Urology 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
Cystoscopy / Panendoscopy
Insertion of ureteral catheters/stents
TUR of prostrate
Bladder biopsy
Transurethral lithalopaxy
Repair of uterovaginal fistula
Ureterolysis
Ureteropelvioplasty
Ureteral anastomosis
Urterolithotomy
Nephropexy
Pyelolithotomy
Open renal biopsy
Total cystectomy
Suprapubic cystostomy
Vesicourethropexy
Cutaneous vesicostomy
Meatotomy
Uretherectomy
Hypospadius repair
Orchiectomy
Hydrocelectomy
Testicular biopsy
Vasectomy
Implanation of artificial sphincter
Penile straightening
Reanastomosis of vas deferens
Retroperitoneal lymph node dissection
Laparoscopic Urological procedures
Microsurgery
Percutaneous nephrostomy
Percutaneous lithotripsy
Ureterscopy
Radical prostatectomy
Retrograde Pyelogram
Stone manipulation
TUR and fulguration of bladder tumor
Transurethral ureteral meatotomy
Perioneal urethrostomy
Intubated ureterotomy
Ureterectomy
Ureteral reimplantation
Transureteroureterostomy
Segmental resection of ureter
Nephrolitotomy
Nephrostomy
Partial cystectomy
Vesical diverticulectomy
Cystoplasty
Repair vesicovaginal fistula
Urethroplasty
Urethral diverticulectomy
Urethrostomy
Circumcision
Radical orchiectomy
Spermatocelectomy
Orchipexy
Epididymectomy
Penile prosthesis
Varicocelectomy
Vasoepidiymal anastomosis
Incontigen injection
Laser procedures
Moderate Sedation
Percutaneous stone manipulation
Renal vascular surgery
Transuretero lithrotripsy
Nephrectomy
Acute Coronary Syndrome
Congestive Heart Failure
Post Open Heart (12-24 hours)
Carotid Endarterectomy
Post Vascular Surgery
Heart Transplant
Pacemaker - Temporary/Permanent
Pacemaker - Epicardial
Sheath Removal
Heart Sounds
Pneumonia
Respiratory Distress
COPD
Breath Sounds
Post Thoracic Surgery
Chest Tube Placement & Management
Trach Management
Modes of Ventilation (AC/PC/SIMV/CPAP)
Intubation/Extubation
External CPAP/BiPAP
Interpretation of Arterial Blood Gases
Stroke Scale Assessment
CVA
Brain Injury
Post Craniotomy
Spinal Cord Injury
Seizure Disorders
ETOH/Drug Withdrawal
GI Bleeding
GI Surgery
Liver Failure
Pancreatitis
Liver Transplant
Pancreas Transplant
Renal Failure
Renal Surgery
Renal Transplant
Arteriovenous Fistula/Shunt
Nephrostomy Tubes
Peritoneal Dialysis
Diabetes - Hypo/Hyperglycemic Crisis
Pituitary Disorders
IV Insulin Protocols
Indwelling Insulin Pumps
Anti- Arrhythmics
Anticoagulants (IV, oral & injection)
Anti-Hypertensives
Anti-Psychotics
Anti-Seizure Medications
Benzodiazepines
Procedural Sedation
Diuretics
Emergency Medications
Inhaled Medications
Insulin
Titrate Vasoactive Drips
Manage Vasoactive Drips - No Titration
Narcotics/Opioid Analgesics (IV, oral & injection)
Nitrates (Oral & Topical)
Non-Opioid Analgesics (IV, Oral & Injection)
Reversal Agents
Steroids (IV, Oral, Inhaled)
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
Starting Ivs
Central Line Blood Draws
Central Line/Implanted Line Care
Arterial Line Management
TPN & Lipids
Blood Product Administration
Administration of Chemotherapy
Dysrhythmia Interpretation
Dysrhythmia Management
Obtain 12 Lead EKG
Interpret 12 Lead EKG
Cardioversion
Defibrillation
Malignant Hyperthermia
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
Pressure Ulcer Risk Assessment/Prevention
Restraints/Use of Least Restrictive Device
Patient/Family Teaching
Age Specific/Population-Based Care
Isolation Precautions
Infection Prevention
Pain Assessment & Management
Charge Experience
Interpretation and Communication of Lab Values
Specialty Beds
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
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)
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.
