Please enable JavaScript in your browser to complete this form.Personal InformationName *FirstLastPlease enter your full legal name as it appears on your Social Security Card.Email *Phone No experience: requires education, training and supervision Intermittent experience: may need support or supervise Proficient: consistent experience, independent Expert level: can teach/supervise others. Work settingsAdult Care Facility/ Assisted Living1234Children’s Hospital1234Inpatient Acute Care1234Level I Trauma Center1234Level II/III Trauma Center1234LTAC Facility1234Rehab Facility1234Skilled Nursing Facility1234Clinical Practice Knowledge by SpecialtyER1234ICU1234MS TELE1234NICU1234Pediatrics1234PICU1234Surgical Services1234Women’s Services1234Emergency CareCardiac arrest / CPR1234Code Management1234Crisis Intervention/Management1234De-escalation techniques1234Disaster ManagementInternal1234External1234Emergency preparedness1234Facility/Bed Diversion1234Managing Assaultive Behavior1234Rapid response teams1234Restraints – physical/chemical1234Legal AspectsAdvanced directives1234Confidentiality – HIPPA Compliance1234Discharge AMA1234Fitness for duty1234Quality Management1234Risk Management41234Sentinel events-monitoring and reporting1234Voluntary /involuntary commitment1234Medications/Methods of deliveryMedication Management1234Automated Medication Dispensing SystemsOmnicell1234Pyxis1234Accudose1234Bar Code Medication Administration1234Professional knowledge/skillsBed Management1234New Admissions1234Post Surgery1234Post Procedures1234Transfer to higher level care1234Customer Service1234Employee wellness program1234Experience managing narcotic diversion1234Experience with Magnet Designation1234Experience with project management: EMR conversions, new equipment 1234implementation1234Experience with shared leadership/council management1234Experience working with staffing modelsCentralized staffing1234Decentralized staffing1234Scheduling1234Fall prevention1234Functions as clinical expert resource1234HCAHPS1234Incident reporting1234Infection control1234Isolation procedures1234Knowledge of regulatory requirements- DPH, TJC, OSHA, etc.1234Multidisciplinary provider team1234National Patient Safety Goals1234Organizational escalation process for facility1234Prevention of pressure ulcers1234Root Cause Analysis process1234Supervising nursing care delivered on all units organizationally1234Universal Precautions1234Workplace safety1234Wound Care1234Financial ManagementBasic understanding of healthcare economics including reimbursement, Medicare, Medicaid, etc.1234Experience with productivity standards and staffing requirements1234Understands census as it relates to expense control and budgeted HPPD1234Human Resource ManagementAdvanced communication skills:1234Advocacy1234Negotiation1234Confrontation1234Conflict Resolution1234Coaching and counseling to performance standards1234Employee Evaluations1234Federal and State scope of practice labor laws – FMLA1234Hiring process/interviewing skills and techniques1234Orientation of new employees1234Performance ImprovementKnowledge of CMS quality indicator data initiatives1234Knowledge of performance improvement tools1234Participates in process improvement activities1234Promotes survey preparedness at all times1234Promoting intradepartmental /interdepartmental communication1234COMPUTERIZED CHARTINGAllscripts1234Cerner1234EPIC1234McKesson1234Meditech1234Other:1234If other, please specifyAge specific competencyNeonate1234Infant1234Child1234Adolescent1234Young Adult1234Middle Adult1234Older Adult1234Submit