APRN - Department of Nursing

INITIAL UMG/JDH AMBULATORY COMPETENCY CHECKLIST 12 of 12
Position Title: Nurse Practitioner
Department: Psychiatry
Employee Name:
Method of Instruction Key:
P = Protocol/Procedure Review
E = Education Session
S = Self Learning Package
C = Clinical Practice
D = Demonstration
Method of Evaluation Key:
O = Observation (in clinical setting)
RD = Return Demonstration
T = Written Test
V = Verbal Review
Method of
Instruction
(Use
Instruction
Key on Left)
Evaluation Summary
Evaluation
Method
(Use
Evaluation
Key on Left)
Comments
Competent Initials Date
Yes No
Conducts medication monitoring patient visits
Orders and monitors patient laboratory tests as appropriate
Knowledgeable in the process of “PEC”- Psychiatric Emergency
Commitment
Acts as a resource for psychiatric group homes providing
needed information (i.e. patient, drug)
Dispenses medication samples to patients per UMG approved
policy and procedure.
Initials/Name: ___us/Ute Schroeder___________ Initials/Name: ______________________________ Initials/Name: __________________________
Competency Checklist Updated: 9/05, 7/07, 1/08, 4/08