Skill Checklists
Interventional Radiology RN
Name
Email
LAST 4 OF SSN
This checklist was electronically signed on (Today’s date)
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
Admit patient to pre-procedure holding
Complete assessments, obtain family history & risk factors
Start peripheral IV
Complete pre-procedure checklist
Transport pre-procedure patient to the Lab
Transport post-procedure patient to in-hospital units
Cerebral Angiogram – Prepare
Cerebral Angiogram – Assist
Lower Extremity Angiogram – Prepare
Lower Extremity Angiogram – Assist
Upper Extremity Angiogram – Prepare
Upper Extremity Angiogram – Assist
Ultrasound Guided Biopsy – Prepare
Ultrasound Guided Biopsy – Assist
CT Scan Guided Biopsy – Prepare
CT Scan Guided Biopsy – Assist
Liver Biopsy and Embolization – Prepare
Liver Biopsy and Embolization – Assist
Prepare and Assist with Line Placement – Broviac
Prepare and Assist with Line Placement – Groshong
Prepare and Assist with Line Placement – Hickman
Prepare and Assist with Line Placement – PICC
Prepare and Assist with Line Placement – PortaCath
Uterine Fibroid Embolization – Prepare
Uterine Fibroid Embolization – Assist
Temporary Hemodialysis Shunt Placement– Prepare
Temporary Hemodialysis Shunt Placement– Assist
Permanent Hemodialysis Shunt Placement– Prepare
Permanent Hemodialysis Shunt Placement– Assist
AV Fistula/Shunt Declotting – Prepare
AV Fistula/Shunt Declotting – Assist
Vertebroplasty – Prepare
Vertebroplasty – Assist
Lumbar Puncture – Prepare
Lumbar Puncture – Assist
Myelogram – Prepare
Myelogram – Assist
Other Procedures (please list):
Provide care for the post-procedure patient
Assess heart sounds and peripheral pulses
Interpret arrhythmias
Perform CPR
Perform defibrillation
Participate as a team member in resuscitation
Assess lung sounds
Set up oxygen devices
Obtain pulse oximetry reading
Interpret ABG
Use Ambu bag
Assist with intubation
Assist with chest tube insertion
Provide care for the patient with mechanical ventilation
Titrate vasoactive drugs
Calculate mcg/min and mcg/kg/min
Use IV infusion pump to calculate drug doses
Administer IV dopamine
Administer IV nitroglycerine
Administer IV dobutamine (Dobutrex)
Administer IV lidocaine
Administer IV diltiazem (Cardizem)
Administer IV epinephrine
Administer IV atropine
Administer IV heparin
Administer IV benzodiazepines (Valium, Versed, Ativan)
Administer IV propofol (Diprivan)
Administer IV neuromuscular blocking agents (Pavulon, Norcuron)
Administer IV narcotics (morphine, fentanyl)
Assess pain level/tolerance
Care of patient with anesthesia/analgesia
Care of patient with IV conscious sedation
Care of patient with narcotic analgesia
Care of patient with patient controlled analgesia (PCA pump)
Assess surgical wound status with/without drain(s)
Care of patient with sterile dressing changes
Care of patient with FemoStop device
Assessment of VasoSeal, AngioSeal, PerClose success
Pediatric (1-18years)
Adolescents (12 - 18 years)
Adult (19 - 65 years)
Older adults (Older than 65years)
Calculate body weight to verify correct dosing of medication
Assess immunization status for pediatric, and adolescent
Set age-appropriate short-term and long-term goals in care planning
Provide age-appropriate education, considering possible vision and hearing impairment for Older than 65years
ACLS
5
BCLS
Other:
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.
