UNIVERSITY OF SOUTH ALABAMA
COLLEGE OF ALLIED HEALTH PROFESSIONS
DEPARTMENT OF CARDIORESPIRATORY CARE
Clinical Competency Checklist
Chest Physical Therapy
Student Name _____________________________________Date_________ Attempt # ____________
Rating Scale: 0 = inappropriate, incorrect, or omitted
1 = needs additional study and practice
2 = completed appropriately and correct
N/A = not applicable
ITEM
RATING
1. Checks written physician order for frequency of chest physical therapy.
______
2. Assures patient identity
______
3. Washes hands
______
4. Completes patient assessment
______
5. Communicates with the patient, explaining the rationale for the therapy,
and instructs the patient how to perform the therapy
______
6. Positions the patient for therapy to the prescribed areas
______
7. Percusses with cupped hands or uses mechanical vibropercusser (if indicated).
______
8. Vibrates during deep expiration (if indicated)
______
9. Encourages coughing or suctioning (if indicated)
______
10. Performs necessary charting to include:
parameters of treatment, quality of cough, sputum characteristics (if obtained),
breath sounds, patient’s reaction, and side effect, if any
______
11. Completes other documentation.
______
90% proficiency required to pass
Total = ________ out of 22
Score = _____ pass _____ fail
Instructor’s Signature: _____________________________________________
Instructor's Name: _______________________________ Credential: ______
(Please print)
Student's Signature: ________________________________________________
Comments ________________________________________________________