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ONCOLOGY NURSING 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) | RADIATION THERAPY: | 1 | 2 | 3 | 4 | ||
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Skin Assessment | ||||||
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Total Body Irradiation | ||||||
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Side Effect Management | ||||||
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External Radiotherapy | ||||||
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Brachytherapy | ||||||
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Radiation Safety Precautions | ||||||
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Intraoperative Radiation | ||||||
| Rating Stars (Click) | ONCOLOGY PATIENT CARE: | 1 | 2 | 3 | 4 | ||
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Renal Failure | ||||||
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Fever | ||||||
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Pneumonia | ||||||
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Cqrdiac Arrhymias | ||||||
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Hypercalcemia | ||||||
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Hyperkalemia | ||||||
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Pancreatitis | ||||||
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Pulmonary Embolism | ||||||
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Bowel Obstruction | ||||||
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Diabetes | ||||||
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Pneumothorax | ||||||
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Stress Fractures | ||||||
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RespiratoryDistress | ||||||
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Spinal Cord Compression | ||||||
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GI Bleed | ||||||
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Pleural Effusion | ||||||
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Infection | ||||||
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Hypokalemia | ||||||
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DIC | ||||||
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Atlelectasis | ||||||
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Lymphedema | ||||||
| Rating Stars (Click) | VASCULAR DEVICES: | 1 | 2 | 3 | 4 | ||
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Flush Catheter | ||||||
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Punctured Catheter | ||||||
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Chemo Port | ||||||
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Omega-Port | ||||||
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S.E.A. Port | ||||||
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Port-A-Cath | ||||||
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Opti-Port | ||||||
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PICC Lines | ||||||
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Obtain Blood Specimens | ||||||
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Line Insertion Assistance | ||||||
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De-Clotting Ports | ||||||
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Groshong Catheters | ||||||
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Catheter Port | ||||||
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Site Care | ||||||
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Broviac Catheters | ||||||
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Patient/Teaching | ||||||
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Hickan Catheters | ||||||
| Rating Stars (Click) | CARE OF PATIENTS WITH: | 1 | 2 | 3 | 4 | ||
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Foley Catheter Irrigations | ||||||
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CVP Line Insertion | ||||||
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Jejunostomy Tubes | ||||||
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Wound Care | ||||||
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Colostomy Care | ||||||
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TURP | ||||||
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Reverse Isolation | ||||||
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Liver Biopsy | ||||||
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Platelet Precautions | ||||||
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Accucheck | ||||||
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NG Tube Insertion | ||||||
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Suprapubic Catheter | ||||||
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Ileostomy | ||||||
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Thoracentesis | ||||||
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Isolation | ||||||
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Foley Catheter Irrigations | ||||||
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Bone Marrow Biopsy | ||||||
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Enterostomal Care | ||||||
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Chest Tube Care | ||||||
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Paracentesis | ||||||
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Gastrostomy Tube | ||||||
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Narcotic Infusion | ||||||
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Hemodialysis | ||||||
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Nephrostomy Tube | ||||||
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Pain Management | ||||||
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Pulse Oximetry | ||||||
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Fistulas/Shunts | ||||||
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Seizure Precautions | ||||||
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Peritoneal Dialysis | ||||||
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Nasotracheal Suctioning | ||||||
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PCA Pumps | ||||||
| Rating Stars (Click) | CARDIOVASCULAR: | 1 | 2 | 3 | 4 | ||
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Hyperalimentation | ||||||
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Peripheral Blood Stem Cells | ||||||
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Packed RBC’s | ||||||
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IV Fluid Hydration | ||||||
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Venoclusive Disease | ||||||
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Fresh Frozen Plasma | ||||||
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Infections | ||||||
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Pneumonitis | ||||||
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Graft Rejection | ||||||
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Platelets | ||||||
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WBC/Lukocytes | ||||||
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Blood /Byproducts | ||||||
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Antivirals | ||||||
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Donor Education | ||||||
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Allogeneic BMT | ||||||
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Antibiotics | ||||||
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GVHD Graft | ||||||
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Autologous BMT | ||||||
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Antifungals | ||||||
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Implantable Infusion Pumps | ||||||
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Medtronic | ||||||
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Infusaid | ||||||
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Ambulatory Infusion Pumps | ||||||
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Synchormed | ||||||
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Cormed | ||||||
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Pharmacia | ||||||
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Auto Syringe | ||||||
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Pancretec | ||||||
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Patency Maintenance | ||||||
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Patient Teaching | ||||||
| Rating Stars (Click) | PSYCHO & SOCIAL CARE: | 1 | 2 | 3 | 4 | ||
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Palliative Care | ||||||
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Hospice Care | ||||||
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Family Support | ||||||
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Counseling/Death/Dying | ||||||
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Identifying Support Groups | ||||||
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Advance Directives | ||||||
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Identifying Resources | ||||||
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Health Care Proxy | ||||||
| Rating Stars (Click) | PHARMACOLOGY: | 1 | 2 | 3 | 4 | ||
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Floxuridine/FUDR | ||||||
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Doxorubicin/Adrianycin | ||||||
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Heparin/Coumadin | ||||||
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Carmustine/BiCNU | ||||||
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Dopamine | ||||||
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Cistplatin | ||||||
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Mitonycin/Mutanycin | ||||||
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Dilantin | ||||||
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Fluorouracil/-FU | ||||||
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Usulfan/Myleran | ||||||
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Neupogen/Epogen | ||||||
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Hydroxyurea/Hydrea | ||||||
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Corticosteroids | ||||||
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Vincristine/Oncovin | ||||||
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Methotrexate/Amethopterin | ||||||
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Morphine | ||||||
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Etoposide/VP-6- | ||||||
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Cyclophosphamide/Cytoxan | ||||||
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Decadron | ||||||
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Belomycin/Blenoxane | ||||||
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Vinblastine/Velban | ||||||
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Melphalan/Alkeran | ||||||
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IV Care/Skills | ||||||
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Chemotherapy Adm | ||||||
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IM/SQ | ||||||
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IVPB | ||||||
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IV Push/Intrathecal | ||||||
| Rating Stars (Click) | ONCOLOGY & GENERAL CARE: | 1 | 2 | 3 | 4 | ||
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Thrombocytopenia | ||||||
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Stomatitis | ||||||
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Hemorrhabe | ||||||
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Oncology PCU | ||||||
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Neuropathy | ||||||
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Bone Marrow Transplant | ||||||
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Death /Dying | ||||||
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Venous Access Devices | ||||||
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Electrolyte Imbalance | ||||||
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Palliative/Hospice Care | ||||||
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Neutropenia | ||||||
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Pain Management | ||||||
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Telemetry | ||||||
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Nutritional Needs | ||||||
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Immunosuppression | ||||||
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IV Maintenance | ||||||
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Septic Shock | ||||||
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Vomiting/Diarrhea/Nausea | ||||||
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Skin Care | ||||||
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Blood/Blood Byproducts | ||||||
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Normal Serum Labs Values | ||||||
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Radiation Therapy | ||||||
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Surgical Patient Care | ||||||
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Chemotherapy Protocols | ||||||
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Implantable Vascular Ports | ||||||
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Patient Teaching | ||||||
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Implantable Infusion Pumps | ||||||
| Rating Stars (Click) | Age Specific Competencies | 1 | 2 | 3 | 4 | ||
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Infant (Birth - 1 year) | ||||||
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Preschooler (ages 2-5 years) | ||||||
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Childhood (ages 6-12 years) | ||||||
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Adolescents (ages 13-21 years) | ||||||
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Young Adults (ages 22-39 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) | ||||||