Occupational Therapist Initial Competency

Name(Required)

Date of Hire(Required)

Date Completed(Required)

Demonstrates ability to process paperwork and associated tasks related to:

1) Self-Assessment

1. Initial Evaluation

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. OASIS Documentation

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Care coordination/discharge planning

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Transfer of patient

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

5) Self-Assessment

5. Documentation

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

6) Self-Assessment

6. Other

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Assessment/Evaluation:

1) Self-Assessment

1. Mental Status/Cognition/Communication

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. Upper Extremity (ROM, strength, coordination)

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Balance/trunk control

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Ambulation/endurance

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

5) Self-Assessment

5. Transfers

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

6) Self-Assessment

6. Visual/sensory/perceptual performance

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

7) Self-Assessment

7. Functional

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

8) Self-Assessment

8. Environment evaluation / barriers

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

9) Self-Assessment

9. Equipment/assistive device needs

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

10) Self-Assessment

10. Evaluate/recommend home modifications

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

11) Self-Assessment

11. Other

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Skilled Treatments/Interventions:

1) Self-Assessment

12. Community/work integration

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. Neuromuscular re-education

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Fall prevention/safety

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Postural control training

Eval Method

Competent

Preceptor Initials(Required)

Date

5) Self-Assessment

5. Safe use of equipment/devices training

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

6) Self-Assessment

6. Self-care management training

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

7) Self-Assessment

7. Energy conservation techniques

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

8) Self-Assessment

8. Breathing techniques

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

9) Self-Assessment

9. Cognitive skills development/training

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

10) Self-Assessment

10. Manual therapy techniques

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

11) Self-Assessment

11. Sensory integrative techniques

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

12) Self-Assessment

12. Community/work integration

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

13) Self-Assessment

13. Fine motor/dexterity/gross motor training

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

14) Self-Assessment

14. Pain assessment and management

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

15) Self-Assessment

15. Miscellaneous Skills

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

16) Self-Assessment

16. Other

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Use of Equipment/Modalities:

1) Self-Assessment

1. Ultrasound

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. Hot/cold packs

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. TENS/FES

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Orthotics/Splints/Immobilizers

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

5) Self-Assessment

5. Pulse oximeter

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

6) Self-Assessment

6. Massage

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

7) Self-Assessment

7. Other

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Infection Control

1) Self-Assessment

1. Hand hygiene technique

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. Proper bag technique

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Personal protective equipment

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Exposure control plan

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

5) Self-Assessment

5. TB exposure control plan

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

6) Self-Assessment

6. Reporting of infections for patient and personnel

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

7) Self-Assessment

7. Standard precautions

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Safety

1) Self-Assessment

1. Assessment of patient safety risks and home safety

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. Emergency preparedness

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Fire extinguishers

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Hazardous materials

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Patient Education

1) Self-Assessment

1. Determines patient / family learning needs

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. Sets measurable objectives

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Develops/implements teaching plan

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Evaluates effectiveness of teaching

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

5) Self-Assessment

5. Revises teaching plan based on patient needs

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

6) Self-Assessment

6. Documents response to teaching

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Other