ONCOLOGY SKILLS CHECKLIST
Name___________
Date_________
Key:
____________________
_______________________
1 = No Experience
2 = Some Experience
3 = Moderate Experience
4 = Proficient
CHECK PROFICIENCY
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CHECK PROFICIENCY
Chemotherapy (Continued)
Oncologic Procedures
Assist with bone marrow Biopsy
i.
Oral
Bronchoscopy
j.
Subcutaneous
Pericardiocentesis
Calculate Body Surface Area (BSA)
Pleurodesis
Check dosage
Assist with liver biopsy
Evaluate Pertinent lab data
Assist with paracentesis
Follow Protocols
Assist with chest tube insertion
Manage cytotoxic spills
Assist with central line placement
Assist with thoracentesis
Patient teaching
IV Therapy:
Safety Handle
1.
Starting IV’s
2.
Administer bone marrow
3.
Administer Blood Components
a.
Cryoprecipitate
b.
Fresh Frozen Plasma
c.
Irradiated Components
d.
Packed red Blood Cells
(PRBC)
e.
Platelet concentrates
a.
Cytotoxic agents
b.
Body fluids after chemotherapy
Radiation therapy
Brachytherapy
External Radiotherapy
Intraoperative Radiotherapy
Intraoperative Radiotherapy (IORT)
Non-sealed radioactive therapy
4.
Antifungals
5.
Antivirals
6.
Total parenteral Nutrition
Patient teaching
Radiation safety precautions
Total body irradiation (TBI)
Care of Patients with:
Chemotherapy:
Acute and/or chronic pain
Administration Chemotherapy:
a.
Intra-arterial
b.
Intramuscular
c.
Intra-peritoneal
d.
Intra-pleural
e.
Intra-veslcular
f.
Intra-thecal (administer & assist)
g.
Intra-vesicular
h.
IVPB & continuous infusion
MCNW-F-008, R2 (3/8/2016)
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a.
Adjuvant medications
b.
Transdermal agents
c.
Oral timed release agents
d.
PCA pump
e.
Epidural medications
f.
IV push narcotic agents
g.
Continuous narcotic infusion
h.
Alternative therapies
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ONCOLOGY SKILLS CHECKLIST
CHECK PROFICIENCY
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CHECK PROFICIENCY
Care of Patients with: (Continued)
Care of Patients Receiving: Continued
i.
Non-pharmacologic strategies
2)
Interferons
j.
Oral time release agents
3)
Interleukins
k.
PCA pump
l.
Transdermal agents
b.
Patient teaching
c.
Recognize and manage side
effects
Experiencing Surgery
a.
Chest tubes
b.
Enteral feeding tubes
a.
Allogeneic BMT
c.
Gastrointestinal drainage tubes
b.
Autologous BMT
d.
Lymphedema
c.
Complications
e.
Ostomy care
f.
Patient teaching
g.
Reconstructive surgery
h.
Wound drains and tubes
Bone Marrow Transplant (BMT)
Alteration of Protective Mechanisms
1)
Graft rejection
2)
Graft vs. host disease
(GVHD)
3)
Infection
4)
Pneumonitis
5)
Venoocclusive disease
a.
Altered mental status
b.
Altered skin integrity
c.
Laminar airflow units
Peripheral blood stem cells
d.
Neuropathy
Ambulatory Infusion Pumps
e.
Neutropenia
Auto Syrige
f.
Stomatitis
a.
Auto syringe
g.
Thrombocytopenia
b.
CADD
Oncologic Emergencies:
c.
Cormed
Disseminated intra-vasculare
coagulation (DIC)
d.
Pancretec
e.
Pharmacia
Hemorrhage
f.
Synchromed
Anaphylaxis
Implantable Pumps
Septic shock
a.
Infusaid
Hypokalemia
b.
Medtronic
Hypercalcemia
c.
Therex
SIADH
Implantable Vascular Access Ports:
Superior Vena Cava Syndrome
Accessing catheter port
Capillary leak syndrome
Chemoport
Fever
Flushing catheter
Acute Tumor Lysis Syndrome (ATLS)
Obtain Blood Specimens
Care of Patients Receiving:
Omega Port
Biotherapy
Opti-Port
a.
Administration of:
Port-O-Cath
1)
S.E.A. Port
Growth Factors
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ONCOLOGY SKILLS CHECKLIST
CHECK PROFICIENCY
1 2 3 4
CHECK PROFICIENCY
1 2 3 4
Implantable Vascular Access Ports: (continued)
Immunosuppressed Patients: (Continued)
Patient teaching:
Reverse isolation procedures
a.
Pre-op
Laminar air flow units
b.
Post-op
Patient teaching
c.
Home care
Pulmonary
Venous Access Devices
Assessment of breathing patterns
a.
Broviac
Oropharyngeal suctioning
b.
Central venous thrombosis
Tracheostomy suctioning
c.
Declot occluded ports or
catheters
Proficient at:
d.
Dressing change
e.
Flush lumens and change caps
f.
Groshong
GASTROINTESTINAL
g.
Hickman
TPN/PPN administration
h.
Insertion of PICC Line
i.
Obtain blood specimens
G-Tubes/J-Tubes (site care and feeding
through)
j.
Patient teaching
Enterostomal care (ostomy care)
k.
Peripherally inserted central
Catheters (PICC Lines)
Flexible feeding tube insertion (Dobhoff,
Miller-Abbott)
l.
Quinton
m.
Temporary repair of severed or
punctured catheter
a.
Incentive spirometry teaching
b.
Pulse oximetry
c.
Chest tube maintenance
NG tube insertion
Colostomy irrigation and patient teaching
Tube feeding assessments (residual
checks, irrigation)
Psychosocial Care
Communication with patients/family
Management of sudden wound
dihiscence
Advance directives
Pediatric BMT experience
Assist with goal setting
Stem cell transplant experience
Death and dying counseling
Familiar with complications
Hospice care
a.
Graft rejection
Identify support groups for patients &
families
b.
Venoocclusive disease
c.
Graft-versus-host disease
(GVHD)
Participate in ethical decision making
ENDOCRINE
Patient & family education
Care of diabetic patient
a.
Cancer screening & detection
b.
Risk factors
Administration of SQ insulin
Administration of IV insulin (IVP and
drip)
Patient teaching self-care & coping skills
Blood glucose monitors (Accucheck,
Onetouch, Basic)
Care of patient with hypothyroidism
(Graves Disease)
Quality of life issues
Referral to interdisciplinary team
members
Use and Administration of
Immunosuppressed Patients:
a. Synthroid
Universal precaution
MCNW-F-008, R2 (3/8/2016)
b. Solu-Cortef
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ONCOLOGY SKILLS CHECKLIST
CHECK PROFICIENCY
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CHECK PROFICIENCY
1 2 3 4
Care of drains and tubes (Hemovac, JP,
Penrose)
c. Prednisone
d. Decadron
Miscellaneous
Wound debridement
Wet to dry dressing changes
Administration Blood and blood
Please check the box/es below for each group in which you have provided ageappropriate care:
.
A. Newborn/Neonate
(birth-30days)
F. Adolescents (12-18
years)
B. Infant (30 days-1 year)
G. Young adults (18-39
years)
C. Toddler (1-3 years)
H. Middle adults (39-64
years)
D. Preschooler (3-5
years)
I. Older adults (64-79
years)
E. School age children (512 years)
J. Elderly adults (80+
years)
The information I have provided is true and accurate to the best of my knowledge. I authorize MedCall NorthWest,Inc. to release this Skills Checklist to
client hospitals as needed in relation to my employment.
Please enter your full legal name as it appears on your Social Security Card.
First Name*
Middle Name *
Last 4 of Social Security Number *
Email:
Last Name*
Date *
(mm/dd/yyyy)
Month/year Oncology skills were last used:
/
* Electronic Signature Agreement. By signing and typing the last 4 of your Social Security Number (SSN) on
this document, you are signing the Document electronically. You agree your electronic signature is the legal
equivalent of your manual signature on the Agreement
MCNW-F-008, R2 (3/8/2016)
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ONCOLOGY SKILLS CHECKLIST
Registered Nurse Job Description Oncology
Name: ___________
______________________Date: _________
__________
Essential duties and responsibilities include:
1. One year general oncology experience in a hospital setting
2. Current RN License (in good standing, without disciplinary investigation or actions)
3. Current BLS/BCLS
4. Knowledge and skill of caring for the terminally ill patient
5. Head-to-toe assessments - knowledge of normal vs. abnormal findings and reporting of
abnormal findings to Charge Nurse, M.D., if warranted
6. Critical thinking to intervene with appropriate intervention for urgent/emergent care. Care of
acute and chronically ill patients
7. Knowledge of hemodynamics
8. Basic IV and central line skills
9. Phlebotomy skills
10. The ability to identify and manage life-sustaining physiologic functions in unstable patients
11. The ability to care for medical/surgical patient, to include orthopedic and neuro skills
12. Knowledge and care of patients undergoing chemotherapy and/or radiation therapy
13. Other duties, as assigned
Please enter your full legal name as it appears on your Social Security Card.
First Name*
Middle Name *
Last 4 of Social Security Number *
Email:
Last Name*
Date *
(mm/dd/yyyy)
Month/year Oncology skills were last used:
/
* Electronic Signature Agreement. By signing and typing the last 4 of your Social Security Number (SSN) on
this document, you are signing the Document electronically. You agree your electronic signature is the legal
equivalent of your manual signature on the Agreement
MCNW-F-008, R2 (3/8/2016)
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