Age of Patients Cared ForSchool 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 (Over 64 + years)* 1 2 3 4 Psychiatric and General SkillsAdmission* 1 2 3 4 Therapeutic Communication Skills* 1 2 3 4 Neurological Assessment* 1 2 3 4 Initial Treatment Plan* 1 2 3 4 Initial Nursing Assessment and Care Plan* 1 2 3 4 Nursing Diagnoses* 1 2 3 4 Nursing Reassessment and Care Planning Update* 1 2 3 4 Behavioristic Charting* 1 2 3 4 Treatment/Goal Oriented* 1 2 3 4 Discharge Planning* 1 2 3 4 Patient Teaching* 1 2 3 4 Active Participation in Multi-Disciplinary Staffing* 1 2 3 4 Group Therapy Leader* 1 2 3 4 Multi-Disciplinary Treatment Team Participation* 1 2 3 4 Participation in Milieu Therapy* 1 2 3 4 Assist Physician in administration of Electroconvulsive Therapy* 1 2 3 4 Suicide Risk Assessment* 1 2 3 4 Suicide Precautions* 1 2 3 4 Psychiatric Emergency Response Team* 1 2 3 4 Rapid Tranquilization* 1 2 3 4 Telephonic Crisis Intervention* 1 2 3 4 Restraints – Application, Assessment and Reassessment of* 1 2 3 4 Seclusion* 1 2 3 4 Management of Drug/Alcohol and Detox Symptoms* 1 2 3 4 Management of Assaultive Behavior* 1 2 3 4 Involuntary/Voluntary Commitment* 1 2 3 4 Vital Signs* 1 2 3 4 Patient Head to Toe Physical Assessment* 1 2 3 4 Insertion and Care of Straight and Foley Catheter* 1 2 3 4 Tube Feeding* 1 2 3 4 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 Pain Management* 1 2 3 4 Automated Med Dispensing Systems* 1 2 3 4 OT Therapy and Medication Delivery SystemsBag and Mask* 1 2 3 4 External CPAP* 1 2 3 4 Face Masks* 1 2 3 4 Inhalers* 1 2 3 4 Nasal Cannula* 1 2 3 4 Portable O2 Tank* 1 2 3 4 Oronaso Pharyngeal Suctioning* 1 2 3 4 Psychiatric – Care of Patients with:Alzheimer’s/Dementia* 1 2 3 4 Bipolar Disorder* 1 2 3 4 PTSD* 1 2 3 4 Anxiety Disorder* 1 2 3 4 Alcohol/Drug Dependency* 1 2 3 4 Depressive Disorder* 1 2 3 4 Eating Disorder* 1 2 3 4 Schizophrenic Disorder* 1 2 3 4 Hallucinations* 1 2 3 4 Electroconvulsive Therapy* 1 2 3 4 Manic Behavior* 1 2 3 4 Med-Psych Patient* 1 2 3 4 Organic Disorder* 1 2 3 4 Violent Behavior* 1 2 3 4 Seclusion and Restraints* 1 2 3 4 Seizure Disorder* 1 2 3 4 Suicidal Behavior* 1 2 3 4 MedicationsAdministration of Oral Psychopathic Medication* 1 2 3 4 Antabuse* 1 2 3 4 Methadone* 1 2 3 4 Heparin* 1 2 3 4 Management of Extrapyramidal Symptoms* 1 2 3 4 Intramuscular* 1 2 3 4 Oral* 1 2 3 4 Rectal* 1 2 3 4 Sub-q* 1 2 3 4 Unit Does* 1 2 3 4 Z-Track* 1 2 3 4 Phlebotomy/IV TherapyPeripheral IV Insertion, Care and Maintenance* 1 2 3 4 Care and Maintenance of PICC Line* 1 2 3 4 Care and Maintenance of Central Line* 1 2 3 4 Administration of Blood/Blood ProductsDrawing Blood from Central Line* 1 2 3 4 Drawing Venous Blood* 1 2 3 4 Management of Patient with Hyperalimentation* 1 2 3 4 SettingsSubstance Abuse/Rehab* 1 2 3 4 Pediatric/Adolescent* 1 2 3 4 Adult* 1 2 3 4 Partial* 1 2 3 4 Inpatient* 1 2 3 4 Outpatient* 1 2 3 4 Eating Disorders Clinic* 1 2 3 4 Locked Unit* 1 2 3 4 Rehab Unit* 1 2 3 4 Please list the EMR systems you have used** 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