Pharmacist Checklist


Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Total Stars:

Obtained Stars:

Ranking: 0%

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

  Practice Settings/Experience         Rating Stars (Click) 1 2 3 4
  Ambulatory Care  
  Clinic  
  Compounding  
  Consulting  
  Correctional Facility (Jail)  
  Diabetes  
  Drug Information  
  Formulary Management  
  Geriatrics  
  Home Health  
  Home Infusion  
  Hospital� Inpatient  
  Hospital� Outpatient  
  Infectious Disease  
  Long Term Care (LTC)  
  Mail Order  
  Military/Government/VA  
  Nuclear  
  Oncology  
  Pain Management  
  Pediatrics  
  Pharmaceutical Research  
  Pharmaceutical Sales  
  Pharmacy Benefits Management (PBM )  
  Poison Control  
  Psychiatric Patient Management  
  Public Health  
  Renal Patient Management  
  Retail� Chain  
  Retail� Independent  
  Sub-Acute Care  
  Veterinary  
  Other:  
  Pharmacy Software Systems         Rating Stars (Click) 1 2 3 4
  Etreby  
  HBS  
  JASRx  
  McKesson� 3PM  
  McKesson� Pharmserv  
  Meditech  
  NDC  
  OPUS� ISM  
  OSCOR  
  PDX  
  PharmNet  
  Pharmtrak  
  PROScript 2000  
  QS1  
  Renlar  
  Rescot� Omni-DX  
  Rx-Link  
  Speed Script TechRx  
  WinPharm  
  Other:  
  Automation         Rating Stars (Click) 1 2 3 4
  Accumed/Baker Cells  
  BAXA� Rapid-Fill (ASF)  
  BAXA� Repeater Pump  
  Baxter  
  Baxter� AUTOMIX Compounder  
  Baxter� MICROMIX Compounder  
  Kirby Lester  
  McKesson� AcuDose-  
  McKesson� Baker Scale  
  McKesson� IntelliShelf-Rx  
  McKesson� MedCarousel  
  McKesson� ROBOT� Rx  
  McKesson� PACMED  
  MTS� Automated Sealers  
  MTS� Prepackaging  
  Parata� PACMED  
  Parata� RDS  
  Parata� APM  
  PharmASSIST� RDS ROBOTx  
  PharmASSIST� ROBOTx  
  PharmASSIST� SmartCabinet  
  PharmASSIST� SmartScale  
  Pyxis  
  Other:  
  Other:  
  Disease State Management         Rating Stars (Click) 1 2 3 4
  AIDS/HIV  
  Anticoagulation  
  Asthma  
  Cardiovascular Disease  
  Chemotherapy  
  Cystic Fibrosis  
  Depression  
  Diabetes  
  Dyslipidemia  
  Hormone Replacement Therapy  
  Hypertension  
  Osteoporosis  
  Pain Management  
  Smoking Cessation  
  Transplant  
  Other:  
  Clinical and Job related Experience         Rating Stars (Click) 1 2 3 4
  Admixture  
  Adolescent Care  
  Aseptic Techniques  
  Blister Packs  
  Cart Check  
  Cart Fill  
  Chemotherapy  
  Computerized Physician Order Entry  
  Consulting  
  Discharge Counseling  
  DME Equipment  
  Drug Information  
  Drug Information  
  Rounds  
  Drug Rehabilitation Programs  
  Emergency Room Enteral Nutrition Products  
  Formulary Management  
  Geriatric Care  
  Hazardous Drug Handling  
  Homeopathic Treatments  
  Hyperalimentation Calculation  
  Immunizations  
  Immunoglobulin Therapy  
  Incontinence Supplies  
  Infectious Disease  
  Infusion Pumps and Systems  
  Intensive Care (ICU)  
  IV Preparation  
  Neonatal Intensive Care (NICU)  
  Oncology  
  Ostomy Supplies  
  OTC selection and recommendations  
  P&T committee participant  
  Pain Management  
  PCA Pumps  
  Pediatric Care  
  Poison Control  
   
  Psychiatric Care  
  Retail Compounding  
  Surgical Supplies  
  Tocolytic TherapyTPN Preparation  
  Transplant Therapy  
  Urological Supplies  
  Other:  
  Age Specific Competencies         Rating Stars (Click) 1 2 3 4
  Infant (Birth - 1 year)  
  Preschooler (ages 2-5 years)  
  Childhood (ages 6-12 years)  
  Adolescents (ages 13-21 years)  
  Young Adults (ages 22-39 years)  
  Adults (ages 40-64 years)  
  Older Adults (ages 65-79 years)  
  Elderly (ages 80+ years)  
  Pharmacokinetic Dosing of         Rating Stars (Click) 1 2 3 4
  Aminoglycosides  
  Anticoagulation  
  Digoxin  
  Lithium  
  Theophylline  
  Vancomycin  
  Other:  
  Other:  
  Other: