CVOR RN Skills Checklist

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(CVOR RN)

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I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Instructions:This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

SCRUB GENERAL SURGERY

AKA/BKA (Amputation):

★★★★

Radical Mastectomy:

★★★★

Abdominal - Perineal Resection:

★★★★

Cholecystectomy (Open):

★★★★

Exploratory Laparatomy:

★★★★

Appendectomy:

★★★★

SCRUB CARDIAC

DaVinci Procedures:

★★★★

Coronary Artery By-Pass:

★★★★

Mitral Valve Repair/Replacement:

★★★★

Aortic Valve Replacement:

★★★★

Multiple Valve Transposition:

★★★★

Septal Defects:

★★★★

Ventricular aneurysm Repair:

★★★★

Bring Back Heart:

★★★★

Pericardial Window:

★★★★

Intra-Aortic Balloon Insertion:

★★★★

Heartport or Similar CABG:

★★★★

Thoraco approach Mid-Cab:

★★★★

Aortic Arch Replacement:

★★★★

Aortic Valve Conduit:

★★★★

Mechanical Heart/LVAD:

★★★★

Pediatric Hearts:

★★★★

Tetrology of Fallot:

★★★★

Chamberlain Procedure:

★★★★

Femoral Artery Cannulation:

★★★★

AICD Insertion:

★★★★

Saphenous Vein Harvest:

★★★★

Endoscopic Vein Harvest:

★★★★

Gastric Artery Harvest:

★★★★

Radial Vein Harvest:

★★★★

Carotid Endarterectomy:

★★★★

Abdominal Aortic Aneurysm:

★★★★

Femoral-Popliteal By-Pass Graft:

★★★★

Thrombectomy:

★★★★

AV Shunt:

★★★★

Pacemaker Insertion:

★★★★

SCRUB LAPARASCOPIC PROCEDURES

Cholecystectomy (Open):

★★★★

Appendectomy:

★★★★

Hernia:

★★★★

Nissan:

★★★★

Colectomy:

★★★★

Gastrectomy:

★★★★

Inguinal/Ventral hernia Repair:

★★★★

Splenectomy:

★★★★

Bowel Rescetion/Colostomy:

★★★★

Thyroidectomy:

★★★★

Rectal Procedures:

★★★★

Esophagascopy/Gastrocopy:

★★★★

SCRUB PEDIATRIC CASES

Inguinal Hernia Repair:

★★★★

Pyloric Stenosis:

★★★★

Circumcision:

★★★★

Exploratory Laparotomy:

★★★★

SCRUB VASCULAR SURGERY

Carotid Endarterectomy:

★★★★

Abdominal Aoric Aneurysm:

★★★★

Femoral-Popliteal By-Pass Graft (Insitu):

★★★★

Femoral-Popliteal By-Pass Graft (Graph):

★★★★

Portacath, Tesio, Hickman:

★★★★

AV Shunt:

★★★★

Thrombecomy:

★★★★

Pacemaker Insertion:

★★★★

Arterial Stenting:

★★★★

Intra-Operative Angioplasty:

★★★★

Subclavian/Carotid By-Pass:

★★★★

SCRUB ORTHOPEDICS

Total Hip Replacement:

★★★★

Bipolar Hip:

★★★★

Compression Hip Screw:

★★★★

Total Knee Replacement:

★★★★

Knee Artoscopy:

★★★★

ACL Knee Repair:

★★★★

harrington Rod or Similar:

★★★★

I.M. Rodding:

★★★★

Hand and Foot procedures:

★★★★

Mini Fragment Screws & Plates:

★★★★

External Fixation:

★★★★

Shoulder Repair:

★★★★

Shoulder Arthoscopy:

★★★★

Spinal Fusion:

★★★★

Fracture Table Set-Up:

★★★★

Drills, Saws and Reamers:

★★★★

SCRUB GYNECOLOGY

D&C:

★★★★

Diagnostic Laparascope:

★★★★

Laparoscopic Asst'd Vaginal Hysterectomy:

★★★★

Abdominal Hysterectomy:

★★★★

Vaginal Hysterectomy:

★★★★

Anterior/Posterior Repair:

★★★★

MMK (Marshall Marchetti Krantz):

★★★★

Tuboplasty:

★★★★

BLT (Bilateral Tubal Ligation):

★★★★

C-Section:

★★★★

SCRUB UROLOGY

Radical Prostatectomy:

★★★★

Radical Lymph Node Dissection:

★★★★

Insertion Penile Prosthesis:

★★★★

Hydrocelectomy:

★★★★

Cystoscopy:

★★★★

Ureteroscopy:

★★★★

TURP/TURBT:

★★★★

SCRUB NEUROLOGY

Cervical Laminectomy (Anterior):

★★★★

Cervical Laminectomy (Posterior):

★★★★

Lumbar Lamincetomy, Discectomy:

★★★★

Percutaneous Micro Discectomy:

★★★★

Craniotomy for Tumor:

★★★★

Craniotomy for Aneurysm:

★★★★

Burr Holes:

★★★★

VP Shunts:

★★★★

Transphenoidal Hypothypectomy:

★★★★

Harrington Rod or Similar:

★★★★

SCRUB PLASTICS

Mammoplasty:

★★★★

Facelifts:

★★★★

Skin Grafts:

★★★★

Rhinoplasty:

★★★★

Cleft Lip Repair:

★★★★

Abdominalplasty:

★★★★

Blepharoplasty:

★★★★

Otoplasty:

★★★★

Muscle Flaps:

★★★★

Trauma:

★★★★

Transplant Surgery:

★★★★

Organ Procurements (Harvest):

★★★★

SCRUB ENT

Middle Ear:

★★★★

T&A:

★★★★

Myringotomy:

★★★★

Tympanoplasty:

★★★★

Radical Neck Dissection:

★★★★

Septoplasty:

★★★★

Sinus Endoscopy:

★★★★

SCRUB THORACIC

Thoracotomy:

★★★★

Thoracoscopy:

★★★★

Age Specific Competencies

Infant (Birth - 1 year):

★★★★

Preschooler (ages 2-5 years):

★★★★

Childhood (ages 6-12 years):

★★★★

Adolescents (ages 13-21 years):

★★★★

Young Adults (ages 22-39 years):

★★★★

Adults (ages 40-64 years):

★★★★

Older Adults (ages 65-79 years):

★★★★

Elderly (ages 80+ years):

★★★★