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1.877.891.4286
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Medication Aide – Skills Checklist
This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Precision Nationwide Staffing.
0 = Not Applicable
1 = No Experience
2 = Some Experience
3 = Intermittent Experience
4 = Experienced
5 = Very Experienced
Age of Patients Cared For
Pediatric
*
0
1
2
3
4
5
Adult
*
0
1
2
3
4
5
Geriatric
*
0
1
2
3
4
5
General Skills
Standard Precautions
*
0
1
2
3
4
5
Isolation Precautions
*
0
1
2
3
4
5
Obtain Vital Signs
*
0
1
2
3
4
5
Medication Dispensing Systems
*
0
1
2
3
4
5
Medication Dispensing Systems - List Types
*
Electronic Documentation
*
0
1
2
3
4
5
Electronic Documentation - List Types
*
Medication Administration procedures
Two Patient Identifiers
*
0
1
2
3
4
5
Check for/Document Allergies
*
0
1
2
3
4
5
Rights of Medication Administration
*
0
1
2
3
4
5
Supervision of Patient Taking Own Medications
*
0
1
2
3
4
5
Setting Up Medications for Patient to Take
*
0
1
2
3
4
5
Administration/Response to PRN Medications
*
0
1
2
3
4
5
Medication Monitoring
Monitor Pt for Unintended Med Actions/Side Effects
*
0
1
2
3
4
5
Monitor for Allergic/Toxic Reactions
*
0
1
2
3
4
5
Report All Unintended Reactions to Supervising Nurse
*
0
1
2
3
4
5
Medication Formulations
Oral Tablets/Capsules/Liquid/Sublingual Medications
*
0
1
2
3
4
5
Oral Enteric-Coated
*
0
1
2
3
4
5
Oral Long-Acting/Extended Release
*
0
1
2
3
4
5
Ophthalmic (eye)
*
0
1
2
3
4
5
Otic (ear)
*
0
1
2
3
4
5
Nasal
*
0
1
2
3
4
5
Suppositories
*
0
1
2
3
4
5
Aerosols
*
0
1
2
3
4
5
Topicals/Transdermals
*
0
1
2
3
4
5
Medication Types
Cardiovascular
*
0
1
2
3
4
5
Anticoagulants
*
0
1
2
3
4
5
Diuretics
*
0
1
2
3
4
5
Potassium
*
0
1
2
3
4
5
Pulmonary
*
0
1
2
3
4
5
Antibiotics
*
0
1
2
3
4
5
Neurologic
*
0
1
2
3
4
5
Psychiatric
*
0
1
2
3
4
5
Pain Relief
*
0
1
2
3
4
5
Oral Hypoglycemics
*
0
1
2
3
4
5
Clinical Settings
Acute Care
*
0
1
2
3
4
5
Long Term Care
*
0
1
2
3
4
5
Acute long Term Care
*
0
1
2
3
4
5
Assisted Living
*
0
1
2
3
4
5
Other Settings
*
0
1
2
3
4
5
Information & Agreement
Application ID
*
Please enter your application ID. This ID should be 15 characters long and have the format of PHNMS##########. You should have received an email containing your application ID when you submitted your initial application. If not, please contact our staff.
Applicant Name
*
First
Last
Applicant Email
*
Applicant Phone
*
I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified within the last 2 years.
*
I agree to the terms below.
The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Precision Nationwide Staffing. Submit this skills evaluation with your initial application. To be updated annually.
Signature
*