Oncology Skills Checklist

Oncology Skills Checklist
Answer Key

1. No Experience 2. Requires Supervision 3. Proficient 4. Can Teach Others

Medications*

	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*

	1	2	3	4
Head, Neck, Chest
Hematologic System
Gastrointestinal Tract
Reproductive System
Skin (Melanomas / Nonmelanomas)
Urinary Tract

Emergencies*

	1	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*

	1	2	3	4
Patient / Family Education
Advance Directives
Acute Phase
Chronic Phase
Terminal Phase
Bereavement Phase
After Treatment (Survivorship)

Antineoplastic Agents*

	1	2	3	4
Bleomycin
Dactinomycin (Actinomycin)
Daunorubicin (DaunoXome)
Doxorubicin (Adriamycin)

Routes of Administration*

	1	2	3	4
Oral / SQ / IM
Intraarterial
Intrathecal / Intraventricular
Intraperitoneal (Tenckhoff Catheter)
Intrapleural
Intravesicular

Alkylating Agents*

	1	2	3	4
Bulsulfan (Myleran)
Chlorambucil (Leukeran)
Cisplatin (Platinol)
Cyclophosphamide (Cytoxan)
Mechlorethamine (Mustargen)

Oncology Health Care Settings*

	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*

	1	2	3	4
Infertility
Changes in Libido
Erectile Dysfunction

Nutrition*

	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*

	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*

The Information I Provided is True & Accurate
Name Signature*
Date*

MonthDayYear
Date
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