Cath Lab 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
Scrub Cath Lab Procedures
Circulate Cath Lab Procedures
Monitor Cath Lab Procedures
Airway Maintenance
Arm Cases
Biopsy
Co-Ox Setup Q.C., Run Sample
Defibribulator Setup/Use
IABP
Power Injector Setup/Use
Left Heart Catheterization
Right Heart Catheterization
PTCA/Stents/Ballons
Radiation Protection
Atherectomy
Permanent Pacemaker
Temporary Pacemaker
Setting Threshold of Pacemakers
Rotablator
Sphygmomanometer Monitoring
Transducer Setup/Calibration
Run Angiojet Machine
IVUS
Handoff Reports
Coronary Intervention
Hematoma Recognition & Mgt
Coronary Atherectomy
FFR
ECMO
Stent Implantation
Rotational Coronary Atherectomy
Intra Aortic Balloon Pump
Closure Device
Temporary Pacemakers
Angiojet
Radial
Brachial
Peripherals
Impella
PPM
ICD
BiV
Loop Recorder
Structural Heart
Manifold
ACIST/Medrad
Hybrid OR
Simultaneously Scrub & Pan Xray Table
Sheath Pulls
STEMI
TAVR
Prep Access Site
Vascular Closure Systems (Perclose, StarClose)
Rotoblator
Hemodynamic Monitoring
Interpretation of Dysrhythmias
Fluoroscopy
GE Innova IGS
Recognition of Life-Threatening Arrhythmias
Coronary IFR
Coronary FFR
Phillips
Siemens
Toshiba
GE
Siemens Artis Zeego
Shimadzu
Cannon Alphenix
Electronic Documentation
GE MacLab Marquette
Mennen
Merge Cardio/Camtronics VERICIS
McKesson
Phillips Xper IM/WITT
Siemens Sensis
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 years to 64 years)
Older Adults (64 years to 79 years)
Elderly Adults (over 79+ years)
Cerner
Epic
Mac Lab
Meditech
Xper
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.
