Skills Checklist - Infection Prevention RN

This Skills Checklist is a self-evaluation to assess your recent experience in various clinical settings focusing on the past 2 years.

0 = No Experience
1 = Some Experience
2 = Intermittent Experience
3 = Experienced
4 = Very Experienced

*For best experience on Mobile, turn your device horizontal.

SETTING*

	0	1	2	3	4
Acute
Rehab
Inpatient
Outpatient
Home Health
SNF
Schools

Orthopedic*

	0	1	2	3	4
Fractures
Total Joint Replacements
Osteoarthritis-Frozen Shoulder
Hand Injuries
Post Operative Care
Amputations

Neurologic:*

	0	1	2	3	4
Stroke Rehabilitation
Cognitive Disorders
Head Trauma
Spinal Cord Injury
Neuromuscular Diseases
Alzheimer’s/Dementia
Adaptive Equipment-Wheelchair

Prosthetics / Orthotics:*

	0	1	2	3	4
Upper Extremity Prosthetics

Procedures / Treatments:*

	0	1	2	3	4
Splinting - Wrist
Splinting - Hand
Splinting - Elbow
Functional - Dynamic Splinting
Adaptive Equipment
Joint Mobilization
Myofacial Release
Soft Tissue Manipulation
Iontophoresis
TENS
Hydrotherapy - Whirlpool
Sterilization Techniques
Cryotherapy
Wound Management
Debridement
Ultrasound
Phonophoresis
Cognitive Techniques
Vision Therapy
Neurodevelopmental Techniques
Adaptive Equipment Assessment
Adaptive Equipment Training
Feeding Techniques
Exercise Programs
Postural Education
Home Safety Evaluation
Community Re-entry
Group Treatment

Skilled Nursing Documentation:*

	0	1	2	3	4
Medicare A
Medicare B
State Healthcare

Other:*

	0	1	2	3	4
Cardiac Rehab
ICU Procedures
CCU Procedures
SICU Procedures
Burn Management
Work Hardening - Work Site Eval
Functional Capacity Eval
Transfers
Gait Training
Muscle Energy Techniques
Activities of Daily Living
Electronic Documentation

AGE*

	0	1	2	3	4
Newborn (birth-30 days)
Infant (30 days - 1 year)
Toddler (1 - 3 years)
Preschooler (3 - 5 years)
School Age (5 - 12 years)
Adolescents (12 - 18 years)
Young Adults (18 - 39 years)
Middle Adults (39 - 64 years)
Older Adults (64+ years)

Position Category*

Start Typing to get Suggested Options

Total Years of Experience*

First Name*

Last Name*

Social Security #*

Date of Birth*

Email*

Phone*

Attestation*

I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified, particularly within the last 2 years. I hereby authorize Alliant Personnel Resources (The Company) to collect, store, and release any information that I have provided in this Skills Checklist and/or any other documentation and information they have collected or that I have submitted in any form to its parent company(s), its subsidiaries, or other subcontractors/its service providers as it deems necessary in its business operations as well as to individuals and companies in relation to consideration of employment as a Healthcare Professional with those companies and individuals. I acknowledge that The Company will take precaution and care to protect my personal information that is collected/stored/shared but cannot guarantee permanent data security and I release The Company from all related liability for damages or punitive liability.

Please verify that you are human*

Signature*

Skills Checklist - OT/COTA