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

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SETTING

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Acute
Rehab
Inpatient
Outpatient
Home Health
SNF
Schools

ADAPTIVE EQUIPMENT

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Assessments
Augmentative Communication
Computer-based Treatment/Adaptive Microswitches

SPEECH / LANGUAGE / HEARING DISABILITIES

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Feeding Disorders
Cleft Palate
Cognitive Rehab
Coma Stimulation
CVA / Stroke Rehab
Dysphagia
Fluency / Stuttering
Head Injury
Hearing Impaired
Laryngectomy
Neurological
Voice

PEDIATRICS

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Cerebral Palsy
Early Intervention
Learning Language Disabilities
Mental Retardation
NDT for Speech

OTHER SKILLS

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Accent Reduction
Aural Rehabilitation / Speech Reading
Biofeedback-EMG
Cognitive Assessment
Co-Treatment with OT
Co-Treatment with PT
Family Education
Group Activities
In-service Education
Myofunctional Therapies
Prosthetics- Cleft Palate
Rehab Feeding Group
Sign Language
Tracheostomy
Ventilator
Videofluoroscopy
FEEST
Electronic Documentation

AGE

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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

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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.

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Skills Checklist - SLP