Pharmacist Skills Checklist
    PROFICIENCY SCALE
    1. No Experience 2. Need Training
    3. Able to perform with supervision 4. Able to perform independently

    PRACTICE SETTINGS1234

    Ambulatory Care*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Correctional Facility (Jail)*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Home Health*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Hospital– Inpatient*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Hospital– Outpatient*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Long Term Care (LTC)*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Mail Order*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Military/Government/VA/I.H.S.*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Oncology Center*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Outpatient Clinic*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Retail*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    PHARMACY SOFTWARE SYSTEMS & EMR1234

    Allscripts*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Bar Coding for Medication Administration*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Cerner*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Computer Physician Order Entry*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    CPSI*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Dr. First*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Eclipsys*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Epic*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    GE*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    McKesson*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    MedHost*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Meditech*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    PDX*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Quadramed*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    QS1*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    ScriptPro*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Siemens*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    SureScript*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    EMR Conversion*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    AUTOMATION1234

    Accumed/baker cells*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Baxter*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    McKesson– AcuDose-Rx*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    McKesson– MedCarousel*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    McKesson– ROBOT– Rx*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    McKesson– PACMED*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Omnicell*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Parata*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    PharmAssist*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Pyxis*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    JOB RELATED EXPERIENCE1234

    Aseptic techniques*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Blister Packs*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Cart Check & Fill*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Chemotherapy Preparation*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Critical care unit*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Drug Information rounds*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Emergency Room*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Enteral nutrition products*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Formulary compliance*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Formulary management*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Hazardous drug handling*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Home Infusion*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Informatics*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    IV Admixture*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Managed Care*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Non-Sterile Compounding*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Pain Management*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    PBM prior authorization initiation/follow-up Poison control*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Psychiatric patient management*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Renal patient management*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Sterile Compounding*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    TPN preparation*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    PHARMACISTS IN PHARMACOKINETIC DOSINGYesNo

    Aminoglycosides*1 - Yes2 - No

    Anticoagulation*1 - Yes2 - No

    Digoxin*1 - Yes2 - No

    Lithium*1 - Yes2 - No

    Phenobarbital*1 - Yes2 - No

    Phenytoin*1 - Yes2 - No

    Valporic Acid*1 - Yes2 - No

    Vancomycin*1 - Yes2 - No

    PHARMACISTS IN CLINICAL DISEASE STATE MANAGEMENTYesNo

    Anticoagulation*1 - Yes2 - No

    Asthma*1 - Yes2 - No

    Cardiovascular Disease*1 - Yes2 - No

    Depression*1 - Yes2 - No

    Diabetes*1 - Yes2 - No

    Infectious Disease*1 - Yes2 - No

    Oncology*1 - Yes2 - No

    Pain Management*1 - Yes2 - No

    Smoking Cessation D*1 - Yes2 - No

    Solid Organ Transplant*1 - Yes2 - No

    PHARMACISTS IN AMBULATORY CAREYesNo

    Adult Internal Medicine*1 - yes2 - No

    Advanced Heart Failure/Pulmonary Hypertension*1 - Yes2 - No

    Anticoagulation*1 - Yes2 - No

    Asthma/COPD*1 - Yes2 - No

    Diabetes*1 - Yes2 - No

    Hematology/Oncology*1 - Yes2 - No

    Multidisciplinary HIV/Infectious Disease*1 - Yes2 - No

    Pediatrics*1 - Yes2 - No

    PHARMACISTS IN HOSPITAL PHARMACY – INPATIENTYesNo

    Cardiology*1 - Yes2 - No

    Critical Care*1 - Yes2 - No

    Drug Information – Medication Safety Officer*1 - Yes2 - No

    Emergency Room*1 - Yes2 - No

    ICU*1 - Yes2 - No

    Infectious Disease*1 - Yes2 - No

    Informatics*1 - Yes2 - No

    Internal Medicine*1 - Yes2 - No

    Neurology*1 - Yes2 - No

    NICU*1 - Yes2 - No

    Pediatrics*1 - Yes2 - No

    Solid Organ Transplant*1 - Yes2 - No

    PHARMACISTS IN HOME INFUSIONYesNo

    Preparation*1 - Yes2 - No

    Verification Only*1 - Yes2 - No

    AGE SPECIFIC/POPULATION-BASED CARE1234

    Neonate/Infant*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Toddler/Preschool*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    School Age*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Adolescents*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Young/Middle Adults*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    Older Adults/Geriatrics*1 - No Experience2 - Need Training3 - Able to perform with supervision4 - Able to perform independently

    CERTIFICATIONS (Current at time of completing this form)YesNo

    APhA*1 - Yes2 - No

    ASHP*1 - Yes2 - No

    Board Cert Specialization*1 - Yes2 - No

    BLS*1 - Yes2 - No

    ACLS*1 - Yes2 - No

    PALS*1 - Yes2 - No