Supervisor/Preceptor Comments: Previous Experience Instruction, Review, or Skill Demonstration For Repeat Review Review of Skill Skills Endocrine D A B C E of Date and (Required) Done Initials Date and Complete Initials Needed Diabetic management and Competency Competency teaching Insulin injection teaching Insulin pump management and teaching Diabetic skin/foot/nail care and teaching Hyper/hypoglycemia S/S teaching (parameters, if applicable) Teaching blood glucose monitoring Other: State specific requirements: Supervisor/Preceptor Comments: Previous Experience Instruction, Review, or Skill Demonstration For Repeat Review Review of Skill Skills Medication D A B C E of Date and Administration Done Initials Date and Complete Initials (Required) Needed Intradermal Competency Competency Subcutaneous Intramuscular Intravenous Inhalation Oral G, J or NG tube Teaching medication administration specific requirements:
Supervisor/Preceptor Comments: Previous Experience Instruction, Review, or Skill Demonstration Endocrine (Required) A B C D E Review of Needed Review of Complete Skill Done Date and Initials Competency For Repeat Skills Date and Initials Competency Diabetic management and teaching Insulin injection teaching Insulin pump management and teaching Diabetic skin/foot/nail care and teaching Hyper/hypoglycemia S/S teaching (parameters, if applicable) Teaching blood glucose monitoring Other: State specific requirements: Supervisor/Preceptor Comments: Previous Experience Instruction, Review, or Skill Demonstration Medication Administration (Required) A B C D E Review of Needed Review of Complete Skill Done Date and Initials Competency For Repeat Skills Date and Initials Competency Intradermal Subcutaneous Intramuscular Intravenous Inhalation Oral G, J or NG tube Teaching medication administration specific requirements:
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