ROWAN COUNTY HEALTH DEPARTMENT - Public …



REFUGEE HEALTH

Competency Skills Checklist

Competencies and nursing skills are to be confirmed/assessed by the supervisor during the initial evaluation and at the time of the annual evaluation.

|PROGRAM COMPETENCY SUBJECTS |DATE REVIEWED |REVIEWER’S INITIALS |

|I. |NC Refugee Health Program Purpose | |

| |A. |Identify / Treat any |  |

| | |threat to public |  |

| | |health | |

| |A. |Overseas exam, flight|  |

| | |to US port of entry, | |

| | |quarantine review at | |

| | |port of entry and | |

| | |send notification to | |

| | |state, flight to NC | |

| | |on same day, assisted| |

| | |by NC refugee | |

| | |resettlement agency &| |

| | |local sponsors | |

| |A. |Medicaid if meets |  |

| | |categorical (children| |

| | |and adults pregnant | |

| | |or with dependent | |

| | |children) and income | |

| | |requirements - may | |

| | |have limitations | |

| |A. |Schedule within 30 |  |

| | |days of arrival and |  |

| | |refer to private | |

| | |provider if cannot | |

| | |complete physical | |

| | |exam portion | |

| |A. |  |

| | |mmigrantrefugeehealt|  |

| | |h/guidelines/domesti|  |

| | |c/domestic-guideline| |

| | |s.html | |

| | |Medical history / | |

| | |review of health | |

| | |documents | |

| |A. |Tuberculosis |  |

| | |screening - see |  |

| | |Tuberculosis | |

| | |Competency Skills | |

| | |Checklist | |

| |A. |A physical exam |  |

| | |should be completed | |

| | |for all newly | |

| | |arrived refugees | |

| |A. |To identify individuals with medical conditions that legally exclude them from being able to come to|  |  |

| | |the U.S. |  | |

| |A. | |  | |

| |A. |  | |

| | |th-departments | | |

| |A. |

|Communication |Achieved |Needs Improvement |Not Achieved |Not Applicable |

|1. Employee introduces self and explains purpose of visit. | | | | |

|2. Employee establishes rapport with caregiver/client. | | | | |

|3. Employee communicates with client/caregiver in a professional, culturally, and age | | | | |

|appropriate manner. | | | | |

|4. Employee communicates with staff in a professional manner. | | | | |

|5. Employee provided services confidentially. | | | | |

|History Taking |Achieved |Needs Improvement |Not Achieved |Not Applicable |

|6. Employee conducts history in accordance with programmatic guidelines. | | | | |

|7. Employee allows client/caregiver time to explain responses. | | | | |

|8. Employee allows client/caregiver time to ask questions. | | | | |

|9. Employee uses leading questions to elicit client information. | | | | |

| Health Counseling / Education |Achieved |Needs Improvement |Not Achieved |Not Applicable |

|10. Employee provides education and counseling in accordance with programmatic | | | | |

|guidelines. | | | | |

|11. Employee provides age-appropriate and program-specific counseling in a clear, | | | | |

|precise and professional manner. | | | | |

|12. Client verbalized an understanding of information/counseling provided. | | | | |

|13. Employee allows client time to ask questions and answers client’s questions | | | | |

|appropriately. | | | | |

|Physical Assessment |Achieved |Needs Improvement |Not Achieved |Not Applicable |

|14. Employee explains procedures to client/caregiver. | | | | |

|15. Employee provides client privacy. | | | | |

|16. Employee attempts to establish rapport and make client comfortable. | | | | |

|17. Employee performs components of physical assessment in accordance with programmatic | | | | |

|guidelines. | | | | |

|18. Employee discusses finding with client/caregiver. | | | | |

|19. Employee makes appropriate referrals based on | | | | |

|findings. | | | | |

|Case Management |Achieved |Needs Improvement |Not Achieved |Not Applicable |

|20. Employee has a system of documenting and follow-up of referrals. | | | | |

|21. Employee maintains a Tickler File of client and follow-up Tickler system. | | | | |

|22. Employee documentation supports all client contacts and referral / follow-up | | | | |

|information. | | | | |

|23. Follow-up is conducted in accordance with agency / programmatic guidelines. | | | | |

|24. Records are maintained in accordance with HIPAA guidelines. | | | | |

|25. Employee documents assessments, counseling and client’s information in approved | | | | |

|format in accordance with programmatic guidelines. | | | | |

|Documentation |Achieved |Needs Improvement |Not Achieved |Not Applicable |

|26. Documentation is precise and clear. | | | | |

|27. Employee uses approved abbreviations. | | | | |

|28. Documentation supports referrals and follow-up. | | | | |

Observer / Preceptor Comments:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Feedback Provided to Employee: Date: _____________

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Follow-up Planned:

________________________________________________________________________________________________________________________________________________________________

Supervisor’s Signature: ___________________________________ Date: _________________

Employee’s Signature: ____________________________________ Date: _________________

The program supervisor should maintain this information within the program files.

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