Social Worker 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. Care coordination/discharge planning

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Transfer of patient

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Documentation

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

5) Self-Assessment

5. Other

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Assessment/Evaluation:

1) Self-Assessment

1. Psychosocial

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. Financial

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Emotional

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Spiritual

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

5) Self-Assessment

5. Terminal care

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

6) Self-Assessment

6. Other

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

Skilled Treatments/Interventions:

1) Self-Assessment

1. Counseling for long range planning and decision making

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

2) Self-Assessment

2. Counsel and assist with out-of-home placement

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

3) Self-Assessment

3. Community resource planning and information

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

4) Self-Assessment

4. Short-term therapy related to illness

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

5) Self-Assessment

5. Evaluate home/family situation

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

6) Self-Assessment

6. Promote community services and provide education

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

7) Self-Assessment

7. Provide advocacy, referral and linkage with community services

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

8) Self-Assessment

8. Counsel and assist with financial matters

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

9) Self-Assessment

9. Assist with strengthening the family support system

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

10) Self-Assessment

10. Assist with resolution of conflict related to illness

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

11) Self-Assessment

11. Identify and advocate for patients at risk for physical or mental abuse and/or neglect

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

12) Self-Assessment

12. Identify and evaluate patients at high risk for suicide

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

13) Self-Assessment

13. Identify and evaluate patients with inadequate food, medications and/or medical supplies

Eval Method

Competent

Preceptor Initials(Required)

Date(Required)

14) Self-Assessment

14. 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