February 20, 2019

Occupational Therapist-dont use

Name*
Full Name
Self-Assessment Rating Scale:
No Experience
Theory or observation only during the past 12 months

Limited Experience
Performed less than 12 times within the past 12 months and may need a review

Experienced
Performed at least once per month within the past 12 months and may need minimal assistance

Highly Skilled
Performed on at least a weekly basis over the past 12 months; proficient

Therapy - Pediatrics

	No Experience	Limited Experience	Experienced	Highly Skilled
Care of child - Burn care
Care of child - Cerebral palsy
Care of child - Cystic fibrosis
Care of child - Muscular dystrophy
Care of child - Spina bifida
Care of child - Traumatic brain injury
Critical care procedures
ICU procedures
Isolation precautions
Neurologic - Congenital defects
Neurologic - Developmental disabilities sequencing test
Neurologic - Head injury
Neurologic - Neurodevelopmental deficits
Neurologic - Neurodevelopmental techniques
Neurologic - Sensory integrative deficits
Neurologic - Spinal cord injury
Neurologic - Visual perceptual disorers
NICU
Orthopedics - Birth defects
Orthopedics - Developmental diseases of bone
Orthopedics - Fractures
Procedure/Treatment - Adaptive equipment assessment
Procedure/Treatment - Adaptive equipment training
Procedure/Treatment - Dynamic splints
Procedure/Treatment - Feeding
Procedure/Treatment - Postural balance training
Procedure/Treatment - Resting splints
Procedure/Treatment - Sensory integration techniques
Procedure/Treatment - Splinting - Hand
Procedure/Treatment - Splinting - Lower extremity
Procedure/Treatment - Splinting - Wrist
Procedure/Treatment - Vision therapy
Procedure/Treatment - Lower extremity prosthetics
Procedure/Treatment - Upper extremity prosthetics
SICU procedures

Therapy - Adult

	No Experience	Limited Experience	Experienced	Highly Skilled
Burn management
Cardiac rehab
Care of patient - Traumatic brain injury
Care of patient - Ventilator dependent/assisted
CCU Procedures
ICU Procedures
Neurologic - Adaptive Equipment - Wheelchair
Neurologic - Cognitive disorders
Neurologic - Head trauma
Neurologic - Neuromuscular disease
Neurologic - Spinal cord injury
Neurologic - Stroke rehabilitation
Orthopedic - Amputations
Orthopedic - Back injuries/surgeries
Orthopedic - Fractures
Orthopedic - Hand injury
Orthopedic - Osteoarthritis
Orthopedic - Total joint replacement
Procedure/Treatment - Activities of daily living
Procedure/Treatment - Adaptive equipment assisting
Procedure/Treatment - Adaptive equipment training
Procedure/Treatment - Cognitive techniques
Procedure/Treatment - Community re-entry
Procedure/Treatment - Cryotherapy
Procedure/Treatment - Debridement
Procedure/Treatment - Exercise programs
Procedure/Treatment - Feeding techniques
Procedure/Treatment - Functional - Dynamic splinting
Procedure/Treatment - Functional - Capacity evaluation
Procedure/Treatment - Gait training
Procedure/Treatment - Group treatment
Procedure/Treatment - Home safety evaluation
Procedure/Treatment - Hydrotherapy
Procedure/Treatment - Iontophoresis
Procedure/Treatment - Joint mobilization
Procedure/Treatment - Muscle energy techniques
Procedure/Treatment - Myofacial release
Procedure/Treatment - Neurodevelopment techniques
Procedure/Treatment - Phonophoresis
Procedure/Treatment - Postural education
Procedure/Treatment - Soft tissue manipulation
Procedure/Treatment - Splinting - Elbow
Procedure/Treatment - Splinting - Hand
Procedure/Treatment - Splinting - Wrist
Procedure/Treatment - Sterilization techniques
Procedure/Treatment - TENS
Procedure/Treatment - Transfers
Procedure/Treatment - Ultrasound
Procedure/Treatment - Vision therapy
Procedure/Treatment - Whirlpool
Procedure/Treatment - Work capacity evaluation
Procedure/Treatment - Wound management
Prosthetics - Above knee
Prosthetics - Ankle/foot orthosis
Prosthetics - Below knee

Therapy - Geriatrics

	No Experience	Limited Experience	Experienced	Highly Skilled
Burn management
Cardiac rehab
Cardiovascular disease
Diabetes
Exercise programs
Geriatric psych
ICU procedures
Neurologic - Adaptive Equipment - Wheelchair
Neurologic - Alzheimers/dementia
Neurologic - Cognitive disorders
Neurologic - Head trauma
Neurologic - Neuromuscular disease
Neurologic - Spinal cord injury
Neurologic - Stroke rehabilitation
Orthopedic - Amputation
Orthopedic - Arthritis
Orthopedic - Fractures
Orthopedic - Hand injuries
Orthopedic - Osteoarthritis
Orthopedic - Post operative care
Orthopedic - Shoulder injury
Orthopedic - Total joint replacement
Pacemakers
Procedure/Treatment - Activities of daily living
Procedure/Treatment - Adaptive equipment assessment
Procedure/Treatment - Adaptive equipment training
Procedure/Treatment - Cognitive rehab
Procedure/Treatment - Community re-entry
Procedure/Treatment - Documentation - Medicare A
Procedure/Treatment - Documentation - Medicare B
Procedure/Treatment - Documentation - State healthcare
Procedure/Treatment - Feeding techniques
Procedure/Treatment - Functional - Dynamic splinting
Procedure/Treatment - Gait training
Procedure/Treatment - Home safety evaluation
Procedure/Treatment - Hydrotherapy
Procedure/Treatment - Massage
Procedure/Testing - Neurodevelopment training
Procedure/Treatment - Resting splints
Procedure/Treatment - Splinting - Elbow
Procedure/Treatment - Splinting - Hand
Procedure/Treatment - Splinting - Wrist
Procedure/Treatment - Sterilization techniques
Procedure/Treatment - TENS
Procedure/Treatment - Transfers
Procedure/Treatment - Ultrasound
Procedure/Treatment - Vision therapy
Procedure/Treatment - Whirlpool
Procedure/Treatment - Wound management
Prosthetics - Above knee
Prosthetics - Ankle/foot orthosis
Prosthetics - Below knee
Prosthetics - Upper extremity

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