Download Orientation Competency Assessment and Validation Tool

Orientation Competency Assessment and Validation Tool
Name/Title:
Date(s):
Unit:
Self-Assessment
Can
Do
Needs
Review
Never
Done
Validation
Competencies
Discussed/
Reviewed
Initials
and
Date
Performance
Criteria
Initials
and
Date
1.0 Demonstrates
Compliance with
Policy/Standards
1.1 Department Policy and
Procedure Manual
1.2 Organization Policy and
Procedure Manual
1.3 Infection Prevention
1.4 Tuberculosis Control
1.5 Blood-borne Pathogens
1.6 Back Safety/Ergonomics
1.7 Fire Safety
1.8 Hazardous Materials
(SDS)
1.9 Electrical Safety
1.10 Radiation Safety
1.11 Disaster Emergency
Preparedness
© Joint Commission Resources, Inc. May be adapted for internal use.
1
Self-Assessment
Can
Do
Needs
Review
Never
Done
Validation
Competencies
Discussed/
Reviewed
Initials
and
Date
Performance
Criteria
Initials
and
Date
1.12 Age-Appropriate Care:
Adult and Pediatric
1.13 Threat Management
1.14 Infant Security
1.15 Performance
Improvement / Risk
Management
1.16 Significant Event
2.0 Demonstrates
Competence in Patient Care
and Technical Skills
2.1 Medical Emergency
Management
2.2 Checking Crash Cart
Equipment
2.3 Computer Entry
2.4 Data Collection
2.5 Immunization Update
2.6 Medication
Administration/Dosage
Calculation
2.6.1 Administering
Intradermal Medication
2.6.2 Administering
Intramuscular Medication
2.6.3 Administering SubQ
Medication
© Joint Commission Resources, Inc. May be adapted for internal use.
2
Self-Assessment
Can
Do
Needs
Review
Validation
Never
Done
Competencies
Discussed/
Reviewed
Initials
and
Date
Performance
Criteria
Initials
and
Date
2.6.4 Administering
Inhalation Treatments
2.6.5 IV Insertion
IV 1
IV 2
IV 3
2.7 Administering Blood and
Blood Components
2.8 Dressing and Wound
Care
2.9 Blood Glucose
Monitoring / Quality Control
2.10 Performing
Catheterization
2.11 Urinalysis QA
2.12 Oxygen Therapy
2.13 Procedural Sedation
Monitoring
2.14 Physical Assessment
2.14.1 Blood Pressure
2.14.2 Pulse
2.14.3 Respiration
2.14.4 Temperature
2.14.5 Pulse Oximetry
© Joint Commission Resources, Inc. May be adapted for internal use.
3
Self-Assessment
Can
Do
Needs
Review
Never
Done
Validation
Competencies
Discussed/
Reviewed
Initials
and
Date
Performance
Criteria
Initials
and
Date
2.14.6 Height
2.14.7 Weight
2.15 Ear Lavage
2.16 Triage and Advice of
Patients
2.17 Application of
Restraints
3.0 Demonstrates
Knowledge of Patient’s
Rights and Advocacy
3.1 Advance Directives
3.2 Member’s Rights
3.3 Quality of Service
3.4 Promotion of Preventive
Care (Clinical Guidelines)
3.5 Patient/Family Education
3.6 Confidentiality
3.7 Obtaining Consents
3.8 Abuse Reporting
3.9 Patient Identification
4.0 Demonstrates
Competence in
Department-Specific
Technical and Patient Care
Skills (per Separate Skills
Record)
© Joint Commission Resources, Inc. May be adapted for internal use.
4
Self-Assessment
Can
Do
Needs
Review
Validation
Never
Done
Competencies
Discussed/
Reviewed
Initials
and
Date
Performance
Criteria
Initials
and
Date
5.0 Identifies Own Learning
Needs
5.1
5.2
Initials:
Print Name/Signature:
Initials:
Print Name/Signature:
© Joint Commission Resources, Inc. May be adapted for internal use.
5