Pharmacist Skills Checklist
  Pharmacist Skills Checklist
   NAME    
   LAST 4 OF SSN      
   DATE    
I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.  
Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.  
Proficiency Scale: 1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

 
       
Rating Stars (Click) Practice Settings/Experience 1 2 3 4  
Academia  
Ambulatory Care  
Clinic  
Compounding  
Consulting  
Correctional Facility (Jail)  
Diabetes  
Drug Information  
Formulary Management  
Geriatrics  
Home Health  
Home Infusion  
Hospital– Inpatient  
Hospital– Outpatient  
Infectious Disease  
Long Term Care (LTC)  
Mail Order  
Military/Government/VA  
Nuclear  
Oncology  
Pain Management  
Pediatrics  
Pharmaceutical Research  
Pharmaceutical Sales  
Pharmacy Benefits Management (PBM )  
Poison Control  
Psychiatric Patient Management  
Public Health  
Renal Patient Management  
Retail– Chain  
Retail– Independent  
Sub-Acute Care  
Veterinary  
Other:  
Other:  
Other:  
Rating Stars (Click) Pharmacy Software Systems 1 2 3 4  
Etreby  
HBS  
JASRx  
McKesson– 3PM  
McKesson– Pharmserv  
Meditech  
NDC  
OPUS– ISM  
OSCOR  
PDX  
PharmNet  
Pharmtrak  
PROScript 2000  
QS1  
Renlar  
Rescot– Omni-DX  
Rx-Link  
Speed Script  
TechRx  
WinPharm  
Other:  
Rating Stars (Click) Automation 1 2 3 4  
Accumed/Baker Cells  
BAXA– Rapid-Fill (ASF)  
BAXA– Repeater Pump  
Baxter  
Baxter– AUTOMIX Compounder  
Baxter– MICROMIX Compounder  
Kirby Lester  
McKesson– AcuDose-Rx  
McKesson– Baker Scale  
McKesson– IntelliShelf-Rx  
McKesson– MedCarousel  
McKesson– ROBOT– Rx  
McKesson– PACMED  
MTS– Automated Sealers  
MTS– Prepackaging  
Parata– PACMED  
Parata– RDS  
Parata– APM  
PharmASSIST– RDS ROBOTx  
PharmASSIST– ROBOTx  
PharmASSIST– SmartCabinet  
PharmASSIST– SmartScale  
Pyxis  
Other:  
Other:  
Rating Stars (Click) Disease State Management 1 2 3 4  
AIDS/HIV  
Anticoagulation  
Asthma  
Cardiovascular Disease  
Chemotherapy  
Cystic Fibrosis  
Depression  
Diabetes  
Dyslipidemia  
Hormone Replacement Therapy  
Hypertension  
Osteoporosis  
Pain Management  
Smoking Cessation  
Transplant  
Other:  
Other:  
Other:  
Rating Stars (Click) Clinical and Job related Experience 1 2 3 4  
Admixture  
Adolescent Care  
Aseptic Techniques  
Blister Packs  
Cart Check  
Cart Fill  
Chemotherapy  
Computerized Physician Order Entry  
Consulting  
Discharge Counseling  
DME Equipment  
Drug Information  
Drug Information Rounds  
Drug Rehabilitation Programs  
Emergency Room  
Enteral Nutrition Products  
Formulary Management  
Geriatric Care  
Hazardous Drug Handling  
Homeopathic Treatments  
Hyperalimentation Calculation  
Immunizations  
Immunoglobulin Therapy  
Incontinence Supplies  
Infectious Disease  
Infusion Pumps and Systems  
Intensive Care (ICU)  
IV Preparation  
Neonatal Intensive Care (NICU)  
Oncology  
Ostomy Supplies  
OTC selection and recommendations  
P&T committee participant  
Pain Management  
PCA Pumps  
Pediatric Care  
Poison Control  
Psychiatric Care  
Retail Compounding  
Surgical Supplies  
Tocolytic Therapy  
TPN Preparation  
Transplant Therapy  
Urological Supplies  
Other:  
Other:  
Other:  
Rating Stars (Click) Age Specific Competencies 1 2 3 4  
Infant (Birth - 1 year)  
Preschooler (ages 2-5 years)  
Childhood (ages 6-12 years)  
Adolescents (ages 13-21 years)  
Young Adults (ages 22-39 years)  
Adults (ages 40-64 years)  
Older Adults (ages 65-79 years)  
Elderly (ages 80+ years)  
Rating Stars (Click) Pharmacokinetic Dosing of 1 2 3 4  
Aminoglycosides  
Anticoagulation  
Digoxin  
Lithium  
Theophylline  
Vancomycin  
Other:  
Other:  
Other: