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Home Health Skills Checklist
Please mark your level of experience
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
WORK SETTINGS
1
2
3
4
Adult Home Health
1
2
3
4
Psych Home Health
1
2
3
4
Pedi Home Health
1
2
3
4
Home Infusion
1
2
3
4
Home Health Hospice
1
2
3
4
CARDIOVASCULAR
1
2
3
4
ACS/Post MI
1
2
3
4
Heart Failure
1
2
3
4
Post Cardiac Surgery
1
2
3
4
Cardiac Auscultation (Rate/Rhythm)
1
2
3
4
Peripheral Pulse/Circulation Checks
1
2
3
4
PULMONARY
1
2
3
4
Asthma
1
2
3
4
COPD
1
2
3
4
Pneumonia
1
2
3
4
Lung Cancer
1
2
3
4
Pulmonary Emboli
1
2
3
4
Auscultate Lung Sounds
1
2
3
4
Oxygen Administration
1
2
3
4
Oxygen Safety
1
2
3
4
Oro/Nasotracheal Suctioning
1
2
3
4
CPAP/BiPAP
1
2
3
4
Ventilator Management
1
2
3
4
NEUROLOGICAL
1
2
3
4
CVA
1
2
3
4
Alzheimer's Disease/Dementia
1
2
3
4
Parkinson's
1
2
3
4
Degenerative Neurologic Disorders (ALS, MS, etc.)
1
2
3
4
Brain Tumor
1
2
3
4
Brain Injury
1
2
3
4
Para/Quadriplegia
1
2
3
4
Seizure Disorder
1
2
3
4
Level of Consciousness/Neuro Changes
1
2
3
4
ORTHOPEDICS
1
2
3
4
Joint Replacement
1
2
3
4
DVT Prophylaxis/Recognition
1
2
3
4
Incision Checks
1
2
3
4
Staple Removal
1
2
3
4
Fractures
1
2
3
4
Cast/Brace
1
2
3
4
Amputation
1
2
3
4
Arthritis
1
2
3
4
Assistive Equipment/Lift Devices
1
2
3
4
In Home PT/INR
1
2
3
4
GASTROINTESTINAL
1
2
3
4
Nutritional Assessment
1
2
3
4
Colostomy/Ileostomy Management
1
2
3
4
Fecal Incontinence/Diarrhea
1
2
3
4
Bowel Obstruction
1
2
3
4
GI Bleed
1
2
3
4
Post GI Surgery
1
2
3
4
Hepatitis Liver Failure
1
2
3
4
NG Tubes
1
2
3
4
Feeding Tubes
1
2
3
4
Feeding Pumps
1
2
3
4
Drainage Devices
1
2
3
4
RENAL/GENITOURINARY
1
2
3
4
Hemodialysis
1
2
3
4
AV Fistula/Shunt
1
2
3
4
Peritoneal Dialysis
1
2
3
4
Post Bladder Surgery
1
2
3
4
Post Prostate Surgery
1
2
3
4
Urostomy
1
2
3
4
Urinary Incontinence
1
2
3
4
Bladder Catheter Insertion/Maintenance
1
2
3
4
Suprapubic Catheter Insertion/Maintenance
1
2
3
4
ENDOCRINE/METABOLIC
1
2
3
4
Diabetes
1
2
3
4
Hyper/Hypoglycemia
1
2
3
4
Diabetic Skin Assessment
1
2
3
4
Cushing's / Addison's Disease
1
2
3
4
Thyroid Disease
1
2
3
4
Insulin Pumps
1
2
3
4
Glucometers
1
2
3
4
WOUND/SKIN CARE
1
2
3
4
Braden Scale
1
2
3
4
Pressure Ulcer Prevention
1
2
3
4
Pressure Ulcer Staging
1
2
3
4
Pressure Ulcer Management
1
2
3
4
Burns
1
2
3
4
Wound Care
1
2
3
4
Wound Cultures
1
2
3
4
Wound Vac
1
2
3
4
ONCOLOGY
1
2
3
4
Risk for Infection
1
2
3
4
Symptom Management
1
2
3
4
Side Effects of Treatment
1
2
3
4
Terminal Disease
1
2
3
4
INFECTIOUS DISEASE
1
2
3
4
MRSA
1
2
3
4
VRE
1
2
3
4
C. Difficile
1
2
3
4
HIV
1
2
3
4
Tuberculosis
1
2
3
4
Isolation Precautions
1
2
3
4
PHLEBOTOMY/IV THERAPY
1
2
3
4
Peripheral Venipuncture for Labs
1
2
3
4
Start IVs
1
2
3
4
Peripheral IVs
1
2
3
4
PICC/CVP Lines
1
2
3
4
Venous Access Ports
1
2
3
4
Infusion Pump Set up and Management
1
2
3
4
PSYCHIATRIC
1
2
3
4
Cognitive Disorders
1
2
3
4
Mood Disorders
1
2
3
4
Schizophrenia/Psychotic Disorders
1
2
3
4
Medication Compliance
1
2
3
4
WOMEN'S HEALTH/MATERNAL-INFANT CARE
1
2
3
4
Pregnancy Related Complications
1
2
3
4
Fetal Heart Tones
1
2
3
4
Contractions
1
2
3
4
Post Partum Mother/Baby Visit
1
2
3
4
Newborn Care
1
2
3
4
Phototherapy
1
2
3
4
Breast Feeding Support
1
2
3
4
PEDIATRICS
1
2
3
4
Growth and Development
1
2
3
4
Respiratory Distress Syndrome
1
2
3
4
Bronchopulmonary Dysplasia
1
2
3
4
Cystic Fibrosis
1
2
3
4
Muscular Dystrophy
1
2
3
4
Spina Bifida
1
2
3
4
Spinal Surgery
1
2
3
4
Sickle Cell Disease
1
2
3
4
Trach Care/Suctioning
1
2
3
4
Ventilator Management
1
2
3
4
PAIN MANAGEMENT
1
2
3
4
Verbal/Nonverbal Pain Scales
1
2
3
4
Response to Pain Management Interventions
1
2
3
4
PCA Pump
1
2
3
4
Epidural Cath/Site Monitoring/Pump
1
2
3
4
Non-Pharmacologic Pain Measures
1
2
3
4
PALLIATIVE AND END OF LIFE CARE
1
2
3
4
Palliative Symptom Management
1
2
3
4
Pain Management/Response
1
2
3
4
Family Support/Teaching
1
2
3
4
After Death Protocols
1
2
3
4
MEDICATIONS
1
2
3
4
Alzheimer's Medications
1
2
3
4
Antiarrhythmics
1
2
3
4
Antibiotics/Antivirals
1
2
3
4
Anti-Depressants
1
2
3
4
Anti-Hypertensives
1
2
3
4
Anti-Psychotics
1
2
3
4
Anti-Seizure Medications
1
2
3
4
Benzodiazepines
1
2
3
4
Calculation of Pediatric Dosages
1
2
3
4
Coumadin
1
2
3
4
Diuretics
1
2
3
4
Enoxaparin
1
2
3
4
Inhaled Medications
1
2
3
4
Nebulizer Medications
1
2
3
4
Insulin
1
2
3
4
Opioid and Non-Opioid Analgesics
1
2
3
4
Oral Chemotherapy
1
2
3
4
Oral Hypoglycemics
1
2
3
4
Oral & Topics Nitrates
1
2
3
4
Rivaroxaban
1
2
3
4
Sedative/Hypnotics
1
2
3
4
Steroids
1
2
3
4
HOME HEALTH
1
2
3
4
Intake/Admissions
1
2
3
4
Case Manager
1
2
3
4
Supervise LVNs/HHAs
1
2
3
4
Medicare/Medicaid
1
2
3
4
Long/Short Term Disability
1
2
3
4
Private Insurance
1
2
3
4
Telephonic Assessments
1
2
3
4
Management of Complaints
1
2
3
4
APS Reports
1
2
3
4
OASIS
1
2
3
4
Diagnosis Coding
1
2
3
4
Document Plan of Care
1
2
3
4
Clinical Assessment Documentation
1
2
3
4
PROFESSIONAL KNOWLEDGE AND SKILLS
1
2
3
4
National Patient Safety Goals/Core Measures
1
2
3
4
Safety Assessment
1
2
3
4
Fall Assessment and Prevention
1
2
3
4
Patient/Family Teaching
1
2
3
4
Age Specific/Population Based Care
1
2
3
4
COMPUTERIZED CHARTING
1
2
3
4
Epic
1
2
3
4
Cerner
1
2
3
4
Eclipsys
1
2
3
4
McKesson
1
2
3
4
Meditech
1
2
3
4
Other Computerized System
1
2
3
4
Computerized Physician Order Entry
1
2
3
4
Bar Coding for Medication Administration
1
2
3
4
Yes
No
EMR Conversion
Yes
No
First Name
*
Last Name
*
Phone Number
*
Last 4 of Social Security Number
*
Email Address
*
Date Completed:
*
+
By checking the "Agree" box and clicking “Submit” below you certify and acknowledge the information provided on this checklist is accurate to the best of your knowledge and an accurate representation of your abilities.
*
Agree