Oncology Skills Checklist Date:* Name: (First, MI, Last)* Email MEDICATIONS / IV THERAPYAdminister PO Medications* N/A Inexperienced Limited Experience Experienced Highly Experienced Administer IM / SQ Medications* N/A Inexperienced Limited Experience Experienced Highly Experienced Administer IV Medications* N/A Inexperienced Limited Experience Experienced Highly Experienced Needle-less Systems* N/A Inexperienced Limited Experience Experienced Highly Experienced Infusion Pumps* N/A Inexperienced Limited Experience Experienced Highly Experienced Establish Peripheral IVs* N/A Inexperienced Limited Experience Experienced Highly Experienced Discontinue Peripheral IVs* N/A Inexperienced Limited Experience Experienced Highly Experienced Pain Assessment / Management* N/A Inexperienced Limited Experience Experienced Highly Experienced Draw Blood for Lab Studies* N/A Inexperienced Limited Experience Experienced Highly Experienced Admin Blood / Blood Products* N/A Inexperienced Limited Experience Experienced Highly Experienced Central Venous Lines (CVL)* N/A Inexperienced Limited Experience Experienced Highly Experienced Hickman / Broviac Catheters* N/A Inexperienced Limited Experience Experienced Highly Experienced PCA / CADD* N/A Inexperienced Limited Experience Experienced Highly Experienced Port-A-Cath* N/A Inexperienced Limited Experience Experienced Highly Experienced Infusaid* N/A Inexperienced Limited Experience Experienced Highly Experienced Infuse-A-Port* N/A Inexperienced Limited Experience Experienced Highly Experienced CARE OF ONCOLOGICAL PATIENTHead, Neck, Chest* N/A Inexperienced Limited Experience Experienced Highly Experienced Hematologic System* N/A Inexperienced Limited Experience Experienced Highly Experienced Gastrointestinal Tract* N/A Inexperienced Limited Experience Experienced Highly Experienced Reproductive System* N/A Inexperienced Limited Experience Experienced Highly Experienced Skin (Melanomas / Nonmelanomas)* N/A Inexperienced Limited Experience Experienced Highly Experienced Urinary Tract* N/A Inexperienced Limited Experience Experienced Highly Experienced EmergenciesCardiac Tamponade* N/A Inexperienced Limited Experience Experienced Highly Experienced Dissesminated Intravascular Coagulation* N/A Inexperienced Limited Experience Experienced Highly Experienced Hypercalcemia* N/A Inexperienced Limited Experience Experienced Highly Experienced Organ Obstruction* N/A Inexperienced Limited Experience Experienced Highly Experienced Sepsis* N/A Inexperienced Limited Experience Experienced Highly Experienced Spinal Cord Compression* N/A Inexperienced Limited Experience Experienced Highly Experienced Superior Vena Cavae Syndrome* N/A Inexperienced Limited Experience Experienced Highly Experienced Tumor Lysis Syndrome* N/A Inexperienced Limited Experience Experienced Highly Experienced Family / Psychosocial NeedsPatient / Family Education* N/A Inexperienced Limited Experience Experienced Highly Experienced Advance Directives* N/A Inexperienced Limited Experience Experienced Highly Experienced Acute Phase* N/A Inexperienced Limited Experience Experienced Highly Experienced Chronic Phase* N/A Inexperienced Limited Experience Experienced Highly Experienced Terminal Phase* N/A Inexperienced Limited Experience Experienced Highly Experienced Bereavement Phase* N/A Inexperienced Limited Experience Experienced Highly Experienced After Treatment (Survivorship)* N/A Inexperienced Limited Experience Experienced Highly Experienced ANTINEOPLASTIC AGENTSBleomycin* N/A Inexperienced Limited Experience Experienced Highly Experienced Dactinomycin (Actinomycin)* N/A Inexperienced Limited Experience Experienced Highly Experienced Daunorubicin (DaunoXome)* N/A Inexperienced Limited Experience Experienced Highly Experienced Doxorubicin (Adriamycin)* N/A Inexperienced Limited Experience Experienced Highly Experienced Routes of AdministrationOral / SQ / IM* N/A Inexperienced Limited Experience Experienced Highly Experienced Intraarterial* N/A Inexperienced Limited Experience Experienced Highly Experienced Intrathecal / Intraventricular* N/A Inexperienced Limited Experience Experienced Highly Experienced Intraperitoneal (Tenckhoff Catheter)* N/A Inexperienced Limited Experience Experienced Highly Experienced Intrapleural* N/A Inexperienced Limited Experience Experienced Highly Experienced Intravesicular* N/A Inexperienced Limited Experience Experienced Highly Experienced Alkylating AgentsBulsulfan (Myleran)* N/A Inexperienced Limited Experience Experienced Highly Experienced Chlorambucil (Leukeran)* N/A Inexperienced Limited Experience Experienced Highly Experienced Cisplatin (Platinol)* N/A Inexperienced Limited Experience Experienced Highly Experienced Cyclophosphamide (Cytoxan)* N/A Inexperienced Limited Experience Experienced Highly Experienced Mechlorethamine (Mustargen)* N/A Inexperienced Limited Experience Experienced Highly Experienced AntimetabolitesCytarabine (Ara-C)* N/A Inexperienced Limited Experience Experienced Highly Experienced Fluorouracil (5-FU)* N/A Inexperienced Limited Experience Experienced Highly Experienced Mercaptopurine (6-MP)* N/A Inexperienced Limited Experience Experienced Highly Experienced Methotrexate* N/A Inexperienced Limited Experience Experienced Highly Experienced Leucovorin Rescue Protocol* N/A Inexperienced Limited Experience Experienced Highly Experienced Antineoplastic AntibioticsBleomycin* N/A Inexperienced Limited Experience Experienced Highly Experienced Dactinomycin (Actinomycin)* N/A Inexperienced Limited Experience Experienced Highly Experienced Daunorubicin (DaunoXome)* N/A Inexperienced Limited Experience Experienced Highly Experienced Doxorubicin (Adriamycin)* N/A Inexperienced Limited Experience Experienced Highly Experienced Plant AlkaloidsPaclitaxel (Taxol)* N/A Inexperienced Limited Experience Experienced Highly Experienced Vinblastine (Velban)* N/A Inexperienced Limited Experience Experienced Highly Experienced Vincristine (Oncovin)* N/A Inexperienced Limited Experience Experienced Highly Experienced Hormonal AntineoplasticsLeuprolide (Lupron)* N/A Inexperienced Limited Experience Experienced Highly Experienced Megestrol (Megace)* N/A Inexperienced Limited Experience Experienced Highly Experienced Tamoxifen (Nolvadex)* N/A Inexperienced Limited Experience Experienced Highly Experienced Testolactone (Teslac)* N/A Inexperienced Limited Experience Experienced Highly Experienced Staff Minimize Risk of ExposureDuring Preparation* N/A Inexperienced Limited Experience Experienced Highly Experienced During Administration* N/A Inexperienced Limited Experience Experienced Highly Experienced During Disposal* N/A Inexperienced Limited Experience Experienced Highly Experienced CLASSIFICATION OF NEOPLASMSStaging - TNM System* N/A Inexperienced Limited Experience Experienced Highly Experienced Tissue of Origin* N/A Inexperienced Limited Experience Experienced Highly Experienced Biologic Behavior* N/A Inexperienced Limited Experience Experienced Highly Experienced Degree of Cell Differentiation* N/A Inexperienced Limited Experience Experienced Highly Experienced Anatomic Site* N/A Inexperienced Limited Experience Experienced Highly Experienced Radiation Therapy (RT)Electromagnetic (Xrays, Gamma Rays)* N/A Inexperienced Limited Experience Experienced Highly Experienced Particulate (Alpha, Beta)* N/A Inexperienced Limited Experience Experienced Highly Experienced External Beam Therapy* N/A Inexperienced Limited Experience Experienced Highly Experienced Knowledge of Early Effects of RT* N/A Inexperienced Limited Experience Experienced Highly Experienced Knowledge of Interim. Effects of RT* N/A Inexperienced Limited Experience Experienced Highly Experienced Knowledge of Late Effects of RT* N/A Inexperienced Limited Experience Experienced Highly Experienced Brachytherapy (Sealed Sources)Interstitial Radiation Therapy* N/A Inexperienced Limited Experience Experienced Highly Experienced Intracavitary Radiation Therapy* N/A Inexperienced Limited Experience Experienced Highly Experienced Radiopharmaceutical (Unsealed Sources)Tracer Dose* N/A Inexperienced Limited Experience Experienced Highly Experienced Therapeutic Dose* N/A Inexperienced Limited Experience Experienced Highly Experienced Surgical InterventionCurative Surgery* N/A Inexperienced Limited Experience Experienced Highly Experienced Diagnostic Surgery* N/A Inexperienced Limited Experience Experienced Highly Experienced Mechanical Device Insertion* N/A Inexperienced Limited Experience Experienced Highly Experienced Palliative Surgery* N/A Inexperienced Limited Experience Experienced Highly Experienced Prophylactic Surgery* N/A Inexperienced Limited Experience Experienced Highly Experienced Reconstructive Surgery* N/A Inexperienced Limited Experience Experienced Highly Experienced Rehabilitative Surgery* N/A Inexperienced Limited Experience Experienced Highly Experienced Bone Marrow Transplant - Allogenic* N/A Inexperienced Limited Experience Experienced Highly Experienced Bone Marrow Transplant - Syngenic* N/A Inexperienced Limited Experience Experienced Highly Experienced ONCOLOGY HEALTH CARE SETTINGSAdult* N/A Inexperienced Limited Experience Experienced Highly Experienced Pediatrics* N/A Inexperienced Limited Experience Experienced Highly Experienced Cancer Center* N/A Inexperienced Limited Experience Experienced Highly Experienced Radiation Oncology* N/A Inexperienced Limited Experience Experienced Highly Experienced Surgical Oncology* N/A Inexperienced Limited Experience Experienced Highly Experienced Bone Marrow Unit* N/A Inexperienced Limited Experience Experienced Highly Experienced Research / Clinical Trials* N/A Inexperienced Limited Experience Experienced Highly Experienced Subacute / Skilled Nursing* N/A Inexperienced Limited Experience Experienced Highly Experienced Home Health Care* N/A Inexperienced Limited Experience Experienced Highly Experienced Hospice* N/A Inexperienced Limited Experience Experienced Highly Experienced Clinic - Risk Assess / Screening / Diagnosis* N/A Inexperienced Limited Experience Experienced Highly Experienced Clinic - Surgery / Gyn* N/A Inexperienced Limited Experience Experienced Highly Experienced Clinic - Medical / Hematology* N/A Inexperienced Limited Experience Experienced Highly Experienced Clinic - Immunology / Infectious* N/A Inexperienced Limited Experience Experienced Highly Experienced Recognition & Management ofAnxiety / Depression* N/A Inexperienced Limited Experience Experienced Highly Experienced Metabolic Alterations* N/A Inexperienced Limited Experience Experienced Highly Experienced Hypersensitivity* N/A Inexperienced Limited Experience Experienced Highly Experienced Fatigue* N/A Inexperienced Limited Experience Experienced Highly Experienced HematopoieticAnemia* N/A Inexperienced Limited Experience Experienced Highly Experienced Leukopenia* N/A Inexperienced Limited Experience Experienced Highly Experienced Thrombocytopenia* N/A Inexperienced Limited Experience Experienced Highly Experienced GastrointestinalAnorexia / Dehydration* N/A Inexperienced Limited Experience Experienced Highly Experienced Nausea / Vomiting* N/A Inexperienced Limited Experience Experienced Highly Experienced Constipation / Diarrhea* N/A Inexperienced Limited Experience Experienced Highly Experienced Muscositis / Ulceration* N/A Inexperienced Limited Experience Experienced Highly Experienced Hepatic Toxicity* N/A Inexperienced Limited Experience Experienced Highly Experienced IntegumentaryAlopecia* N/A Inexperienced Limited Experience Experienced Highly Experienced Dermatitis* N/A Inexperienced Limited Experience Experienced Highly Experienced Hyperpigmentation* N/A Inexperienced Limited Experience Experienced Highly Experienced GenitourinaryCystitis* N/A Inexperienced Limited Experience Experienced Highly Experienced Renal Toxicity* N/A Inexperienced Limited Experience Experienced Highly Experienced CardiovascularCardiac Toxicity* N/A Inexperienced Limited Experience Experienced Highly Experienced Phlebitis* N/A Inexperienced Limited Experience Experienced Highly Experienced Extravasation* N/A Inexperienced Limited Experience Experienced Highly Experienced NeurologicNeurotoxicity* N/A Inexperienced Limited Experience Experienced Highly Experienced Ototoxicity* N/A Inexperienced Limited Experience Experienced Highly Experienced Metabolic Encephalopathy* N/A Inexperienced Limited Experience Experienced Highly Experienced Peripheral Neuropathy* N/A Inexperienced Limited Experience Experienced Highly Experienced PulmonaryFibrosis* N/A Inexperienced Limited Experience Experienced Highly Experienced Pneumonitis* N/A Inexperienced Limited Experience Experienced Highly Experienced Edema* N/A Inexperienced Limited Experience Experienced Highly Experienced ReproductiveInfertility* N/A Inexperienced Limited Experience Experienced Highly Experienced Changes in Libido* N/A Inexperienced Limited Experience Experienced Highly Experienced Erectile Dysfunction* N/A Inexperienced Limited Experience Experienced Highly Experienced NUTRITIONAssess Nutritional Status* N/A Inexperienced Limited Experience Experienced Highly Experienced Assess / Manage Nutritional Impairment* N/A Inexperienced Limited Experience Experienced Highly Experienced Interpretation of Lab Values* N/A Inexperienced Limited Experience Experienced Highly Experienced Oral Feedings* N/A Inexperienced Limited Experience Experienced Highly Experienced Enteral Tube Feeding* N/A Inexperienced Limited Experience Experienced Highly Experienced Peripheral Parenteral Nutrition (PPN)* N/A Inexperienced Limited Experience Experienced Highly Experienced Central TPN* N/A Inexperienced Limited Experience Experienced Highly Experienced BLS MM slash DD slash YYYY ACLS MM slash DD slash YYYY Telemetry Certificate MM slash DD slash YYYY ONS Chemo/Biotherapy Certification MM slash DD slash YYYY Other Chemo Certification MM slash DD slash YYYY Areas of Expertise:Consent* By submitting this form, I agree to all terms and conditions and agree to authorize consent PhoneThis field is for validation purposes and should be left unchanged.