Your name
Your Email
Last 4 Of SSN
Date
E-Signature
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.
Newborn/Neonate (Birth to 30 days): 0★★★★−
Infant (31 days to 12 months): 0★★★★−
Toddler/Preschool (13 months to 5 years): 0★★★★−
School Age Child/Adolescent (6 years to 18 years): 0★★★★−
Young Adults/Middle Adult (19 years to 64 years): 0★★★★−
Older Adults/Elderly (65+ years): 0★★★★−
Standard Precautions: 0★★★★−
Isolation Precautions: 0★★★★−
Care of Patient in Restraints: 0★★★★−
Patient/Family Education: 0★★★★−
Patient Identification: 0★★★★−
Specialty Beds: 0★★★★−
End of Life/Palliative Care: 0★★★★−
Collect Appropriate Data: 0★★★★−
Knowledge of current Joint Commission National: 0★★★★−
Acute Care/Hospital: 0★★★★−
SNF/Long Term Care: 0★★★★−
Managed Care: 0★★★★−
Home Health: 0★★★★−
Hospice: 0★★★★−
Outpatient: 0★★★★−
Physician Office: 0★★★★−
Understanding of health care economics and policies: 0★★★★−
Concepts of capital budgeting: 0★★★★−
Department/Unit budgeting: 0★★★★−
Recruitment techniques: 0★★★★−
Interviewing techniques: 0★★★★−
Labor laws pertaining to hiring: 0★★★★−
Orientation of new employees: 0★★★★−
Knowledge of quality improvement tools: 0★★★★−
Patient Safety: 0★★★★−
Workplace Safety: 0★★★★−
Promotion of interdepartmental communication: 0★★★★−
Performance management: 0★★★★−
Staff development: 0★★★★−
Coaching and mentoring: 0★★★★−
Project management: 0★★★★−
Business development: 0★★★★−
Developing strategic plans: 0★★★★−
Cultural competence: 0★★★★−
Ethical behavior and practice: 0★★★★−
Professional association involvement: 0★★★★−
Conflict management: 0★★★★−
Team dynamics: 0★★★★−
JCAHO standards: 0★★★★−
OSHA standards: 0★★★★−
Risk Management/Service Utilization: 0★★★★−
Local Department of Health: 0★★★★−
State Department of Health: 0★★★★−
Sitter services: 0★★★★−
Please list the EMR systems you have used:
Other Skills:
