Hospice

Information

Proficiency Scale

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Assessment Section

Work Settings

✔ Home Hospice *
★ ★ ★ ★ ★
✔ Inpatient Hospice *
★ ★ ★ ★ ★
✔ Pediatric Hospice *
★ ★ ★ ★ ★
✔ Home Health/Hospice Setting *
★ ★ ★ ★ ★

Assessment

✔ Intake Assessment *
★ ★ ★ ★ ★
✔ Assessment Interview *
★ ★ ★ ★ ★
✔ Physical Exam *
★ ★ ★ ★ ★
✔ Coping Status *
★ ★ ★ ★ ★
✔ Environmental Status *
★ ★ ★ ★ ★

Plan of Care

✔ Set Goals with Pt/Family *
★ ★ ★ ★ ★
✔ Collaborate with Other Team Members *
★ ★ ★ ★ ★
✔ Ensure Continuity of Care *
★ ★ ★ ★ ★

Symptom Management

✔ Urgent Assessment of Symptoms *
★ ★ ★ ★ ★
✔ Reduce Symptoms to Level Acceptable to Pt. *
★ ★ ★ ★ ★
✔ Report Symptoms/Management to Provider *
★ ★ ★ ★ ★
✔ Treat Underlying Cause *
★ ★ ★ ★ ★
✔ Severity Scale *
★ ★ ★ ★ ★
✔ Management of Nausea *
★ ★ ★ ★ ★
✔ Management of Constipation *
★ ★ ★ ★ ★
✔ Management of Fatigue *
★ ★ ★ ★ ★
✔ Anorexia/Cachexia *
★ ★ ★ ★ ★
✔ Restlessness *
★ ★ ★ ★ ★
✔ Educate Family on Symptom Management *
★ ★ ★ ★ ★

Pain Management

✔ Identify Source of Painq *
★ ★ ★ ★ ★
✔ Pain Severity *
★ ★ ★ ★ ★
✔ PAINAD Scale for Non Verbal Patient *
★ ★ ★ ★ ★
✔ Reduce Pain to Level Acceptable to Patient *
★ ★ ★ ★ ★
✔ WHO 3 Step Ladder *
★ ★ ★ ★ ★
✔ Non-Pharmacologic Management of Pain *
★ ★ ★ ★ ★
✔ Pharmacologic Management of Pain *
★ ★ ★ ★ ★
✔ Effects of Pharmacologic Treatment *
★ ★ ★ ★ ★
✔ Nociceptive/Neuropathic/Mixed Pain *
★ ★ ★ ★ ★
✔ Management of Nociceptive Pain *
★ ★ ★ ★ ★
✔ Management of Neuropathic Pain *
★ ★ ★ ★ ★
✔ Educate Family on Pain Management *
★ ★ ★ ★ ★

Wound Care

✔ Positioning Techniques *
★ ★ ★ ★ ★
✔ Bed/Support Surface Selection *
★ ★ ★ ★ ★
✔ Pressure Ulcer Staging/Management *
★ ★ ★ ★ ★
✔ Response to Treatment *
★ ★ ★ ★ ★
✔ Evaluate Factors that Impede Healing *
★ ★ ★ ★ ★
✔ Educate Family on Positioning/Shearing *
★ ★ ★ ★ ★

Pediatrics

✔ Developmentally Appropriate Assessment *
★ ★ ★ ★ ★
✔ Parental/Sibling Support *
★ ★ ★ ★ ★
✔ Pediatric Support Team Collaboration *
★ ★ ★ ★ ★

Medication Administration

✔ Equianalgesic Conversion Formula *
★ ★ ★ ★ ★
✔ Titration of Opioids *
★ ★ ★ ★ ★
✔ IV Pump Management *
★ ★ ★ ★ ★
✔ Evaluate Effectiveness of Medications *
★ ★ ★ ★ ★
✔ Family Management of Medications *
★ ★ ★ ★ ★
✔ Disposal of Medications *
★ ★ ★ ★ ★

After Death

✔ Facility Family/Cultural Rituals/Rites *
★ ★ ★ ★ ★
✔ Patient Care after Death *
★ ★ ★ ★ ★
✔ Coordinate Mortuary Services *
★ ★ ★ ★ ★
✔ Bereavement Services *
★ ★ ★ ★ ★

Compliance

✔ Scope and Frequency of Services *
★ ★ ★ ★ ★
✔ Medicare/State Regulations for Hospice *
★ ★ ★ ★ ★
✔ Document Progression of Decline *
★ ★ ★ ★ ★
✔ DME Authorization & Documentation of Need/Order *
★ ★ ★ ★ ★
✔ OASIS-C *
★ ★ ★ ★ ★

Professional Knowledge and Skills

✔ Identify Source of Suffering *
★ ★ ★ ★ ★
✔ Palliative Care Philosophy *
★ ★ ★ ★ ★
✔ Patient/Family Directs Goals of Care *
★ ★ ★ ★ ★
✔ Maximize Quality of Life *
★ ★ ★ ★ ★
✔ Cultural Diversity *
★ ★ ★ ★ ★
✔ Supervision of Ancillary Staff *
★ ★ ★ ★ ★
✔ National Patient Safety Goals/Core Measures *
★ ★ ★ ★ ★
✔ Fall Risk Assessment/Prevention *
★ ★ ★ ★ ★
✔ Infection Prevention *
★ ★ ★ ★ ★
✔ Isolation Precautions *
★ ★ ★ ★ ★
✔ Interpretation and Communication of Lab Values *
★ ★ ★ ★ ★

EMR

✔ Epic *
★ ★ ★ ★ ★
✔ Cerner *
★ ★ ★ ★ ★
✔ Eclipsys *
★ ★ ★ ★ ★
✔ Allscripts *
★ ★ ★ ★ ★
✔ McKesson *
★ ★ ★ ★ ★
✔ Meditech *
★ ★ ★ ★ ★
✔ Other Computerized System *
★ ★ ★ ★ ★
✔ Computerized Physician Order Entry *
★ ★ ★ ★ ★
✔ Bar Coding for Medication Administration *
★ ★ ★ ★ ★