Oncology Competency Self Assessment

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1 Oncology Competency Self Assessment Directions Please circle a value for each question to provide us and the interested facilities with an assessment of your clinical experience. These values confirm your strengths within your specialty and assist the facility in the selection process of the healthcare professional. 1 No 2 Some (Require Assistance) 3 Intermittent (May Require Assistance) 4 d (Performs without Assistance) 5 Very d (Able to Teach/Supervise) Print Name Last 4 Digits of SS# Date Settings Inpatient oncology unit Outpatient oncology unit Hospice/palliative care Participation in support groups Death & dying counseling General Skills Awareness of HCAHPS Advanced directives Patient/family teaching Restrictive devices (restraints) Lift/transfer devices Specialty beds End of life care/palliative care Automated Medication Dispensing System, Pyxis, Omnicell, or other Bar coding for medication administration National Patient Safety Goals Accurate patient identification Effective communication Interpretation & communication of lab values Medication administration Labeling Anticoagulation therapy Reconciliation Monitoring conscious sedation Pain assessment & management Use of PCA (IV, intrathecal, epidural) Infection control Universal precautions Isolation Minimize risk for falls Medical Staffing Network Rev. 06/15 F01202 Oncology 1 of 7

2 1 No 2 Some (Require Assistance) 3 Intermittent (May Require Assistance) 4 d (Performs without Assistance) 5 Very d (Able to Teach/Supervise) General Skills - cont. Prevention of pressure ulcers Wound care Cardiac Monitoring & Emergency Care Obtains 12 lead EKG Interpretation of rhythm strips Treatment of dysrythmias Use of rapid response teams Cardiac arrest/cpr O2 therapy & delivery Pulse oximetry Use of doppler IV Therapy Starting & maintaining peripheral IVs Blood draw: venous Central line care Blood draw: central line Care & management of ports Care & management of PICC/Groshong/Hickman TPN & lipids Administration of blood/blood products Administration of chemotherapy Continuous infusion IV push Oral Monitoring chemotherapy (does not initiate) Other Diabetes mellitus Blood Glucose Monitoring (BGM) Insulin administration Cardiovascular Cardiac assessment Care of Patient with: CHF Cardiac disease (CAD/MI/post CABG) Hypertension Pacemakers Medical Staffing Network Rev. 06/15 F01202 Oncology 2 of 7

3 1 No 2 Some (Require Assistance) 3 Intermittent (May Require Assistance) 4 d (Performs without Assistance) 5 Very d (Able to Teach/Supervise) Respiratory Ascultation of breath sounds Chest PT Tracheostomy care Oral or nasotracheal suctioning Assist with chest tube insertion & management Assist with thoracentesis Care of Patient with: Asthma COPD Pneumonia Tuberculosis GI/GU NG tube insertion Long term feeding tube insertion (Dobhoff/Keofeed) Care of the patient with enteral feedings Gastrostomy tube Jejunostomy tube Colostomy & enterostomal care Ileostomy Peritoneal dialysis Hemodialysis Care of shunts & fistulas Nephrostomy tube Suprapubic catheter Foley catheter insertion & management Neuro Comprehensive neuro assessment Seizure precautions Care of Patient with: Post neuro surgery TIA/CVA Degenerative neurological disorders Medical Staffing Network Rev. 06/15 F01202 Oncology 3 of 7

4 1 No 2 Some (Require Assistance) 3 Intermittent (May Require Assistance) 4 d (Performs without Assistance) 5 Very d (Able to Teach/Supervise) Oncology Specific Care Assist with bone marrow biopsy Immunosuppression/laminar airflow Administration of chemotherapy Use & Administration of the Following: Fluorouracil (5-FU) Doxorubicin (Adriamycin) Methotrexate (amethopterin) Mitomycin (Mutamycin) Bleomycin (blenoxane) Hydroxyurea (Hydrea) Melphalan (Alkeran) Usulfan (Myleran) Etoposide (VP ) Cistplatin Vinblastine (Velban) Vincristine (Oncovin) Cyclophosphamide (Cytoxan) Avastin Taxol Herceptin Carboplatin Taxotere Oxaliplatin Dilantin Corticosteroids Decadron IVIG Epogen/neupogen Biotheraputic agents (Rituxan) Care of the Patient Pre & post Bone Marrow Transplant (BMT) BMT patient care Patient & donor education Peripheral blood stem cells Solid tumors Hematologic disorders Autologous BMT Medical Staffing Network Rev. 06/15 F01202 Oncology 4 of 7

5 1 No 2 Some (Require Assistance) 3 Intermittent (May Require Assistance) 4 d (Performs without Assistance) 5 Very d (Able to Teach/Supervise) Care of the Patient - cont. Allogeneic BMT BMT complications Infection Graft rejection GVHD Graft-Versus-Host Disease Care of Oncology Adverse Effects Compromise: Other Nausea/vomiting/diarrhea Stomatitis Neuropathy Neutropenia Thrombocytopenia Nutritional needs Fever Infection Septic shock Cardiovascular Compromise Cardiac dysrhythmias Superior vena cava syndrome Cardiac tamponade Carotid rupture Lymphedema Respiratory Compromise Pneumonia Atelectasis Pneumothorax Pleural effusion Pulmonary embolism Respiratory distress GI/GU Compromise Bowel obstruction Renal failure Pancreatitis GI bleed Hematologic Compromise DIC (Disseminated Intravascular Coagulopathy) Hemorrhage Medical Staffing Network Rev. 06/15 F01202 Oncology 5 of 7

6 1 No 2 Some (Require Assistance) 3 Intermittent (May Require Assistance) 4 d (Performs without Assistance) 5 Very d (Able to Teach/Supervise) Care of Oncology Adverse Effects Fluid & Electrolytes Compromise Electrolyte imbalances Hypercalcemia Hypovolemia Skin & Muscle Stress fractures Spinal Cord Compression (SCC) Care of Patients Receiving Radiation therapy External radiotherapy Total body irradiation Intraoperative Radiation Therapy (IORT) & implants Brachytherapy Radiation safety procedures Age Specific Competencies Newborn/neonate (birth-30 days) Infant (31 days-1 year) Toddler (ages 2-3 years) Preschool (ages 4-5 years) School age (ages 6-12 years) Adolescent (ages years) Young adult (ages years) Adult (ages years) Older adult (ages years) Elderly (ages 80+ years) Medical Staffing Network Rev. 06/15 F01202 Oncology 6 of 7

7 1 No 2 Some (Require Assistance) 3 Intermittent (May Require Assistance) 4 d (Performs without Assistance) 5 Very d (Able to Teach/Supervise) Please list any Additional Skills: Additional training: Additional equipment: Fax to: The information on this and all preceding pages is true and correct. Signature Date 2015 Medical Staffing Network Rev. 06/15 F01202 Oncology 7 of 7

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