Administrative Registered Nurse Skills Checklist

Cath Lab / Interventional Radiology Skills Checklist

Fill Out and Submit your Skills Checklist

(Cath Lab / Interventional Radiology)

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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

Work Setting

Procedural Cath Lab:

★★★★

lnterventional Cath Lab:

★★★★

EP Lab:

★★★★

Interventional Radiology:

★★★★

Pre/Post Procedural Setting:

★★★★

Charge Experience:

★★★★

Other Setting (List):

★★★★

Equipment

Automatic Implantable Cardiac Defibrillator:

★★★★

Cardioversion:

★★★★

Intra Aortic Balloon Pump (IABP):

★★★★

SV02 Recording:

★★★★

Ventilator Management:

★★★★

Cardiac Cath Lab Procedures

AICD Placement:

★★★★

Aortography:

★★★★

Cardiac Biopsy:

★★★★

Cardiac Implant Closure Device:

★★★★

Cardiac Stent Placement:

★★★★

Diagnostic Cardiac Catheterization Adult:

★★★★

Diagnostic Cardiac Catheterization-Pediatric/Neonatal:

★★★★

Directional Coronary Atherectomy:

★★★★

IABP Placement/Removal:

★★★★

Internal Mammary Angiography:

★★★★

Laser Assisted Procedures:

★★★★

Percutaneous Transluminal Coronary Angioplasty:

★★★★

Pericardiocentesis:

★★★★

Permanent Pacemaker Placement:

★★★★

Pulmonary Angiography:

★★★★

Rotational Coronary Atherectomy:

★★★★

Saphenous Vein Graft Angiography:

★★★★

Transluminal Extraction Catheter:

★★★★

Valvuloplasty:

★★★★

Ventricular Assist Device Insertion:

★★★★

Electrophysiology Procedures

Electrophysiology Evaluation:

★★★★

Baseline Measurements:

★★★★

Cardiac Ablation:

★★★★

Cardiac Mapping:

★★★★

Cardioversion:

★★★★

Conduction Study:

★★★★

Internal Cardioverter Defibrillator Implant:

★★★★

Tilt Table Study:

★★★★

IR-Gastrointestinal Studies

Angioplasty:

★★★★

Chemoembolization:

★★★★

Cholecystostomy:

★★★★

Embolization:

★★★★

ERCP:

★★★★

Esophageal Stent Placement:

★★★★

Gastrojejunostomy:

★★★★

Gastrostomy Tube Placement:

★★★★

Liver Ablation:

★★★★

Pericentesis:

★★★★

Percutaneous Hepatic Angiography:

★★★★

TIPS:

★★★★

IR-Genitourinary Studies

Adrenal Angiography:

★★★★

Angiography of Female GU System:

★★★★

Angiography of Male GU System:

★★★★

Cystostomy:

★★★★

Embolization:

★★★★

Nephrostomy:

★★★★

Percutaneous Stone Extraction:

★★★★

Renal Angiography:

★★★★

Renal Artery Angioplasty:

★★★★

Renal Artery Stent Placement:

★★★★

Ureteral Stent:

★★★★

IR-Neurologic Studies

Cerebral Angiography:

★★★★

Carotid Angiography:

★★★★

Neurologic Angioplasty:

★★★★

Neurologic Thrombolysis:

★★★★

Vertebroplasty:

★★★★

IR-Peripheral Vascular Studies

Angioplasty:

★★★★

Central Venous Access/Port Placement:

★★★★

Dialysis Graft Creation/Revision:

★★★★

Dialysis Graft lnterventional:

★★★★

Peripheral Vascular Embolization:

★★★★

Stent Graft Placement:

★★★★

SVC/IVC Venograph:

★★★★

Thoracic Aortography:

★★★★

Upper and Lower Extremity Angiography:

★★★★

IR-Pulmonary Procedures

Chest Tube Placement:

★★★★

Pulmonary Embolization:

★★★★

Pulmonary Angiography:

★★★★

Thoracentesis:

★★★★

Professional Knowledge And Skills

Conscious/Procedural Sedation:

★★★★

Assist w/Central Line/Venous Line Insertion:

★★★★

Venous Sampling:

★★★★

Topical Hemostasis (D-Stat, Chito-Seal, Syvek Patch, etc.):

★★★★

Vascular Closure Systems (Perclose, StarClose, etc.):

★★★★

External Compression Devices (C-Clamp, Sandbags,etc.):

★★★★

Physiologic Monitoring/Recording:

★★★★

Sheath Removal and Monitoring:

★★★★

National Patient Safety Goals/Core Measures:

★★★★

Universal Protocol Procedures:

★★★★

Isolation Precautions:

★★★★

Infection Prevention:

★★★★

Age Specific/Population-Based Care:

★★★★

Fall Risk Assessment/Prevention:

★★★★

EMR

Cerner:

★★★★

Eclipsys:

★★★★

Epic:

★★★★

GE:

★★★★

McKesson:

★★★★

Meditech:

★★★★

Other Computerized System:

★★★★

Computerized Physician Order Entry:

★★★★

Medication Administration using Bar Coding Technology:

★★★★

EMR Conversion:

Certifications

BLS

Expiry:

ACLS

Expiry:

PALS

Expiry:

CCRN

Expiry:

Telemetry Certificate

Expiry:

Arrhythmia Course

Expiry:

Other: Expiry:

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):

★★★★

Cath Lab / Interventional Radiology Skills Checklist

Fill Out and Submit your Skills Checklist

(Cath Lab / Interventional Radiology)

Proficiency Scale:

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