Oncology Skills Checklist
Answer Key
1. No Experience 2. Requires Supervision 3. Proficient 4. Can Teach Others
Medications
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Rows
1
2
3
4
Administer PO Medications
Administer IM / SQ Medications
Administer IV Medications
Needle-less Systems
Infusion Pumps
Establish Peripheral IVs
Discontinue Peripheral IVs
Pain Assessment / Management
Draw Blood for Lab Studies
Admin Blood / Blood Products
Central Venous Lines (CVL)
Hickman / Broviac Catheters
PCA / CADD
Port-A-Cath
Infusaid
Infuse-A-Port
Care of Oncological Patient
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Rows
1
2
3
4
Head, Neck, Chest
Hematologic System
Gastrointestinal Tract
Reproductive System
Skin (Melanomas / Nonmelanomas)
Urinary Tract
Emergencies
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Rows
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2
3
4
Cardiac Tamponade
Dissesminated Intravascular Coagulation
Hypercalcemia
Organ Obstruction
Sepsis
Spinal Cord Compression
Superior Vena Cavae Syndrome
Tumor Lysis Syndrome
Family/Psychosocial Needs
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Rows
1
2
3
4
Patient / Family Education
Advance Directives
Acute Phase
Chronic Phase
Terminal Phase
Bereavement Phase
After Treatment (Survivorship)
Antineoplastic Agents
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Rows
1
2
3
4
Bleomycin
Dactinomycin (Actinomycin)
Daunorubicin (DaunoXome)
Doxorubicin (Adriamycin)
Routes of Administration
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Rows
1
2
3
4
Oral / SQ / IM
Intraarterial
Intrathecal / Intraventricular
Intraperitoneal (Tenckhoff Catheter)
Intrapleural
Intravesicular
Alkylating Agents
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Rows
1
2
3
4
Bulsulfan (Myleran)
Chlorambucil (Leukeran)
Cisplatin (Platinol)
Cyclophosphamide (Cytoxan)
Mechlorethamine (Mustargen)
Oncology Health Care Settings
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Rows
1
2
3
4
Adult
Pediatrics
Cancer Center
Radiation Oncology
Surgical Oncology
Bone Marrow Unit
Research / Clinical Trials
Subacute / Skilled Nursing
Home Health Care
Hospice
Clinic - Risk Assess / Screening / Diagnosis
Clinic - Surgery / Gyn
Clinic - Medical / Hematology
Clinic - Immunology / Infectious
Reproductive
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Rows
1
2
3
4
Infertility
Changes in Libido
Erectile Dysfunction
Nutrition
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Rows
1
2
3
4
Assess Nutritional Status
Assess / Manage Nutritional Impairment
Interpretation of Lab Values
Oral Feedings
Enteral Tube Feeding
Peripheral Parenteral Nutrition (PPN)
Central TPN
Age Specific
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Rows
1
2
3
4
Newborn/Neonatal (up to 30 days)
Infant (30 days to 1 year)
Toddler (1 to 3 years)
Preschooler (3 to 5 years)
School Age (5 to 12 years)
Adolescents (12 to 18 years)
Young Adults (18 to 39 years)
Middle Adults (40 to 64 years)
Older Adults (65 & up)
Undertaking
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The Information I Provided is True & Accurate
Name Signature
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Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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