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HomeGeriatric and Long Term Care Skills Checklist

Geriatric and Long Term Care Skills Checklist

Instructions:

Please rate your experience / frequency (within the last year) using the following scale (check the appropriate boxes below):

  • 0 = No Experience / Observed Only
  • 1 = Limited Experience / Rarely Done (<6 times/year)
  • 2 = May Need Some Review / Occasionally Done (1 – 2 times/month)
  • 3 = Experienced / Frequently Done (daily or weekly)

Geriatric and Long Term Care Skills Checklist

  • TYPE OF FACILITY EXPERIENCE

  • AGE OF PATIENTS CARED FOR

  • GENERAL SKILLS

  • MEDICATIONS-KNOWLEDGE AND USE OF

  • PHLEBOTOMY / IV THERAPY

  • CARDIAC GENERAL

  • CARDIAC-Care of patient with:

  • KNOWLEDGE AND USE OF

  • RESPIRATORY GENERAL

  • RESPIRATORY-Care of patient with:

  • KNOWLEDGE AND USE OF

  • NEURO GENERAL

  • NEURO-Care of patient with:

  • SENSORY DEFICITS-Care of patient with:

  • KNOWLEDGE AND USE OF

  • GI GENERAL

  • GASTROINTESTINAL-Care of patient with:

  • ENDOCRINE GENERAL

  • ENDOCRINE-Care of patient with:

  • KNOWLEDGE AND USE OF

  • RENAL/GU GENERAL

  • RENAL/GU - Care of patient with:

  • ORTHOPEDIC GENERAL

  • ORTHOPEDIC-Care of patient with:

  • WOUND/SKIN-Care of patient with:

  • WOUND/SKIN GENERAL

  • ADDITIONAL SKILLS-Care of patient with: