Psych / Behavioral Health Skills Checklist
   NAME  
   Email-Id
   DATE    
I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Instructions:

This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

 
Proficiency Scale: 1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

 
Rating Stars (Click)
TREATMENT SETTINGS EXPERIENCE: 1
2
3
4
Inpatient hospital psychiatric unit
Inpatient acute psychiatric facility
Chronic psychiatric facility
Outpatient clinic/community setting
Forensic unit (prison)
Eating disorder unit
Substance abuse/rehab unit
Locked unit/ward
Rating Stars (Click)
LEGAL/ETHICAL EXPERIENCE: 1
2
3
4
Advanced directives
Legal right’s of the mentally ill
Informed consent
Right to refuse treatment
Voluntary commitment
Involuntary commitment
Restrictive devices (restraints)
Use of seclusion
Terrasoff “duty to warn”
Rating Stars (Click)
EMERGENCY CARE EXPERIENCE: 1
2
3
4
Use of rapid response teams
Cardiac arrest/CPR
Airway management
Oxygen therapy
Oral/nasotracheal suctioning
Pulse oximetry
IV therapy
Start & maintaining peripheral IVs
Blood draw: venous
Infusion pumps
Rating Stars (Click)
SKILLED NURSING CARE EXPERIENCE: 1
2
3
4
Assessment of circulation/peripheral pulses
Blood Glucose Monitoring (BGM)
Foley catheter insertion/maintenance
NG tube insertion/maintenance
Wound care/dressing changes
Administration of blood/blood products
Management of fluid/electrolyte balance
Seizure precautions
National Patient Safety Goals
Accurate patient identification
Effective communication
Interpretation & communication of lab values
Medication administration
Awareness of HCAHPS
Bar coding for medication administration
Labeling (medications & specimens)
Medication reconciliation
Anticoagulation therapy
Pain assessment & management
Infection control
Universal precautions
Isolation
Minimize risk for falls
Prevention of pressure ulcers
Rating Stars (Click)
CLINICAL ASSESSMENT TOOLS EXPERIENCE - INTELLIGENCE ASSESSMENT: 1
2
3
4
Wechsler Intelligence Scale (WAIS)
Wechsler Intelligence Scale for Children
Rating Stars (Click)
PSYCHOLOGICAL TESTING: 1
2
3
4
Minnesota Multiphasic Personality Inventory (MMPI)
Beck Depression Inventory (BDI)
Thematic Apperception Test (TAT)
Child’s Apperception Test (CAT)
Informal cognitive status assessment
Mental status assessment
Gestalt test
Stanford-Binet test
Rating Stars (Click)
COMMUNICATION TECHNIQUES EXPERIENCE: 1
2
3
4
Active listening
Restatement/reflection
Clarification
Focusing
Confronting
Summarizing
Rating Stars (Click)
THERAPEUTIC INTERVENTIONS EXPERIENCE: 1
2
3
4
Limit setting
Positive reinforcement
Reality orientation
Questioning
Rating Stars (Click)
PSYCHIATRIC DISORDERS EXPERIENCE - MOOD DISORDERS 1
2
3
4
Major depression
Dysthymia
Bipolar disorder (manic-depressive illness)
Type I
Type II
Rating Stars (Click)
ANXIETY DISORDERS: 1
2
3
4
GAD - Generalized Anxiety Disorder
Panic
Post Traumatic Stress Disorder
Obsessive-compulsive
Phobias
Rating Stars (Click)
PSYCHOTIC DISORDERS: 1
2
3
4
Schizophrenia
Schizoaffective disorder
Schizophreniform disorder
Rating Stars (Click)
PERSONALITY DISORDERS: 1
2
3
4
Antisocial
Passive/aggressive
Paranoia
Borderline
Schizotypal personality disorder
Rating Stars (Click)
CONGENITAL DISORDERS: 1
2
3
4
Mental retardation
Down’s syndrome
Cystic fibrosis
Cerebral palsy
Spina bifida
Rating Stars (Click)
DEGENERATIVE DISORDERS: 1
2
3
4
Alzheimer’s disease
Parkinson’s disease
Huntington’s chorea
Rating Stars (Click)
EATING DISORDERS: 1
2
3
4
Anorexia nervosa
Bulimia nervosa
Pica
Rating Stars (Click)
CRISIS MANAGEMENT EXPERIENCE: 1
2
3
4
Homicide
Suicide/suicide precautions
Rape
Violence/family & individuals
Rating Stars (Click)
SUBSTANCE USE / ABUSE EXPERIENCE: 1
2
3
4
Withdrawal syndrome
Alcohol or ETOH
CIWA scale
Delirium tremens (DTs)
Wernicke-Korsakoff
Rating Stars (Click)
DRUG USE/ABUSE: 1
2
3
4
Hallucinogenics
Opiates
Heroin
Prescription
Stimulants (amphetamines/cocaine/MDMA)
Benzodiazepine
Drug withdrawal/detoxification
COWS scale for opiate withdrawal symptom assessment
Rating Stars (Click)
SEXUALITY DYSFUNCTION EXPERIENCE - GENDER IDENTITY DISORDERS: 1
2
3
4
Paraphilias
Psychosexual dysfunctions
Rating Stars (Click)
CHILD/ADOLESCENT DYSFUNCTION EXPERIENCE: 1
2
3
4
Conduct disorder
Separation anxiety disorders
ADHD (Attention Deficit Hyperactivity Disorder)
ADD (Attention Deficit Disorder)
Rating Stars (Click)
ELIMINATION DISORDERS: 1
2
3
4
Encopresis
Enuresis
Rating Stars (Click)
PERVASIVE DEVELOPMENTAL DISORDERS: 1
2
3
4
Autism
Asperger’s syndrome
Rett syndrome
Self destructiveness
Suicidal behavior
Runaway behavior
Substance abuse
Delinquent behavior
Neglect/lack of parental involvement
Physical/sexual abuse
Care of the patient with delusions
Care of the patient with hallucinations
Rating Stars (Click)
THERAPEUTIC APPROACHES EXPERIENCE: 1
2
3
4
Psychotherapy
Behavior therapy
Milieu management
Relationship/family therapy
Electroconvulsive Therapy (ECT)
Crisis counseling
Behavior modification
Group therapy
Rating Stars (Click)
MEDICATIONS EXPERIENCE: 1
2
3
4
Analgesics/narcotics (MS, Dilaudid, Demerol, fentanyl, methadone)
Antidepressants (TCA, MAOIs, SSRIs)
Antiolytics (Valium, Ativan, Xanax)
Antiparkinson (levodopa, Sinemet)
Antipsychotic (Thorazine, Haldol, zyrexa, Seroquel)
Mood stabilizer (lithium, Depakote, Tegretol)
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Rating Stars (Click)
AGE-SPECIFIC COMPETENCIES EXPERIENCE: 1
2
3
4
School age (ages 6-12 years)
Adolescents (ages 13-21 years)
Young adult (ages 22-39 years)
Adults (ages 40-64 years)
Older adult (ages 65-79 years)
Elderly (ages 80+ years)