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CYNET_SYSTEMS_MAIN_LOGO.gif   Psychiatric Tech Skills Checklist
   NAME    
   LAST 4 OF SSN      
   DATE    
I hereby certify that ALL information I have provided to IMCS Group 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) Proficiency Scale 1 2 3 4  
0
 General Duties   
0
 Admit/Orient Involuntary Clients   
0
 Admit/Orient Voluntary Clients  
0
 Advance Directives   
0
 Ambulatory Cuffs   
0
 Assist Activities of Daily Living   
0
 Assist with Personal Hygiene  
0
 Cultural Diversity   
0
 Discharge Clients   
0
 Discharge Planning  
0
 Documentation-Computer  
0
 Documentation-Written   
0
 Full Restraints  
0
 HIPAA Regulations   
0
 Initial Interview  
0
 Initial Screening Assessment  
0
 Isolation Techniques   
0
 Mutli-Disciplinary Planning  
0
 Oxygen Administration  
0
 Participate in Interdisciplinary Team  
0
 Patient Teaching  
0
 Reassess/Update Plan of Care  
0
 Referral to Community Resources  
0
 Supervise Unlicensed Personnel  
0
 Vital Signs  
0
 Wrist Restraints  
Rating Stars (Click) Eating Disorders 1 2 3 4  
0
 Anorexia Nervosa   
0
 Bulimia Nervosa   
0
 Obesity   
0
 Interventions/Therapies  
0
 Assultive Behavior  
Rating Stars (Click) Care of Psychiatric Disorders 1 2 3 4  
0
 Anxiety Disorders  
0
 Bipolar Disorder  
0
 Catatonic Psychotic Disorder  
0
 Delusional Disorders  
0
 Depression  
0
 Dissociative Identity Disorder  
0
 Hallucinations  
0
 Obsessive/Compulsive Disorder  
0
 Panic Attacks  
0
 Paranoid Psychotic Disorder  
0
 Phobias  
0
 Schizophrenia  
0
 Suicidal Ideation/Attempts  
Rating Stars (Click) Assist with Psychotherapy 1 2 3 4  
0
 Behavioral  
0
 Couple/Family  
0
 Group  
0
 Individual  
Rating Stars (Click) Personality Disorders 1 2 3 4  
0
 Cluster A-Paranoid/Schizoid  
0
 Cluster B-Antisocial/Borderline  
0
 Cluster C-Anxious/Fearful  
Rating Stars (Click) Cognitive Disorders 1 2 3 4  
0
 Alzheimer's (Dementia)  
0
 Amnestic Disorders  
0
 Delirium  
0
 Dementia  
Rating Stars (Click) Certified "Management of Assultive Behavior" 1 2 3 4  
0
 Crisis Intervention  
0
 Drug & Alcohol Education  
0
 Education or Vocational Training   
0
 Teach Independent Living Skills   
0
 Therapeutic Communication   
0
 Therapeutic Milieu  
Rating Stars (Click) Assist with Alternative Therapies: 1 2 3 4  
0
 Biofeedback  
0
 ElectroConvulsive Therapy  
0
 Expressive Therapy (Art, Movement)  
0
 Guided Imagery  
0
 Massage Therapy  
0
 Mediation  
0
 Recreational Therapy  
0
 Therapeutic Touch   
Rating Stars (Click) Meds/IV Therapy  1 2 3 4  
0
 Administer IM & SQ Meds   
0
 Administer PO Medications  
0
 Administer Topical Medications  
0
 Identify Appropriate Level of Care   
0
 Discontinue Peripheral IV's  
0
 Pain Assessment/Management  
Rating Stars (Click) Substance-Related Disorders: 1 2 3 4  
0
 ADHD  
0
 Alcohol-Related  
0
 Developemntal/Autistic Disorders  
0
 Drug-Related  
0
 Mental Retardation  
0
 Post Traumatic Stress Disorder  
0
 Sexual Abuse/Assault  
0
 Sexual Disorders  
0
 Somatoform Disorders (Pain etc.)  
0
 Survivor of Abuse/Violence  
Rating Stars (Click) Psychotropic Agents: 1 2 3 4  
0
 Antianxiety Agents  
0
 Anticholinergics/Antiparkinsons  
0
 Anticonvulsants  
0
 Antidepressants/Mood Elevators  
0
 Antimanic Agents  
0
 Antipsychotic Agents  
0
 Hypnotics  
0
 Management of Med Side Effects  
0
 Recognition of Med Side Effects  
Years of Experience Continuum of Care Settings Hospital Settings Years  
Med-Psych Unit  
Transitional Care Hospital  
Freestanding Psych Hospital  
Community-Based Hospital   
Subacute Care Units   
Long-Term Care Facilities  
Community Mental Health Services Years  
Emergency Clinic   
Day Treatment Programs   
Residential Programs   
Home Care  
Aftercare/Rehab Clinic   
Corrections/ Prison   
Rating Stars (Click) EMR 1 2 3 4  
0
 Epic  
0
 Cerner  
0
 Eclipsys  
0
 McKesson  
0
 Meditech  
0
 Other Computerized System  
0
 Computerized Physician Order Entry  
0
 Bar Coding for Medication Administration  
MY EXPERIENCE IS PRIMARILY IN:  
Unit No. of Years Unit No. of Years  
BURN POST PARTUM  
CRITICAL UNIT LABOR & DELIVERY  
PACU NEWBORN NURSERY  
NEUROLOGY LEVEL II NICU  
TELEMETRY LEVEL III NICU  
MEDICAL PICU  
SURGICAL  PEDIATRICS  
ONCOLOGY OB/GYN  
ORTHOPEDICS PSYCHIATRY  
OPERATING ROOM RRT  
EMERGENCY ROOM CRT  
TRAUMA CENTER LEVEL 1    
COMMUNITY ER    
RURAL ER    
Rating Stars (Click) PROFICIENCY SCALE  1 2 3 4  
0
 Newborn (birth-30 days)  
0
 Infant (30 days-1 yrs)  
0
 Toddler (1-3 yrs)  
0
 Preschooler (3-5 yrs)  
0
 School Age (5-12 yrs)  
0
 Adolescents (12-18 yrs)  
0
 Young Adults (18-39 yrs)  
0
 Middle Adults (39-64 yrs)  
0
 Older Adults (64 yrs +)