Skill Checklists
Radiology Technologist
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
Adult Inpatient
ER/Trauma
Adult Outpatient
Pediatric Inpatient
Pediatric Outpatient
Chest Studies
Abdominal Studies
Foreign Body/Soft Tissue Studies
Specimen Radiography
Upper
Lower
Pelvis Obls/Judet Views
Pelvis SI Joints
Pelvis Sacrum/Coccyx
Cervical Spine-Obls/Flexion/Extension
Thoracic Spine-Swimmer’s View
Lumbar Spine-Obls/Flexion. Extension
Facial Bones
Mandible
Mastoids
Orbits
Sinus Series
TMJ
Skull Series
Renal
Spine
Barium Swallow/Esophagram
Modified Barium Swallow/Protocol Swallow
Swallow Studies with Videotaping
Upper GI Series-Single Contrast
Upper GI Series-Air Contrast
Small Bowel Follow Through
Barium Enema-Single Contrast
Water Soluble Contrast Enema (e.g. Hypaque)
Barium Enema-Air Contrast
Lower GI Studies thru Colostomy
Urethrography
Cystogram
Voiding Cystogram
IVP
IVP with Tomograms
Cervical Spine
Thoracic Spine
Lumbar Spine
Broncoscopy with Fluoro Guidance
Bedside Line and Tube Placement
Sterile Procedures in OR
Spine Work
Operative Cholangiography
Hip Studies
Extremity Studies
Cystography
Retrograde Urography
National Patient Safety Goals
Computerized Charting
Newborn/neonate (birth-30 days)
Infant (30 days-1 year)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64+)
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.
