Psych / Behavioral Health Skills Checklist

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TREATMENT SETTINGS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Inpatient hospital psychiatric unit123
Inpatient acute psychiatric facility123
Chronic psychiatric facility123
Outpatient clinic/community setting123
Forensic unit (prison)123
Eating disorder unit123
Substance abuse/rehab unit123
Locked unit/ward123
LEGAL/ETHICAL EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Advanced directives123
Legal right’s of the mentally ill123
Informed consent123
Right to refuse treatment123
Voluntary commitment123
Involuntary commitment123
Restrictive devices (restraints)123
Use of seclusion123
Terrasoff “duty to warn”123
EMERGENCY CARE EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Use of rapid response teams123
Cardiac arrest/CPR123
Airway management123
Oxygen therapy123
Oral/nasotracheal suctioning123
Pulse oximetry123
IV therapy123
Start & maintaining peripheral IVs123
Blood draw: venous123
Infusion pumps123
SKILLED NURSING CARE EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Assessment of circulation/peripheral pulses123
Blood Glucose Monitoring (BGM)123
Foley catheter insertion/maintenance123
NG tube insertion/maintenance123
Wound care/dressing changes123
Administration of blood/blood products123
Management of fluid/electrolyte balance123
Seizure precautions123
National Patient Safety Goals123
Accurate patient identification123
Effective communication123
Interpretation & communication of lab values123
Medication administration123
Awareness of HCAHPS123
Bar coding for medication administration123
Labeling (medications & specimens)123
Medication reconciliation123
Anticoagulation therapy123
Pain assessment & management123
Infection control123
Universal precautions123
Isolation123
Minimize risk for falls123
Prevention of pressure ulcers123
CLINICAL ASSESSMENT TOOLS EXPERIENCE - INTELLIGENCE ASSESSMENT:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Wechsler Intelligence Scale (WAIS)123
Wechsler Intelligence Scale for Children123
PSYCHOLOGICAL TESTING:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Minnesota Multiphasic Personality Inventory (MMPI)123
Beck Depression Inventory (BDI)123
Thematic Apperception Test (TAT)123
Child’s Apperception Test (CAT)123
Informal cognitive status assessment123
Mental status assessment123
Gestalt test123
Stanford-Binet test123
COMMUNICATION TECHNIQUES EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Active listening123
Restatement/reflection123
Clarification123
Focusing123
Confronting123
Summarizing123
THERAPEUTIC INTERVENTIONS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Limit setting123
Positive reinforcement123
Reality orientation123
Questioning123
PSYCHIATRIC DISORDERS EXPERIENCE - MOOD DISORDERS

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Major depression123
Dysthymia123
Bipolar disorder (manic-depressive illness)123
Type I123
Type II123
ANXIETY DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
GAD - Generalized Anxiety Disorder123
Panic123
Post Traumatic Stress Disorder123
Obsessive-compulsive123
Phobias123
PSYCHOTIC DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Schizophrenia123
Schizoaffective disorder123
Schizophreniform disorder123
PERSONALITY DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Antisocial123
Passive/aggressive123
Paranoia123
Borderline123
Schizotypal personality disorder123
CONGENITAL DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Mental retardation123
Down’s syndrome123
Cystic fibrosis123
Cerebral palsy123
Spina bifida123
DEGENERATIVE DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Alzheimer’s disease123
Parkinson’s disease123
Huntington’s chorea123
EATING DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Anorexia nervosa123
Bulimia nervosa123
Pica123
CRISIS MANAGEMENT EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Homicide123
Suicide/suicide precautions123
Rape123
Violence/family & individuals123
SUBSTANCE USE / ABUSE EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Withdrawal syndrome123
Alcohol or ETOH123
CIWA scale123
Delirium tremens (DTs)123
Wernicke-Korsakoff123
DRUG USE/ABUSE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Hallucinogenics123
Opiates123
Heroin123
Prescription123
Stimulants (amphetamines/cocaine/MDMA)123
Benzodiazepine123
Drug withdrawal/detoxification123
COWS scale for opiate withdrawal symptom assessment123
SEXUALITY DYSFUNCTION EXPERIENCE - GENDER IDENTITY DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Paraphilias123
Psychosexual dysfunctions123
CHILD/ADOLESCENT DYSFUNCTION EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Conduct disorder123
Separation anxiety disorders123
ADHD (Attention Deficit Hyperactivity Disorder)123
ADD (Attention Deficit Disorder)123
ELIMINATION DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Encopresis123
Enuresis123
PERVASIVE DEVELOPMENTAL DISORDERS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Autism123
Asperger’s syndrome123
Rett syndrome123
Self destructiveness123
Suicidal behavior123
Runaway behavior123
Substance abuse123
Delinquent behavior123
Neglect/lack of parental involvement123
Physical/sexual abuse123
Care of the patient with delusions123
Care of the patient with hallucinations123
THERAPEUTIC APPROACHES EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Psychotherapy123
Behavior therapy123
Milieu management123
Relationship/family therapy123
Electroconvulsive Therapy (ECT)123
Crisis counseling123
Behavior modification123
Group therapy123
MEDICATIONS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Analgesics/narcotics (MS, Dilaudid, Demerol, fentanyl, methadone)123
Antidepressants (TCA, MAOIs, SSRIs)123
Antiolytics (Valium, Ativan, Xanax)123
Antiparkinson (levodopa, Sinemet)123
Antipsychotic (Thorazine, Haldol, zyrexa, Seroquel)123
Mood stabilizer (lithium, Depakote, Tegretol)123
Automated Medication Dispensing System, Pyxis, Omnicell, or other123
AGE-SPECIFIC COMPETENCIES EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
School age (ages 6-12 years)123
Adolescents (ages 13-21 years)123
Young adult (ages 22-39 years)123
Adults (ages 40-64 years)123
Older adult (ages 65-79 years)123
Elderly (ages 80+ years)123

Attestation

ATTESTATION: *