PSYCHIATRIC SKILLS CHECKLIST
Name:
When completing this ckecklist, please indicate your level of proficiency in each area according to the scale below. Place a check mark in box which best describes your expertiese with each skill.

The scale is as follows:
1. Not performed   2. Intermitten experience   3. Very experienced.
CARE OF PATIENT ON PSYCHOTROPIC MEDICATIONS
  1. Anti-anxiety agents   1 2 3
  2. Anti-convulsants   1 2 3
  3. Anti-psychotics:  
    1. Evaluation of side effects:  
      1. hypotension   1 2 3
      2. extrapyramidal   1 2 3
      3. oversedation   1 2 3
      4. anticholinergic   1 2 3
      5. agranulocytosis   1 2 3
      6. photosensitivity   1 2 3
      7. early signs of tardive dyskinesia   1 2 3
      8. Neuroleptic Malignant Syndrome   1 2 3
    2. Rapid tranquilization   1 2 3
    3. Antipsychotics:  
      1. Proloxin   1 2 3
      2. Haldol   1 2 3
      3. Clorizil   1 2 3
  4. Anti-Parkinsonism agents:  
    1. Benadryl   1 2 3
    2. Cogentin   1 2 3
  5. Anti-depressants:  
    1. Tricyclics:  
      1. Anticholinergic side effects   1 2 3
      2. Anticholinergic delirium   1 2 3
      3. monitoring therapeutic blood levels   1 2 3
    2. Monoamine oxidase inhibitors (MAOI):  
      1. food/drug interactions   1 2 3
      2. tyramine dietary restriction   1 2 3
      3. hypertensive crisis   1 2 3
  6. Lithium Carbonate:  
    1. Therapeutic blood levels   1 2 3
    2. Signs of toxicity   1 2 3
  7. Medications for hyperactivity  
    1. Ritalin and Cylert:  
      1. side effects   1 2 3
      2. appetite   1 2 3
      3. growth in children   1 2 3
  8. Assessment for PRN psychotropics   1 2 3
  9. Psychotropic drug overdose   1 2 3
  10. Psychotropic drug interactions   1 2 3
  11. Patient teaching:  
    1. Self-administered medication   1 2 3
    2. Long-term use of medication   1 2 3
ENVIRONMENTAL AND UNIT SAFETY
  1. Identification of safety hazards in milieu   1 2 3
  2. Unlocked unit precautions   1 2 3
  3. Locked unit precautions   1 2 3
  4. Privilege levels - escorting patients off unit,liability for passes/outings   1 2 3
  5. Escape /runaway precautions-flow sheets   1 2 3
  6. A.W.O.L. - notifying authorities   1 2 3
  7. Patient searches:  
    1. Confiscation of contraband   1 2 3
    2. Strip searches   1 2 3
    3. Legalities   1 2 3
  8. Alarm systems  
    1. Unit security   1 2 3
    2. Panic alarms and responses   1 2 3
  9. Utilization of security personnel   1 2 3
LEGAL
  1. Knowledge of legal status  
    1. Involuntary holds   1 2 3
    2. Court-ordered evaluations   1 2 3
    3. Voluntary consent for evaluation/treatment   1 2 3
    4. Certification procedures   1 2 3
    5. Legal custody/guardianship   1 2 3
  2. Patients’ rights   1 2 3
  3. Child abuse reporting   1 2 3
  4. Restriction of phone, mail, visitors, clothes, and/or personal property   1 2 3
  5. Confidentiality/release of information   1 2 3
  6. Patients’ right to refuse medication   1 2 3
  7. Use of:  
    1. Emergency or involuntary medication   1 2 3
    2. Court-ordered medication   1 2 3
MEDICAL MANAGEMENT
  1. Infection control procedures  
    1. Assessment of risk   1 2 3
    2. Blood and body fluid precautions   1 2 3
  2. Tube feedings   1 2 3
  3. Neurological vital signs   1 2 3
  4. Management of patient with seizure disorder   1 2 3
  5. Obstructed airway management:  
    1. Heimlich maneuver   1 2 3
    2. Insertion of oro-pharyngeal airway   1 2 3
    3. Intubation   1 2 3
    4. Assisted ventilation - Ambu bag   1 2 3
    5. Oxygen administration   1 2 3
    6. Oro-naso-pharyngeal suctioning   1 2 3
  6. Initiating cardiopulmonary resuscitation   1 2 3
  7. Insertion and care of IV's   1 2 3
  8. Informed consent for medical procedures   1 2 3
MILIEU MANAGEMENT
  1. Assessment of therapeutic milieu   1 2 3
  2. Participation in milieu therapy   1 2 3
  3. Structuring therapeutic programming   1 2 3
  4. Leading community meetings   1 2 3
  5. Behavioral contracting:  
    1. Individuals   1 2 3
    2. Groups   1 2 3
  6. Crisis intervention:  
    1. Recognizing potentially dangerous situations   1 2 3
    2. Use of low level interventions to de-escalate:  
      1. individual and/or groups   1 2 3
  7. Behavioral charting   1 2 3
SPECIFIC PSYCHIATRIC CONDITIONS
  1. Assessing and intervening with the patient who demonstrates:  
    1. Thought disorder:  
      1. hallucinations   1 2 3
      2. delusions   1 2 3
      3. paranoia   1 2 3
      4. need for reality orientation   1 2 3
    2. Depressive disorder:  
      1. social withdrawal and apathy   1 2 3
      2. lack of self-care   1 2 3
      3. hopelessness   1 2 3
      4. self-destructive potential   1 2 3
    3. Bipolar disorder:  
      1. manic episodes   1 2 3
    4. Character disorders/personality disorders:  
      1. manipulation   1 2 3
      2. irresponsibility   1 2 3
      3. denial and resistance to change   1 2 3
    5. Borderline personality disorder:  
      1. emotional liability   1 2 3
      2. identity issues   1 2 3
      3. staff splitting   1 2 3
      4. self-destructive behavior   1 2 3
    6. Dissociative disorders:  
      1. multiple personality   1 2 3
      2. hysterical reactions   1 2 3
    7. Post traumatic stress disorder   1 2 3
    8. Eating disorders:  
      1. monitoring physical status   1 2 3
      2. control issues   1 2 3
      3. family therapy   1 2 3
      4. behavioral contracting   1 2 3
    9. Drug/alcohol dependence:  
      1. acute intoxication:  
        1. hallucinogens,PCP   1 2 3
        2. alcohol   1 2 3
        3. polysubstance abuse   1 2 3
      2. withdrawal syndromes:  
        1. alcohol   1 2 3
        2. CNS depressants   1 2 3
        3. CNS stimulants   1 2 3
        4. cocaine   1 2 3
        5. drug/alcohol dependent rehabilitation   1 2 3
    10. Suicidal/self-destructive behavior:  
      1. suicide precautions   1 2 3
      2. one-to-one observation   1 2 3
      3. environmental safety   1 2 3
    11. Aggressive, violent behavior:   1 2 3
    12. Provocative, disruptive behavior   1 2 3
    13. Manipulative, attention-seeking behavior   1 2 3
    14. Threatening, intimidating behavior   1 2 3
  2. Children /adolescents:  
    1. Pervasive developmental disorder (autism,childhood psychosis)   1 2 3
    2. Developmentally disabled   1 2 3
    3. Conduct disorder   1 2 3
    4. Attention deficit disorder/hyperactivity   1 2 3
    5. Enuresis/encopresis   1 2 3
    6. Antisocial behavior   1 2 3
    7. Depressed suicidal behavior   1 2 3
    8. Runaway behavior   1 2 3
    9. Prostitution   1 2 3
    10. Satanic involvement   1 2 3
  3. Chronically mentally ill adult:  
    1. Resources and support systems in community   1 2 3
    2. Family involvement   1 2 3
    3. Long term hospitalization   1 2 3
  4. Organic brain syndrome:  
    1. Geriatric patient  
      1. sensory perceptual precautions   1 2 3
      2. self-care   1 2 3
      3. safety and security precautions   1 2 3
    2. Alzheimers   1 2 3
    3. Huntington’s Chorea   1 2 3
SPECIFIC TREATMENT MODALITIES
  1. Behavioral modification-point & level systems   1 2 3
  2. Behavioral contracting-reward systems   1 2 3
  3. Psychodynamic/psychoanalytic therapies   1 2 3
  4. Rational-emotive therapy   1 2 3
  5. Milieu therapy   1 2 3
  6. Individual therapy   1 2 3
  7. Group therapy   1 2 3
  8. Play therapy   1 2 3
  9. Family therapy   1 2 3
  10. Working with children and their families:  
    1. Therapeutic limit-setting   1 2 3
    2. Teaching basic parenting skills   1 2 3
  11. Care of the patient receiving ECT   1 2 3
  12. Groups teaching:  
    1. Basic social skills   1 2 3
    2. ADL   1 2 3
    3. Emancipation skills   1 2 3
  13. Care of patient in seclusion/restraints:  
    1. Assessment of psychiatric emergency   1 2 3
    2. Ambulatory restraints   1 2 3
    3. Full 4-point restraints   1 2 3
    4. Documentation of physical care   1 2 3
    5. Restraint scissors   1 2 3
  14. Assaultive behavior management:  
    1. Self-protection techniques   1 2 3
    2. Therapeutic physical control and restraint techniques   1 2 3
    3. Take downs   1 2 3
    4. Care of patient and staff following an assault   1 2 3
TREATMENT PLANNING
  1. Role of nurse in a multidisciplinary treatment team   1 2 3
  2. Primary nurse:  
    1. Admission   1 2 3
    2. Mental status assessment   1 2 3
    3. Initial nursing assessment and nursing care plan   1 2 3
    4. Psychiatric nursing diagnosis   1 2 3
    5. Individual therapy   1 2 3
    6. Group therapy   1 2 3
    7. Patient health teaching   1 2 3
    8. Role-modeling   1 2 3
    9. Nursing reassessment and nursing care plan update   1 2 3
    10. Discharge planning  
      1. continuity of care in the community   1 2 3
      2. family and support system contacts   1 2 3
      3. medications at discharge   1 2 3
      4. AMA discharge   1 2 3
  3. Therapeutic nurse-patient relationship:  
    1. Stages:  
      1. initiation and rapport building   1 2 3
      2. working phase   1 2 3
      3. termination   1 2 3
    2. Boundaries of a therapeutic relationship   1 2 3
    3. Concepts of transference and countertransference   1 2 3
PROFESSIONAL EXPERIENCE AND CERTIFICATIONS
  1. Are you certified in psychiatric nursing? Yes   No If yes, in which specialty area?
  2. Have you received specialized training in specific therapies/treatment modalities (individual, group, family, play, rational emotive, behavior modification, treatment of addictive disorders, eating disorders)? Yes   No If yes, please specify:
  3. Number of years experience in psychiatric nursing with each age group? Children/adolescents:  Adult  Geriatric:
  4. Do you have charge nurse experience? Number of years?
  5. Have you attended an assaultive behavior management course involving self-protective and therapeutic physical control / restraint techniques? Yes   No
The information I have given is true and accurate to the best of my knowledge. Please sign and date below.
SIGNATURE: (Last 4 digits of your SSN)    Reenter your last 4 digits of your SSN:   DATE:

  
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