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