CYNET_SYSTEMS_MAIN_LOGO.gif   RN PHONE TRIAGE 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) Pointers 1 2 3 4  
Demonstrates a clear understanding of EMTALA and HIPAA requirements.  
Obtains appropriate symptom-driven chief complaints  
Determines and documents the acuity level using a specific triage acuity scale  
Utilizes the nursing process for all patients including nursing diagnosis, assessment, plan, implementation, and evaluation  
Consistently apply Principles of Triage  
Perform and document the Rapid Triage Assessment on arriving patients (Identifying and facilitating placement of patients who meet Immediate Bedding Criteria)  
Verbalize and appropriate consider the Bedding Criteria  
Obviously ill or injured (or nurse is able to quickly and confidently determine accurate disposition)  
Open bed (available or able to obtain)  
Available care provider (considering acuity of patient load)  
Perform and document the Comprehensive Triage Assessment (if Immediate Bedding Criteria not met)  
Demonstrate the ability to prioritize patients  
Determine and document patient disposition  
Implement “any open bed policy” appropriately  
Initiate dual triage per department guidelines  
Complete ED triage documentation accurately: capture essentials of triage assessment  
Reassess patients in waiting areas according to acuity scale objectives and/or reassessment policy (Nursing practice reflects department policy)  
Demonstrate an understanding of the rationale for considering the “worst-case scenario” on every patient  
Initiate appropriate nursing interventions and/or diagnostics (by Advanced Triage Protocols according to hospital policy and standards)  
Initiate appropriate Advanced Triage Protocols according to hospital policy and standards  
Participate in peer review  
Participate in triage chart audits  
Rating Stars (Click) EMR: 1 2 3 4  
Allscripts  
Epic  
Meditech  
McKesson  
Homecare Home base  
Cerner  
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) AGE APPROPRIATE CARE 1 2 3 4  
Newborn/Neonatal (birth – 30 days)  
Infant (30 days-1 year)  
Toddler (1-3 years)  
Preschool (3-5 years)  
School Age Children (5-12 years)  
Adolescent (12-17 years)  
Young Adults (18-44 years)  
Middle Adults (45-64 years)  
Older Adults (>65 years)