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Hudson Staffing Travel Nurses| Hospice Online Checklist
Hospice Online Checklist
Thank you for your decision to apply for a travel nursing position with
! Before we can offer you a nursing employment opportunity in the Hospice field, an electronic skills assessment must be completed. Please, complete the nursing skills checklist below, and be sure to review your information thoroughly before clicking the submit button.
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Please enter your full name as it appears on your Social Security Card:
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This profile is for use by healthcare professionals in the Hospice discipline and specialty.
It will not be a determining factor for the program.
Please mark your level of experience
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
Home Health/Hospice Setting
PLAN OF CARE
Set Goals with Pt/Family
Collaborate with Other Team Members
Ensure Continuity of Care
Urgent Assessment of Symptoms
Reduce Symptoms to Level Acceptable to Pt.
Report Symptoms/Management to Provider
Treat Underlying Cause
Management of Nausea
Management of Constipation
Management of Fatigue
Educate Family on Symptom Management
Identify Source of Pain
PAINAD Scale for Non Verbal Patient
Reduce Pain to Level Acceptable to Patient
WHO 3 Step Ladder
Non-Pharmacologic Management of Pain
Pharmacologic Management of Pain
Effects of Pharmacologic Treatment
Management of Nociceptive Pain
Management of Neuropathic Pain
Educate Family on Pain Management
Bed/Support Surface Selection
Pressure Ulcer Staging/Management
Response to Treatment
Evaluate Factors that Impede Healing
Educate Family on Positioning/Shearing
Developmentally Appropriate Assessment
Pediatric Support Team Collaboration
Equianalgesic Conversion Formula
Titration of opioids
IV Pump Management
Evaluate Effectiveness of Medications
Family Management of Medications
Disposal of Medications
Facility Family/Cultural Rituals/Rites
Patient Care after Death
Coordinate Mortuary Services
Scope and Frequency of Services
Medicare/State Regulations for Hospice
Document Progression of Decline
DME Authorization & Documentation of Need/Order
PROFESSIONAL KNOWLEDGE AND SKILLS
Identify Source of Suffering
Palliative Care Philosophy
Patient/Family Directs Goals of Care
Maximize Quality of Life
Supervision of Ancillary Staff
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
Interpretation and Communication of Lab Values
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
Please read and agree to the statements below by marking the checkbox.
You will not be able to submit until you have marked the checkbox.
I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize Hudson Staffing to release this Hospice Skills Checklist to the client facilities in relation to consideration of employment as a healthcare professional with those facilities.
Hudson Staffing will record anonymous electronic information about your connection when you click on the submit button. This information is used for security purposes only. This information will include your IP Address (126.96.36.199) which will be used as a digital signature.
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