Director of Nursing Skills Checklist One program to handle all talent management needs from acquisition to development Personal Information HiddenOverall ScoreOut of 4Name(Required) First Middle Last Last 4 Digits of Social Security Number Email(Required) HiddenDate MM slash DD slash YYYY Proficiency Scale1 – No Experience 2 – Need Training 3 – Able to perform with supervision 4 – Able to perform independentlyAGE OF PATIENTS CARED FORNewborn/Neonate (birth to 30 days)(Required) 1 2 3 4 Infant (1 month to 1 year)(Required) 1 2 3 4 Toddler (1 year to 3 years)(Required) 1 2 3 4 Preschooler (3 years to 5 years)(Required) 1 2 3 4 School Age Child (5 years to 12 years)(Required) 1 2 3 4 Adolescents (12 years to 18 years)(Required) 1 2 3 4 Young Adults (18 years to 39 years)(Required) 1 2 3 4 Middle Adults (39 years to 64 years)(Required) 1 2 3 4 Older Adults (64 years to 79 years)(Required) 1 2 3 4 Elderly Adults (over 79+ years)(Required) 1 2 3 4 LEADERSHIPCommunicates effectively with residents, families, significant others, and other team members(Required) 1 2 3 4 Communicates effectively with peers, physicians, and State agencies(Required) 1 2 3 4 Coordinates resident care to the multidisciplinary team via meetings(Required) 1 2 3 4 Coordinates resident care to the multidisciplinary team via meetings(Required) 1 2 3 4 Knowledgeable and able to execute human recourse policies as applicable to a variety of people issues(Required) 1 2 3 4 Delegates as appropriate(Required) 1 2 3 4 Actions demonstrate excellent customer service skills and builds relationships with families and associates(Required) 1 2 3 4 Monitors the progress of others(Required) 1 2 3 4 Enforces regulatory and employee law compliance(Required) 1 2 3 4 TECHNICALTECHNICAL(Required) 1 2 3 4 Demonstrates excellent technical skills and judgement(Required) 1 2 3 4 Assesses and monitors accuracy of Facility Scorecard and CMS quality indicator date and initiates corrective action as indicated(Required) 1 2 3 4 Actively participates and contributes to facility meetings and process improvement activities(Required) 1 2 3 4 Actively participates and contributes to facility meetings and process improvement activities(Required) 1 2 3 4 Demonstrates basic working knowledge of computer and modules and management reports(Required) 1 2 3 4 Demonstrates basic understanding of quality event investigating and reporting process(Required) 1 2 3 4 Maintains a current knowledge of LTC Federal and state regulations including Medicare, Medicaid, and JCAHO as applicable(Required) 1 2 3 4 Ensure that RAI functions are completed timely for all residents(Required) 1 2 3 4 Provides and monitors the effectiveness of clinical orientation and ongoing training to all associates(Required) 1 2 3 4 PROBLEM SOLVINGUtilizes the nursing process to structure care to individual resident's needs(Required) 1 2 3 4 Demonstrates the ability to assess and interpret data about the resident's status and ensure timely interventions are executed(Required) 1 2 3 4 Collaborates with DNS/ Consultants on identified areas of noncompliance and implements necessary corrective actions(Required) 1 2 3 4 Effectively troubleshoots and ensures allocation of staffing resources to meet the needs of the residents(Required) 1 2 3 4 Demonstrates understanding of census as it relates to HOL, expense control, and budgeted PPD(Required) 1 2 3 4 Assesses and monitors discharge, rehospitalization patterns and implements corrective action as indicated(Required) 1 2 3 4 PROFESSIONAL KNOWLEDGE AND SKILLSNational Patient Safety Goals(Required) 1 2 3 4 Age Specific Care(Required) 1 2 3 4 Population Based Care(Required) 1 2 3 4 Electronic Documentation(Required) 1 2 3 4 Automated Med Dispensing System(Required) 1 2 3 4 AuthorizationsLegal Consent(Required) I agree to the terms and conditions.Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. 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