Dietitian Skills Checklist

Let’s assess your clinical skills and experience. Fill out this checklist to get one step closer to your next opportunity.

1 = No theory and/or experience
2 = Limited Experience
3 = Experienced/minimal support needed to perform
4 = Proficient

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Age of Patients Cared For
Newborn/Neonate (birth to 30 days)*
- 1
- 2
- 3
- 4
Infant (1 month to 1 year)*
- 1
- 2
- 3
- 4
Toddler (1 year to 3 years)*
- 1
- 2
- 3
- 4
Preschooler (3 years to 5 years)*
- 1
- 2
- 3
- 4
School Age Child (5 years to 12 years)*
- 1
- 2
- 3
- 4
Adolescents (12 years to 18 years)*
- 1
- 2
- 3
- 4
Young Adults (18 years to 39 years)*
- 1
- 2
- 3
- 4
Middle Adults (39 years to 64 years)*
- 1
- 2
- 3
- 4
Older Adults (64 years to 79 years)*
- 1
- 2
- 3
- 4
Elderly Adults (over 79+ years)*
- 1
- 2
- 3
- 4
General Skills
Standard Precautions*
- 1
- 2
- 3
- 4
Isolation Precautions*
- 1
- 2
- 3
- 4
Pediatric Respiratory/Cardiac Arrest*
- 1
- 2
- 3
- 4
Adult Respiratory/Cardiac Arrest*
- 1
- 2
- 3
- 4
Crash Carts*
- 1
- 2
- 3
- 4
Defibrillators*
- 1
- 2
- 3
- 4
Patient and Family Education*
- 1
- 2
- 3
- 4
Electronic Documentation*
- 1
- 2
- 3
- 4
List Types:
Managing Food-Drug Interactions*
- 1
- 2
- 3
- 4
Managing Food-Drug Timing*
- 1
- 2
- 3
- 4
Managing Nutrition Therapy Complications*
- 1
- 2
- 3
- 4
Assessment/Patient Care
Develop Plan of Treatment*
- 1
- 2
- 3
- 4
Document Refusal of Care*
- 1
- 2
- 3
- 4
Document Non-Compliance*
- 1
- 2
- 3
- 4
Determine Usual or Adjusted Body Weight*
- 1
- 2
- 3
- 4
Determine Energy Requirements*
- 1
- 2
- 3
- 4
Determine Protein Requirements*
- 1
- 2
- 3
- 4
Determine Fluid Requirements*
- 1
- 2
- 3
- 4
Determine Electrolyte Requirements*
- 1
- 2
- 3
- 4
Determine Fat Requirements*
- 1
- 2
- 3
- 4
Determine Micronutrient Requirements*
- 1
- 2
- 3
- 4
Perform Nutrition Education*
- 1
- 2
- 3
- 4
Perform Nutrition Assessments*
- 1
- 2
- 3
- 4
Nutrition Status
Clinic Malnutrition*
- 1
- 2
- 3
- 4
Poor Diet*
- 1
- 2
- 3
- 4
Eating Difficulties*
- 1
- 2
- 3
- 4
Marginal Malnutrition*
- 1
- 2
- 3
- 4
Metabolic Demands*
- 1
- 2
- 3
- 4
Nutrient Deficiencies*
- 1
- 2
- 3
- 4
Assess Fluid Status*
- 1
- 2
- 3
- 4
Kwashiorkor*
- 1
- 2
- 3
- 4
Marasmus*
- 1
- 2
- 3
- 4
Cachexia*
- 1
- 2
- 3
- 4
Protein Calorie Malnutrition*
- 1
- 2
- 3
- 4
Conditions/Diseases Affecting Nutrition
Abdominal Wounds and Surgeries*
- 1
- 2
- 3
- 4
Abnormal Bleeding*
- 1
- 2
- 3
- 4
Acute MI*
- 1
- 2
- 3
- 4
Acute Renal Failure*
- 1
- 2
- 3
- 4
Alzheimer's Disease*
- 1
- 2
- 3
- 4
Anorexia Nervosa*
- 1
- 2
- 3
- 4
Aspiration*
- 1
- 2
- 3
- 4
Bulimia*
- 1
- 2
- 3
- 4
Cancer*
- 1
- 2
- 3
- 4
Chronic Diarrhea*
- 1
- 2
- 3
- 4
Coma*
- 1
- 2
- 3
- 4
Congenital Heart Defects*
- 1
- 2
- 3
- 4
Congestive Heart Failure*
- 1
- 2
- 3
- 4
COPD*
- 1
- 2
- 3
- 4
CVA*
- 1
- 2
- 3
- 4
Decubitus*
- 1
- 2
- 3
- 4
Depression*
- 1
- 2
- 3
- 4
Diabetes*
- 1
- 2
- 3
- 4
Diabetic Ketoacidosis*
- 1
- 2
- 3
- 4
Draining Abscesses*
- 1
- 2
- 3
- 4
Draining Wounds*
- 1
- 2
- 3
- 4
Drug Overdose*
- 1
- 2
- 3
- 4
Dysphagia*
- 1
- 2
- 3
- 4
Elevated Cholesterol/Triglycerides*
- 1
- 2
- 3
- 4
End Stage Renal Disease*
- 1
- 2
- 3
- 4
Epiglottitis*
- 1
- 2
- 3
- 4
Excessive Alcohol Intake*
- 1
- 2
- 3
- 4
Extensive Burns*
- 1
- 2
- 3
- 4
Failure to Thrive*
- 1
- 2
- 3
- 4
Fever*
- 1
- 2
- 3
- 4
Fistulae*
- 1
- 2
- 3
- 4
Hemodialysis*
- 1
- 2
- 3
- 4
Hepatitis*
- 1
- 2
- 3
- 4
HIV/AIDS*
- 1
- 2
- 3
- 4
Homelessness/Limited Access to Food*
- 1
- 2
- 3
- 4
Hyperemesis*
- 1
- 2
- 3
- 4
Infection*
- 1
- 2
- 3
- 4
Inflammatory Bowel Disease*
- 1
- 2
- 3
- 4
Liver Failure*
- 1
- 2
- 3
- 4
Low Blood Sugar*
- 1
- 2
- 3
- 4
Major Surgery*
- 1
- 2
- 3
- 4
Malabsorption Syndromes*
- 1
- 2
- 3
- 4
Morbid Obesity*
- 1
- 2
- 3
- 4
Mucositis*
- 1
- 2
- 3
- 4
Pancreatitis*
- 1
- 2
- 3
- 4
Peritoneal Dialysis*
- 1
- 2
- 3
- 4
Post-Op Gastric Stapling/Gastric Bypass*
- 1
- 2
- 3
- 4
Pregnancy*
- 1
- 2
- 3
- 4
Protracted Emesis*
- 1
- 2
- 3
- 4
Radiation*
- 1
- 2
- 3
- 4
RDS*
- 1
- 2
- 3
- 4
Refeeding Syndrome*
- 1
- 2
- 3
- 4
Renal Transplants*
- 1
- 2
- 3
- 4
Sepsis*
- 1
- 2
- 3
- 4
Short Gut Syndrome*
- 1
- 2
- 3
- 4
Sickle Cell Anemia*
- 1
- 2
- 3
- 4
Status Asthmaticus*
- 1
- 2
- 3
- 4
Stomatitis*
- 1
- 2
- 3
- 4
Transplants*
- 1
- 2
- 3
- 4
Trauma*
- 1
- 2
- 3
- 4
Tuberculosis*
- 1
- 2
- 3
- 4
Vented Patient*
- 1
- 2
- 3
- 4
Wounds*
- 1
- 2
- 3
- 4
Medication Affecting Nutrition
Steroids*
- 1
- 2
- 3
- 4
Immunosuppressants*
- 1
- 2
- 3
- 4
Antineoplastics*
- 1
- 2
- 3
- 4
Insulin*
- 1
- 2
- 3
- 4
Diuretics*
- 1
- 2
- 3
- 4
Blood Thinners*
- 1
- 2
- 3
- 4
Laxatives*
- 1
- 2
- 3
- 4
Lab Monitoring
LFT's*
- 1
- 2
- 3
- 4
Serum Ammonia*
- 1
- 2
- 3
- 4
Serum Amylase*
- 1
- 2
- 3
- 4
Cholesterol*
- 1
- 2
- 3
- 4
BUN*
- 1
- 2
- 3
- 4
Serum Electrolytes*
- 1
- 2
- 3
- 4
Blood Glucose*
- 1
- 2
- 3
- 4
Hematology*
- 1
- 2
- 3
- 4
Creatinine*
- 1
- 2
- 3
- 4
Albumin*
- 1
- 2
- 3
- 4
Pre-Albumin*
- 1
- 2
- 3
- 4
C-Reactive Proteins*
- 1
- 2
- 3
- 4
Nitrogen Balance*
- 1
- 2
- 3
- 4
Acid/Base Balance*
- 1
- 2
- 3
- 4
Protein-Energy Balance*
- 1
- 2
- 3
- 4
Vitamins and Minerals*
- 1
- 2
- 3
- 4
Managing Nutrition Therapy
Oral Diets*
- 1
- 2
- 3
- 4
Enteral Nutrition*
- 1
- 2
- 3
- 4
Parenteral Nutrition*
- 1
- 2
- 3
- 4
Writing Orders for Nutrition*
- 1
- 2
- 3
- 4
Intake and Output*
- 1
- 2
- 3
- 4
Fluid Balanace*
- 1
- 2
- 3
- 4
Calorie Counts*
- 1
- 2
- 3
- 4
Small Bowel Feeding Tubes*
- 1
- 2
- 3
- 4
Gastrostomy Tubes*
- 1
- 2
- 3
- 4
Jejunostomy Tubes*
- 1
- 2
- 3
- 4
Settings
Hospital*
- 1
- 2
- 3
- 4
Clinic*
- 1
- 2
- 3
- 4
Long Term Care*
- 1
- 2
- 3
- 4
Retirement Center*
- 1
- 2
- 3
- 4
Hospice*
- 1
- 2
- 3
- 4
Home Health*
- 1
- 2
- 3
- 4
Research*
- 1
- 2
- 3
- 4
Daycare*
- 1
- 2
- 3
- 4
Correctional Facility*
- 1
- 2
- 3
- 4
Restaurant*
- 1
- 2
- 3
- 4
Public Health*
- 1
- 2
- 3
- 4
Community Programs*
- 1
- 2
- 3
- 4
Certifications
RD/RDN
Other Skills
List Types:
Application Agreement
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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.*
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I hereby consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*
Name*
First Last
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TODAY'S DATE*
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Title

Title

Dietitian Skills Checklist

Age of Patients Cared For

General Skills

Assessment/Patient Care

Nutrition Status

Conditions/Diseases Affecting Nutrition

Medication Affecting Nutrition

Lab Monitoring

Managing Nutrition Therapy

Settings

Certifications

Other Skills

Application Agreement