Balances
Baker Cells
SOFTWARE SYSTEMS
Cerner
Epic
McKesson (Pharmserv, 3PM)
MEDITECH
Connexus
Nexgen
PDX
QS-1
EnterpriseRX
PROscript 2000
Other(list):

HIP/HI/IV EXPERIENCE
Aseptic Technique
Laminar Flow Hood
TPN Preparation
Chemotherapy Preparation
Antibiotic Preparation
CREDENTIALING/POSITIONS HELD (Current CPhT, Licensed/Registered by State, Staff Technician, Lead Technician, Senior Technician, etc.)
Please list :

NATIONAL PATIENT SAFETY GOALS
Accurate Patient Identification
Effective Communication
Infection Control
Universal Precautions
Patients In Isolation
Minimize Risk For All
Please list any additional skills:

Please list any additional training:

Please list any additional equipment:

Age Specific Competency

Please indicate the appropriate level for each category. When evaluating your competency level, please focus on the following guidelines:

Ability to ensure a safe and caring environment for the specific age groups indicated below.
Ability to communicate and instruct patients in the designated age groups.
Ability to evaluate age-appropriate behavior and skills.

Age Group	Competency Level	Date Last Performed
Newborn (birth-30 days)
Infant (30 days-1 yrs)
Toddler (1-3 yrs)
Preschooler (3-5 yrs)
School Age (5-12 yrs)
Adolescents (12-18 yrs)
Young Adults (18-39 yrs)
Middle Adults (39-64 yrs)
Older Adults (64 yrs +)

To the best of my knowledge, the information represented above is an accurate reflection of my skills and abilities, and I authorize Soliant Health to share the above skills checklist with its clients.