Regional Nurse Consultant

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Email us: info@ikajuq.ca

Call us: 1-888-272-9977

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Regional Nurse Consultant

Please rate your experience / frequency within the last year

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)

AGE OF PATIENTS CARED FOR

Newborn/Neonate (birth to 30 days)

1

2

3

Infant (1 month to 1 year)

1

2

3

Toddler (1 year to 3 years)

1

2

3

Preschooler (3 years to 5 years)

1

2

3

School Age Child (5 years to 12 years)

1

2

3

Adolescents (12 years to 18 years)

1

2

3

Young Adults (18 years to 39 years)

1

2

3

Middle Adults (39 years to 64 years)

1

2

3

Older Adults (64 years to 79 years)

1

2

3

Elderly Adults (over 79+ years)

1

2

3

GENERAL NURSING SKILLS

Standard Precautions

1

2

3

Isolation Precautions

1

2

3

Adult Respiratory/Cardiac Arrest

1

2

3

Crash Carts

1

2

3

Defibrillators

1

2

3

Care of Patient in Restraints

1

2

3

Automated Med Dispensing Systems

1

2

3

Patient/Family Education

1

2

3

Electronic Documentation

1

2

3

Systems Used - Please List

Patient Head to Toe Assessment

1

2

3

Wound Care

1

2

3

Care Planning & Discharge Planning

1

2

3

Consult with Physicians & Ancillary Health Staff

1

2

3

MEDICATIONS - Knowledge and use of

Pouring From Stock Medications

1

2

3

Narcotic Administration

1

2

3

IV Push/Drip Medications

1

2

3

Antibiotics

1

2

3

Oral

1

2

3

Topical

1

2

3

Otic

1

2

3

Rectal

1

2

3

Vaginal

1

2

3

Ophthalmic

1

2

3

Continuous Subcutaneous Infusion Pumps

1

2

3

Total Parenteral Nutrition (TPN)

1

2

3

Peripheral Parenteral Nutrition

1

2

3

Patient Controlled Analgesia (PCA)

1

2

3

Knowledge of "Do Not Use Abbreviations"

1

2

3

SKILLED ENVIRONMENTS

Acute Care/ Hospital

1

2

3

Managed Care

1

2

3

SNF/ Long Term Care

1

2

3

Home Health

1

2

3

Outpatient

1

2

3

GENERAL LEADERSHIP SKILLS

Written Communication Skills

1

2

3

Verbal Communication Skills

1

2

3

Basic Negotiation Skills

1

2

3

Job Related Computer Skills

1

2

3

Ability to Prioritize

1

2

3

Ability to Properly Maintain Records

1

2

3

Ability to Work Effectively in All Situations

1

2

3

Ability to Gather Data, Compile Information and Prepare Reports

1

2

3

Knowledge of Medical Billing Procedures

1

2

3

Community and Relationship Management

1

2

3

Regulations and guidelines of Long Term Care

1

2

3

Conflict Resolution

1

2

3

Quality Audits

1

2

3

Researching new methods and principles

1

2

3

KNOWLEDGE OF HEALTHCARE ENVIRONMENT

HIPAA and Patient Rights

1

2

3

Staff Roles and Responsibilities

1

2

3

Organizational Policy and Risk Management

1

2

3

Quality Improvement

1

2

3

Financial Management

1

2

3

Billing and Reimbursements

1

2

3

Knowledge of current Joint Commission National Patient Safety Goals

1

2

3

Knowledge/familiarity with HCAHPS scores

1

2

3

Knowledge of Oasis

1

2

3

Knowledge of CMS

1

2

3

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