Soliant.com Skills Self Assessment

Oncology
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

Please check appropriate box: RN LPN
Skills	Competency Level	Date Last Performed
CARE OF PATIENTS
RECEIVING CHEMOTHERAPY
Follow protocols
Patient teaching
Check dosage
Evaluation of lab results
ADMINISTRATION OF CHEMOTHERAPY
Oral
IVBP and Continuous Infusion
IV Push
Subcutaneous
Intramuscular
Intrathecal
Intraperitoneal
Intrapleural
Intravesicular
Intra-arterial
Care of patient with extravasation
Handling body fluids and cytotoxic agents
Manage cytotoxic spills
RECEIVING RADIATION THERAPY
Brachytherapy
Nonsealed radioactive therapy
Intraoperative radiotherapy
External radiotherapy
Total body radiation
RECEIVING BONE MARROW TRANSPLANTATION
Peripheral blood stem cells
Autologous BMT
Allogenic BMT
Managing complications
Universal precautions
Reverse Isolation techniques
POST ONCOLOGIC SURGERY
Chest tubes
Feeding tubes
Gastrointestinal drainage tubes
Ostomy Care
Reconstructive surgery
Wound drains and tubes
Dressing changes
Patient teaching
PAIN MANAGEMENT
Epidural medication
Oral, time-released agents
IV push narcaotics
Continuous narcotic infusion
Transdermal agents
Adjuvant medications
PCA pump
ONCOLOGIC EMERGENCIES
Anaphylaxis
Capillary Leak Syndrome
DIC
Disseminated Intravascular Coagulation
Fever
Hemorrhage
Hypercalcemia
Hypokalemia
Septic shock
Superior Vena Cava Symdrome
Syndrome of Inappropriate Antidiuretic Hormone - SIADH
Tumor Lysis Syndrome
PSYCHOLOGICAL CARE
Advance directives
Hospice Care
Patient goal setting
Patient teaching
Resouce, support groups for patients and families
ACCESS DEVICES - PORTS
Hickman - Broviac
Quinton
Groshong
PICC lines
Flush lumens and changing caps
Declot occluded ports
Port-o-cath
Opti-port
Chemoport
S.E.A. Port
Flush catheter
Obtain blood specimens
Patient teaching
ONCOLOGIC PROCEDURES
ASSISTING WITH
Bone marrow biopsy
Central line placement
Chest tube insertion
Liver biopsy
Paracentesis
Thoracentesis
Please list any licenses or certifications held and when they expire:

Please list any area of competence (techniques, procedures, technologies, skills, etc.) where you would like to pursue additional training in order to enhance the level of care, treatment, or services to the population(s) that you serve:

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.