Skills Checklist – Case Manager

Skills Checklist - Case Manager

Name
First Last
Phone
Email

ASSESSMENT/PATIENT CARE - GENERAL*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Admission
Advance Directives
Collect Appropriate Data
Discharge Teaching
Organ/Tissue Donation
Patient and Family Teaching
Managed Care
Insurance Case Management
Workman's Comp
Medicare
Medicaid
Discharge Planning
Nursing Home Placement
Chart Review and Financial Audit
Conservatorship
Adult Protective Services
Child Protective Services
Hospice Referrals
Palliative Care Referrals
Chronic Disease Management
Home Health Referrals
DME

ASSESSMENT/PATIENT CARE - COMPUTERIZED DOCUMENTATION*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Computerized
Documentation
ASSESSMENT/PATIENT CARE - CARDIOVASCULAR PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Acute MI
Angina
Cardiomyopathy
Cardiopulmonary Arrest
Congestive Heart Failure
Heart Transplant
ASSESSMENT/PATIENT CARE - PULMONARY PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
COPD
Lung Transplant
ASSESSMENT/PATIENT CARE - NEUROLOGICAL PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Acute Head Injury
Alzheimer's Disease
Coma
CVA
Multiple Sclerosis
Neuromuscular Disease
Spinal Cord Injury
ASSESSMENT/PATIENT CARE - GASTROINTESTINAL PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Abdominal Wounds and Surgeries
Colostomy
Hepatitis
Liver Failure
Liver Transplant
Pancreatitis
Liver Cancer
Pancreatic Cancer
ASSESSMENT/PATIENT CARE - RENAL/GENITOURINARY PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Acute Renal Failure
End Stage Renal Disease
Hemodialysis
Peritoneal Dialysis
Renal Transplant
Case Manager Check List
ASSESSMENT/PATIENT CARE - ENDOCRINE/METABOLIC PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Diabetics
ASSESSMENT/PATIENT CARE - MUSCULOSKELETAL PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Amputation
Multiple Trauma
Paraplegia
ASSESSMENT/PATIENT CARE - IMMUNOLOGY/HEMATOLOGY/ONCOLOGY PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Cancer
HIV/AIDS
Sickle Cell Anemia
Acute Leukemia
Treatment Side Effects Chemo/Radiation
ASSESSMENT/PATIENT CARE -WOUNDS/INTEGUMENT PATIENT EXPERIENCE*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Burns
Pressure Sores
Staged Decubitus
Ulcers
MEDICATIONS/THERAPEUTIC INTERVENTIONS - MEDICATIONS ADMINISTRATION*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Patient and Family Teaching
MEDICATIONS/THERAPEUTIC INTERVENTIONS - OXYGEN ADMINISTRATION*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Portable Oxygen
Home Oxygen
MEDICATIONS/THERAPEUTIC INTERVENTIONS - PAIN ADMINISTRATION*
Rarely Some Experience Proficient Trainer / Preceptor N/A
Assess Pain Level/Tolerance
Chronic Pain Management
Do you speak any languages other than English?*
- No
If yes, enter languages above, separated by commas.

Age Group Experience*

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Newborn (birth - 30 days)
Infant (30 days - 1 year)
Toddler (1 - 3 years)
Preschooler (3 - 5 years)
School Age (5 - 12 years)
Adolescents (12 - 18 years)
Young Adults (18 - 39 years)
Middle Adults (39-64 years)
Older Adults (64+ years)

Confirmation*
- I attest that the information I have given is both true and, to the best of my knowledge, represents an accurate self assessment of my professional skills and/or education.
Signature
Date
MM slash DD slash YYYY

Skills Checklist – Case Manager

Skills Checklist - Case Manager

Origin Travel Nurses has earned the Joint Commission's Gold Seal of Approval

© 2023 Origin Travel Nurses. All Rights Reserved.

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Acute MI
Angina
Cardiomyopathy
Cardiopulmonary Arrest
Congestive Heart Failure
Heart Transplant

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Acute Head Injury
Alzheimer's Disease
Coma
CVA
Multiple Sclerosis
Neuromuscular Disease
Spinal Cord Injury

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Abdominal Wounds and Surgeries
Colostomy
Hepatitis
Liver Failure
Liver Transplant
Pancreatitis
Liver Cancer
Pancreatic Cancer

	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
Acute Renal Failure
End Stage Renal Disease
Hemodialysis
Peritoneal Dialysis
Renal Transplant
Case Manager Check List