CNA Skills Checklist - DOC by QY2HZe7k

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									  MSI HEALTH INTERNATIONAL.
                                                       P.C.A. / C.N.A. SKILLS CHECKLIST
  The following checklist is used to assess your experience and skills. Please provide a self-assessment of your skills using the following
  guidelines: (MARK WITH AN “X”)
  1 - No experience                                                                          4 - Experienced and able to perform independently
  2 - Require training                                                                       5 - Able to teach and supervise
  3 - Have performed this task and able to perform without supervision

  I understand that the information provided in this application is true to the best of my knowledge. I authorize the release of the information in this document to Master
  Staffing, Inc. and the facilities where I may be employed.


  Name -                             Date -


                     MEDICAL TERMINOLOGY                                                     Endocrine

                                                   1       2      3      4      5            Sensory

Surgical Procedures                                                                                                   PSYCHOLOGICAL

Diagnostic Procedures                                                                    Meaning of self worth

Medical Procedures                                                                       Human behavior

Common diseases and pathology                                                            Social needs

Spelling and pronunciation                                                               Emotional behavior

                 ANATOMY AND PHYSIOLOGY                                                  Developmental stages

Positions and directions                                                                 Cultural influences on behavior

Body planes                                                                              Defense mechanisms

Common diseases and pathology                                                                                       PROFESSIONALISM

           Systems (structure, function, related disease):                               Accepts responsibility for own
                                                                                         actions
   Integumentary                                                                         Knows and performs within ethical
                                                                                         boundaries
   Musculoskeletal
                                                                                         Maintains confidentiality
   Nervous
                                                                                         Functions as a team member
   Cardiovascular
                                                                                                                      COMMUNICATION
   Respiratory
                                                                                                  Adapts communication to individual understanding:
   Digestive
                                                                                             Blind

   Urinary
                                                                                             Deaf

   Reproductive
                                                                                             Geriatric




                                                                               Page 1 of 6
  MSI HEALTH INTERNATIONAL.
                                           P.C.A. / C.N.A. SKILLS CHECKLIST

   Children                                                   Controlled substances

   Seriously ill                                              Worker's Compensation

   Mentally impaired                                          Releasing medical information

   Illiterate                                                 Physician-Patient relationship

   Non-English speaking                                                              COMPUTER SKILLS
                                                              Formats(letters, reports, chart notes,
   Anxious, angry, distraught
                                                              envelopes)

   Motor impaired                                             Transcription

Recognizes & understands non-
                                                              Proofreading
verbal communication

Patient instruction/education                                 Word processing

Professional communication(tact,                              Spreadsheets
courtesy, empathy)
                                                              Email
Interviewing techniques

Organizing and prioritizing                                                             Medical Software:
information
                                                                 Practice information
                       Telephone techniques:
                                                                 New patient
   Multiple lines
                                                                 Diagnostic and procedural coding
   Screening
                                                                 Payment transaction
   Problem calls
                                                                 Electronic claims
   Emergency calls
                                                                 Billing
Writing skills
                                                                 Reports (monthly revenue,
  MEDICAL-LEGAL GUIDELINES & REQUIREMENTS                     accounts receivable)

Medicare/Medicaid reimbursement                               Internet services

                                                                               DOCUMENT MANAGEMENT
Living will
                                                              Filing systems
Reportable incidences
                                                              Medical record orgaization &
OSHA regulations                                              maintenance

HIPPA Standards                                                                         Mail Processing:




                                                       Page 2 of 6
  MSI HEALTH INTERNATIONAL.
                                         P.C.A. / C.N.A. SKILLS CHECKLIST

   Screening                                                Aseptic technique

   Postage meter                                            Hand-washing

                         APPOINTMENTS                       Hazardous waste disposal

Scheduling                                                  Sanitization

Legal guidelines                                            Universal precautions

Protocol (follow-up, routine, urgent)                                                Surgical Asepsis:

Reminders/recalls                                              Scrubbing

Appropriate referral to community                              Gowning/gloving
services

                     OFFICE MANAGEMENT                         Surgical assisting

Maintaining physical plant                                     Equipment prep

Personnel                                                      Autoclave/sterilization techniques

Equipment                                                                           TREATMENT AREA

                                                                             Equipment Prep & Operation:
Supplies
                                                               Cast equipment/materials
Liability coverage
                                                               Electrocardiograph
Time Management

Physician's Professional schedule                              Exam table
and travel
                                                               Microscope
Adherence to policies and
procedures
                                                               Ophthalmoscope
                             Finances:
                                                               Otoscope
   Bookkeeping
                                                               Stethoscope
   Coding
                                                               Oxygen
   Third party billing
                                                               Physical therapy modalities
   Accounting and banking
                                                               Endoscopes
   Payroll
                                                               Scale
                     INFECTION CONTROL
                                                               Sphygmomanometer




                                                     Page 3 of 6
  MSI HEALTH INTERNATIONAL.
                                             P.C.A. / C.N.A. SKILLS CHECKLIST

   Nebulizer                                                       Immunology

   Wheelchair/stretcher                                            Pregnancy

Safety precautions                                                 Microbiology

                 PATIENT PREPARATION                               TB

Vital signs                                                     Vision testing

Explanations/education                                          Hearing test

Instructions                                                    Respiratory testing

History taking                                                  Principals of radiology

              LABORATORY AND DIAGNOSTICS                         MEDICATION PREPARATION AND ADMINISTRATION
                        Blood Collections:                      Knowledge of classes of drugs

   Vein                                                         Side effects/adverse reactions

   Capillary                                                    Dosage calculation

Urine                                                           Immunizations

Stool                                                           Prepare/administer oral medications

Sputum                                                          Prepare/administer parenteral
                                                                medications
                             Swabs:
                                                                Prescription management
   Throat
                                                                Maintaining medication and
                                                                immunization records
   Vaginal
                                                                                          EMERGENCIES
   Wound
                                                                Policies and procedures
Specimen labeling
                                                                Equipment
Specimen preservation
                                                                Assessment/triage
                           Lab Tests:
                                                                                            FIRST AID
   U/A
                                                                                      Identify and Respond to:
   Hematology
                                                                   Bleeding
   Chemistry
                                                                   Burns




                                                         Page 4 of 6
  MSI HEALTH INTERNATIONAL.
                                          P.C.A. / C.N.A. SKILLS CHECKLIST

   Cardiac arrest                                                    Infant(30 days - 1 year)

   Respiratory arrest                                                Toddler(1-3 years)

   Choking                                                           Preschooler(3-5 years)

   Diabetic coma/insulin shock                                       School age children(5-12 years)

   Fracture                                                          Adolescents(12-18 years)

   Poisoning                                                         Young Adults(18-39 years)

   Seizures                                                          Adults(40-64 years)

   Shock                                                             Older Adults(65-80 years)

   Syncope                                                           Eldest Adults(80+)

   Wounds                                                          Adapts method/terminology of pt. instr to comprehension level
                                                                                              of:
                           NUTRITION                                 Newborn/Neonate(birth - 30
                                                                  days)
Basic priciples
                                                                     Infant(30 days - 1 year)
Special needs
                                                                     Toddler(1-3 years)
                        CERTIFICATIONS
                                                                     Preschooler(3-5 years)
    CMA cert. date ________________ Expires _________
                                                                     School age children(5-12 years)
    RMA cert. date ________________ Expires _________
                                                                     Adolescents(12-18 years)
    CPR/BLS cert. date ____________ Expires __________
                                                                     Young Adults(18-39 years)
                  Other: _______________________
                                                                     Adults(40-64 years)
               _____________________________
                                                                     Older Adults(65-80 years)
               _____________________________
                                                                     Eldest Adults(80+)
               _____________________________
                                                                         Ensures a safe environment reflecting specific needs of:
        AGE SPECIFIC PRACTICE CRITERIA
  Please Check-OFF if you have experience with the                   Newborn/Neonate(birth - 30
                     following.                                   days)

        Adapts care to incorporate normal growth/dev of:             Infant(30 days - 1 year)

   Newborn/Neonate(birth - 30                                        Toddler(1-3 years)
days)




                                                           Page 5 of 6
MSI HEALTH INTERNATIONAL.
                                       P.C.A. / C.N.A. SKILLS CHECKLIST

Preschooler(3-5 years)                                              Adults(40-64 years)

School age children(5-12 years)                                     Older Adults(65-80 years)

Adolescents(12-18 years)                                            Eldest Adults(80+)

Young Adults(18-39 years)


   I certify that all of the above information is correct
   and that any misrepresentation or falsification of
   fact may be considered sufficient cause for
   Immediate dismissal from _____________.
   I have filled out this skills checklist to the best of
   my knowledge and agree that all of the information
   Provided is correct (please check box).


NAME (Please Print Clearly)                                                     DATE



SIGNATURE
LICENSE NUMBER


When you have completed the application form, below.

To send this form please completed this form then go to save as type your title and first and last name save this into your
documents or any file so wish.. You will be able to email this form back to richard@msinursing.com we hope this will save
you time.




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