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Travel Nursing Skills Checklists

Congratulations on your decision to apply for a travel nursing position with American Mobile! Before we can offer you a nursing employment opportunity, an electronic skills assessment must be completed. From the nursing skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!


Hospice Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
1. No experience; requires education, training and supervision 2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent 4. Expert level; can teach/supervise others
 
WORK SETTINGS
1 2 3 4
 
Home Health/Hospice Setting
 
Home Hospice
 
Inpatient Hospice
 
Pediatric Hospice
 
ASSESSMENT
1 2 3 4
 
Coping Status
 
Environmental Status
 
Intake Assessment
 
PLAN OF CARE
1 2 3 4
 
Ensure Continuity of Care
 
Set Goals with Pt/Family
 
SYMPTOM MANAGEMENT
1 2 3 4
 
Anorexia/Cachexia
 
Educate Family on Symptom Management
 
Reduce Symptoms to Level Acceptable to Pt.
 
Report Symptoms/Management to Provider
 
PAIN MANAGEMENT
1 2 3 4
 
Educate Family on Pain Management
 
Identify Source of Pain
 
PAINAD Scale for Non Verbal Patient
 
WHO 3 Step Ladder
 
WOUND CARE
1 2 3 4
 
Bed/Support Surface Selection
 
Educate Family on Positioning/Shearing
 
Evaluate Factors that Impede Healing
 
Pressure Ulcer Staging/Management
 
PEDIATRICS
1 2 3 4
 
Parental/Sibling Support
 
MEDICATION ADMINSTRATION
1 2 3 4
 
Disposal of Medications
 
Equianalgesic Conversion Formula
 
Family Management of Medications
 
IV Pump Management
 
Titration of opioids
 
AFTER DEATH
1 2 3 4
 
Bereavement Services
 
Coordinate Mortuary Services
 
Facility Family/Cultural Rituals/Rites
 
Patient Care after Death
 
COMPLIANCE
1 2 3 4
 
DME Authorization & Documentation of Need/Order
 
Medicare/State Regulations for Hospice
 
OASIS-C
 
Scope and Frequency of Services
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Patient/Family Directs Goals of Care
 
Cultural Diversity
 
Supervision of Ancillary Staff
 
Fall Risk Assessment/Prevention
 
Infection Prevention
 
AGE SPECIFIC/POPULATION BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computerized Physician Order Entry
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
Other: Specify
 
Other: Specify
 
EMR Conversion
 
CERTIFICATIONS
 
BLS
 
CHPN
 
ACHPN
 
CHPPN
 
Other Certification: Specify
Hospice Skills Checklist, version 2

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

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