House Supervisor Skills Checklist

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

Age of Patients Cared For
Newborn/Neonate (Birth to 30 days)*
- 1
- 2
- 3
- 4
Infant (31 days to 12 months)*
- 1
- 2
- 3
- 4
Toddler/Preschool (13 months to 5 years)*
- 1
- 2
- 3
- 4
School Age Child/Adolescent (6 years to 18 years)*
- 1
- 2
- 3
- 4
Young Adults/Middle Adult (19 years to 64 years)*
- 1
- 2
- 3
- 4
Older Adults/Elderly (65+ years)*
- 1
- 2
- 3
- 4
General Skills
Standard Precautions*
- 1
- 2
- 3
- 4
Isolation Precautions*
- 1
- 2
- 3
- 4
Care of Patient in Restraints*
- 1
- 2
- 3
- 4
Patient/Family Education*
- 1
- 2
- 3
- 4
Patient Identification*
- 1
- 2
- 3
- 4
Specialty Beds*
- 1
- 2
- 3
- 4
End of Life/Palliative Care*
- 1
- 2
- 3
- 4
Collect Appropriate Data*
- 1
- 2
- 3
- 4
Knowledge of current Joint Commission National*
- 1
- 2
- 3
- 4
SETTING
Acute Care/Hospital*
- 1
- 2
- 3
- 4
SNF/Long Term Care*
- 1
- 2
- 3
- 4
Managed Care*
- 1
- 2
- 3
- 4
Home Health*
- 1
- 2
- 3
- 4
Hospice*
- 1
- 2
- 3
- 4
Outpatient*
- 1
- 2
- 3
- 4
Physician Office*
- 1
- 2
- 3
- 4
MANAGEMENT
Understanding of health care economics and health care policies as it applies to patient care*
- 1
- 2
- 3
- 4
Concepts of capital budgeting*
- 1
- 2
- 3
- 4
Department/Unit budgeting*
- 1
- 2
- 3
- 4
Recruitment techniques*
- 1
- 2
- 3
- 4
Interviewing techniques*
- 1
- 2
- 3
- 4
Labor laws pertaining to hiring*
- 1
- 2
- 3
- 4
Orientation of new employees*
- 1
- 2
- 3
- 4
Knowledge of quality improvement/performance improvement tools*
- 1
- 2
- 3
- 4
Patient Safety*
- 1
- 2
- 3
- 4
Workplace Safety*
- 1
- 2
- 3
- 4
Promotion of interdepartmental communication*
- 1
- 2
- 3
- 4
Performance management*
- 1
- 2
- 3
- 4
Staff development*
- 1
- 2
- 3
- 4
Coaching and mentoring*
- 1
- 2
- 3
- 4
Project management*
- 1
- 2
- 3
- 4
Business development*
- 1
- 2
- 3
- 4
Developing strategic plans*
- 1
- 2
- 3
- 4
Cultural competence*
- 1
- 2
- 3
- 4
Ethical behavior and practice*
- 1
- 2
- 3
- 4
Professional association involvement*
- 1
- 2
- 3
- 4
Conflict management*
- 1
- 2
- 3
- 4
Team dynamics*
- 1
- 2
- 3
- 4
JCAHO standards*
- 1
- 2
- 3
- 4
OSHA standards*
- 1
- 2
- 3
- 4
Risk Management/Service Utilization*
- 1
- 2
- 3
- 4
Local Department of Health*
- 1
- 2
- 3
- 4
State Department of Health*
- 1
- 2
- 3
- 4
Sitter services*
- 1
- 2
- 3
- 4
Please list the EMR systems you have used*
Other Skills:*
*
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.*
*
I hereby consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*
Name*
First Last
Email*
Phone*
TODAY'S DATE*
MM slash DD slash YYYY

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Skills Checklist

Age of Patients Cared For

General Skills

SETTING

MANAGEMENT