= Skills Checklist =

Hospice Skills

Please rank the following skills on a scale of 1 to 4

1 = No theory and/or experience
2 = Limited experience
3 = Experienced/minimal support needed to perform
4 = Proficient

  • Experience with the Following Ages

  • Work Setting

  • Plan of Care

  • Symptom Management

  • Pain Management

  • Wound Care

  • Pediatric

  • Medication Administration

  • After Death

  • Compliance

  • Professional Knowledge and Skills

  • MM slash DD slash YYYY