Licensed Clinical Social Worker Skills Checklist

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PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS:

Proficiency

  1. I have never done the stated task.
  2. I have performed the task/skill infrequently; I require more experience/practice to feel comfortable and proficient.
  3. I have performed the task/skill several times and feel moderately comfortable functioning independently but would require a resource person nearby.
  4. I have performed the task/skill frequently and would feel very comfortable and proficient performing it without supervision or practice.

Frequency

  1. 5 or less Annually
  2. 5 or less Quarterly
  3. 3 or less Monthly
  4. 1 - 5 times Daily/Weekly
ASSESSMENT PROCESS *
SKILLFREQUENCY
Health History
Physical Examination and Review of System
Development of Problem List
Development and Revision of Care Plan
Assesses Response to Treatment
Establishes and Revises Goals
Conducts Complete Initial Evaluation
DOCUMENTATION *
SKILLFREQUENCY
Initial Assessment and Plan
Skilled Visit Notes
Physician's Orders
Discharge Summary
ADHERES TO PLAN OF CARE *
SKILLFREQUENCY
Performs Services as Ordered
Documents according to Plan of Care
Communicates/Coordinates if Appropriate
EFFECTIVE CASE COORDINATION *
SKILLFREQUENCY
Reports and Documents Key Information to Physician, Supervisor, and Case Manager
Team Member (RN, PT, OT, ST, LPN/LVN)
Community Resources
Attends/Participates in Case Conferences as Required
INFECTION CONTROL *
SKILLFREQUENCY
Handwashing
Protective Equipment
Exposure Plan
ASSESSMENT AND EVALUATION *
SKILLFREQUENCY
Psychosocial Assessment
Financial Assessment
Emotional Assessment
Spiritual Assessment
Terminal Care Assessment
PATIENT EDUCATION AND CARE PARTICIPATION *
SKILLFREQUENCY
Establish Rapport with Patients/Families
Development of a Realistic and Actionable Goals List
Develops and Implements Teaching Plan
Engage Patients and Families in the Development of a Care Plan based on Identified Problems/Goals
Locate/Identify and Provide Appropriate, Accurate, and up-to-date Community Resources related to Patient Needs
Provision of Anticipatory Guidance when presenting Care Plan
Serve as a Liaison between Patients/Families and Resource Providers
Serve as an Advocate for Patient-Centered Care
Assist the Interdisciplinary Team with Understanding Significant Social and Emotional Factors related to Health Problems
Participate in Case Conference Activities
Participate in Discharge Planning Activities
AGE SPECIFIC COMPETENCIES *
SKILLFREQUENCY
Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64-79 years)
Elderly adults (80+ years)

Attestation

ATTESTATION: *