Cardiac Echocardiography Skills Checklist

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(Cardiac Echocardiography)

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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

ULTRASOUND-ECHOCARDIOGRAPHY

Adult Echocardiography:

★★★★

Pediatric Echocardiography:

★★★★

Fetal Echocardiography:

★★★★

Trauma Echocardiography:

★★★★

Stress Echocardiography:

★★★★

Treadmill Testing:

★★★★

Dobutamine:

★★★★

Pharmacologic Stress Echo:

★★★★

Transesophageal Echocardiography (TEE):

★★★★

Intraoperative Echocardiography:

★★★★

Contrast Echocardiography:

★★★★

Myocardial Contrast:

★★★★

Echo-Guided Procedures:

★★★★

Plethysmography:

★★★★

Doppler Vascular Procedures:

★★★★

Pressure Measurements:

★★★★

Two-Dimensional Mode:

★★★★

Three-Dimensional Mode:

★★★★

M-Mode:

★★★★

Ped Off Probe:

★★★★

Pulsed Wave Doppler:

★★★★

Continuous Wave Doppler:

★★★★

Color Doppler Mapping:

★★★★

Portable Studies:

★★★★

Invasive Procedure Guidance:

★★★★

EKG/ECG:

★★★★

Parasternal Long Axis View:

★★★★

RVIT:

★★★★

RVOT:

★★★★

Parasternal Short Axis View:

★★★★

4 Chamber View:

★★★★

2 Chamber View:

★★★★

Apical Long:

★★★★

Subcostal View:

★★★★

Subcostal Short Axis of RV Inflow and Outflow:

★★★★

IVC:

★★★★

Hepatic Veins:

★★★★

Abdominal Aorta:

★★★★

Suprasternal Notch:

★★★★

Simpson's Rule:

★★★★

Proximal Isovelocity Surface Area:

★★★★

Diastolgy with TDI:

★★★★

Continuity Equation:

★★★★

PEDIATRIC ECHO

Two-Dimensional Mode:

★★★★

Three-Dimensional Mode:

★★★★

M-Mode:

★★★★

Ped Off Probe:

★★★★

Pulsed Wave Doppler:

★★★★

Continuous Wave Doppler:

★★★★

Color Doppler Mapping:

★★★★

Portable Studies:

★★★★

Invasive Procedure Guidance:

★★★★

EKG/ECG:

★★★★

Parasternal Long Axis View:

★★★★

RVIT:

★★★★

RVOT:

★★★★

Parasternal Short Axis View:

★★★★

4 Chamber View:

★★★★

2 Chamber View:

★★★★

Inverted Apical 4 Chamber View:

★★★★

Inverted Apical 5 Chamber View:

★★★★

Subcostal Long View:

★★★★

Subcostal Long with Sweep:

★★★★

Subcostal Short with Sweep (Bi Caval View):

★★★★

Subcostal Aortic Arch:

★★★★

Subcostal Abdominal Aorta:

★★★★

Subcostal Situs View:

★★★★

Suprasternal Notch View- Long:

★★★★

Suprasternal Notch View- Short:

★★★★

Left Atrium with Pulmonary Veins with Suprasternal Notch:

★★★★

Pulmonary Artery Branches:

★★★★

Ductal View:

★★★★

Arch Sidedness:

★★★★

Scanning Complex Anomolies:

★★★★

Scanning Post-Surgical Repairs:

★★★★

Simpson's Rule:

★★★★

Proximal Isovelocity Surface Area:

★★★★

Diastology:

★★★★

Stress Echo:

★★★★

Continuity Equation:

★★★★

EQUIPMENT

Phillips:

★★★★

Siemens:

★★★★

Toshiba:

★★★★

Hitachi:

★★★★

General Electric:

★★★★

HP:

★★★★

Other:

★★★★

AGE SPECIFIC EXPERIENCE

Newborn/Neonate (birth to 30 days):

★★★★

Infant (1 month to 1 year):

★★★★

Toddler (1 year to 3 years):

★★★★

Preschooler (3 years to 5 years):

★★★★

School Age Child (5 years to 12 years):

★★★★

Adolescents (12 years to 18 years):

★★★★

Young Adults (18 years to 39 years):

★★★★

Middle Adults (39 to 64 years):

★★★★

Geriatric Adults (65+ years):

★★★★