ࡱ> '` p$bjbj{P{P 4::b @@@@@@@T8TH Tb`````;;;PRRRRRR$3h v@;;v@@``j@`@`PPN@@|`T fl0 D0S  BS `|S @|;"]u;;;vvLR;;;TTTzXd&TTTXTTT@@@@@@ Initial Competency Assessment Skills ChecklistOccupational therapist Name: _____________________________________________________________________ Date of Employment: ________________________Date Completed: ___________________ Self AssessmentCompetency for the Occupational TherapistProficiency RequiredEvaluation MethodCompetency Validation Indicated by Preceptors Initials and DateDo you have experience with this skill?Are you competent performing the following:YESNOYESNOVITAL SIGNS/ BP & PULSEa. Demonstration of BP & Pulse testingb. Verbalization of alternate measure placementsc. Pulse Ox readingd. Verbalization of HR/Pulse parameterse. Indications for taking vital signsROM/GONIOMETRYa. Demonstration of using goniometer at selected jointsb. Demonstration of checking functional ROM (recognizing pain limitations)c. Demonstrate assessment of end feel/joint integrityd. Verbalization contraindications for ROM testingMMT/STRENGTHa. Demonstration of testing muscle strength at selected joints (use of dynamometer as indicated)b. Verbalization of testing functional strengthc. Verbalization contraindications for MMT testingBALANCEa. Verbalization of balance assessment during functional activitiesCOORDINATIONa. Examples of coordination/gross motor function tests (finger to nose, heel to shin, heel to toes, alternating rapid movement, cross body movement)  b. Fine motor-functional dressing, buttoning, managing zippersSENSATION/PROPRIOCEPTIONa. Verbalization of examples of sensation tests (Hot/Cold, Two point, Sharp/Dull, Light Touch/Pressure)b. Recognize deficits in proprioception and provide treatment strategiesMUSCLE TONE/REFLEXa. Verbalization of muscle tone (i.e. increased, decreased, flaccid, paraesis, paralysis, paresthesia, hyperesthesia, kinesthesia)EDEMAa. Demonstration of pitting testb. Edema measurement sitesc. Examples of edema reduction techniquesd. Identify indications for lymphedema managementAMBULATION DEVICESCane, Walker, WW, Crutches Height adjustment- demonstrate Monitor patient during functional useBEDSAppropriate height of bed, location Verbalizes proper position of patient sitting at edge and promoting safe transition thru height and location of bed.b. Modifications- discuss rails vs. trapeze vs. hospital bed (electrical vs. manual)O2a. Change tankb. Adjust liter flowc. Flow rate readingd. Nasal canula applicatione. Safety instruction ( no smokingf. Pulse ox- indication, orderSTRENGTHENING PROGRESSIONList options for strengthening modalities Creative strengthening tools, T-band, weights, pedal bike, wheelchair pushups Bed ( sitting ( standing progression Functional- how can strength be functional?HOYER LIFTa. Verbalizes safe use of hoyer, sling sizes, adjustment/fixation to hoyer, and instruction to caregiver with demo, if able.b. Indications (trunk control)SEATING AND MOBILITY-WHEELCHAIRa. Indications for power vs. manualb. Proper fitting ( leg rests, arm rests, seat depth, seat width, height, ability to go to table (take cushion into account)c. Proper fitting of cushion and indication for different cushion types.ORTHOTICSa. Indication and types of hand splints, prosthetics, slings-based on prognosis, dysfunctionb. Indication and types of bracingc. Make appropriate recommendations based on physical presentation of the patientENDURANCEa. Borg/RPE (rate of perceived exertion scale)b. Recognize signs and symptoms of endurance limitationsPOSTUREa. Demonstrate proficiency in normal postural alignment in sitting and standingBODY MECHANICSa. Use of transfer/gait beltb. Body mechanics for bending, lifting, reaching and computer ergonomicsPAINa. Faces Scaleb. Verbal analog scalec. Visual analog scaled. Pain management techniques- verbalize traditional and alternative therapiese. Identify ineffective and inappropriate pain management and appropriate follow-upMENTAL/COGNITIVE STATUSa. Alert and oriented x3b. Patients current level of alertness, orientation, comprehension, concentration, and immediate memory for simple commands.c. Suggest interventions (money management, memory log)HOME SAFETY/ENVIRONMENTAL ADAPTATIONS a. Evaluation and adaptation of environmental barriers in bathroom, bedroom, kitchen, entrance/exitb. Suggestive adaptive equipmentFUNCTIONAL MOBILITYDemonstrate, assess and teach: bed mobility transfers ambulation wheelchair managementADLsa. Assess and teach basic toileting, dressing, grooming, and bathingb. 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