Advantage RN ~ Travel Nurse Staffing Company

OCCUPATIONAL THERAPY SKILLS CHECKLIST

This profile is for use by occupational therapists with more than one year experience in their discipline and specialty. It will not be a determining factor for the program.

Please enter your full legal name as it appears on your Social Security Card.

First Name: Last Name: Email:

Please check the boxes below for each age group for which you have provided age-appropriate care:

A. Newborn/Neonatal (birth - 30days)
B. Infant (30 days - 1 year)
C. Toddler (1-3 years)
D .Preschooler (3-5 years)
E. School age children (5-12 years)
F. Adolescents (12-18 years)
G. Young adults (18-39 years)
H. Middle adults (39-64 years)
I. Older adults (64+)

Please indicate the number of years experience in the following areas:

J. Orthopedics
K. Neurological
L. Psychiartric
M. Prostetics/Orthotics/Functional Training
N. Adaptive Equipment
O. Vocational Training
P. Pediatrics
Q. Modalities

Please indicate your level of experience in the following procedures: A: Theory, no practice  B. Intermittent  C. One-Two Years Current Experience  D. Two-plus years experience, can function independently

Skill

Experience

 Skill

Experience
A. Orthopedic A B C D E. Adaptive Equpment A B C D
1. Arthritis programs   1. Assessment
a. Energy conservation 2. Frabrication
b. Joint protection 3. Functional activities  
2. Hand Injury a. ADLs
3. Hip fractures b. Home environment
4. Mobilization techniques c. Pre-discharge planning
5. Therapeutic exercise d. Splinting
6. Total hip/knee replacement 4. Wheelchair
7. Total joint replacement/upper extremities F. Vocational Training  
B. Neurological   1. Cognitive assessment
1. CVA 2. Functional capacity evaluation
2. Head trauma 3. Job task analysis
3. Peripheral nerve injuries 4. Perceptual assessment
4. Spinal cord injury   5. Work hardening  
a. Adaptive equipment a. BTE
b. Functional splinting b. Valpar
c. Wheelchair evaluation G. Pediatrics  
5. Stroke rehabilitation 1. Developmental testing
C. Psychiatric   2. Discharge planning referral & resources
1. Accute disorders 3. Equipment Assessment  
2. Chronic disorders a. Activities of daily living
3. Community re-entry b. Wheelchair positioning device
4. Crisis intervention 4. Neurodevelopmental testing
5. Group treatment 5. Orthotics
6. Standardized assessment tools 6. Sensory integrative testing
7. Substance abuse 7. Visual perceptual skills testing
D. Prosthetics/Orthotics/Functional Training   H. Modalities  
1. Above knee prosthetics 1. Biofeedback
2. Below knee prosthetics 2. Edema massage
3. Dynamic splints 3. Feeding techniques
4. Myofascial release (MFR) 4. Fluidotherapy
5. Orthoplast 5. Muscle stimulation
6. Serial/inhibitory casting 6. Oral motor facilities
7. Static splints 7. Paraffin bath
8. Upper extremity prosthetics 8. Therapeutic pool

The information I have given is true and accurate to the best of my knowledge.  I hereby authorize Advantage RN to release this Occupational Therapy Skills Checklist to facilities of Advantage RN in relation to consideration of my employment.