Instructions:

Please rate your skill level for each task using the scale below:

1 – Limited experience

2 – Basic competency

3 – Proficient

4 – Highly skilled

Documentation and Recordkeeping

1

2

3

4

Recording medication administration in MAR

Documenting missed doses or refusals

Identifying and reporting medication errors

Updating and maintaining resident medication profiles

Handling controlled substances and maintaining logs

Ensuring proper storage of medications

Communicating with healthcare providers about medication orders

Resident Care and Interaction

1

2

3

4

Explaining medications and instructions to residents

Monitoring residents for medication effectiveness

Assisting with vital signs monitoring before medication administration

Observing and reporting changes in resident conditions

Providing emotional support during medication administration

Additional Skills

1

2

3

4

Ability to work under pressure and multitask

Effective communication with residents, families, and staff

Knowledge of emergency protocols for medication reactions

Familiarity with facility policies and procedures

I certify that all the above information is correct, and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from the agency. I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct.

Personal Information

Instructions:

Medication Administration

Documentation and Recordkeeping

Knowledge of Medications

Resident Care and Interaction

Infection Control and Safety

Additional Skills