Skill Checklists
Dosemetrist
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
Newborn (0 to 1)
Toddler (1 to 3)
Preschool (3 to 5)
School age (6 to 12)
Adolescent (13 to 18)
Adult (19 to 65)
Elderly (over 65)
Acute Care/Hospital
Mobile
Ambulatory Care/Clinic
Portable
Post-Acute Care
Surgery
EPIC
CERNER
PACS
Neutropenic Precautions
Droplet Precautions
N95 Masks
CAPR/PAPR Respirators
Appropriate Use Criteria
Assess for Claustrophobia/Distress
Assess Client for Signs of Acute Stroke
Bed to Bed Transfers
Bedside Procedures
Care of Patients in Restraints
CPR/Emergency Crash Cart and Defibrillator
COVID-19 Clients/Precautions
Ensures Safety and Comfort of Patients
Environmental Safety Hazards Monitoring
Explanation of Procedure
Manage Medical Equipment (e.g., Oxygen Tank, IV Tubing)
Obtain Informed Consent
Obtain Client History
Client Discharge with Post-Procedure Instructions
Client Instruction and Education
Patient Preparation
Client Identification
Perform Fall Assessment
Perform Vital Signs
Use of 2 Patient Identifiers and Documentation
Proper Client Positioning for Procedure
Sterile and Aseptic Technique
Stretcher to Bed Transfer
Transfer of Client using Proper Lifting Techniques and Equipment)
Transfer to Imaging Table
Transfer to Wheelchair
Verify Lab Results Prior to Procedure
Biologic Effects of Radiation
Custom Shields
Dose and Exposures
Dose Calculation and Verification
Handling and Disposal of Toxic or Hazardous Materials
Radiation Protection (Patient and Self)/ALARA Principles
Radiation Tissue Tolerance
Receiving, Handling, Use, and Disposal of Radioactive Isotopes
Regulation and Accreditation Requirements
Somatic Effects of Radiation
Worker Dosimetry
Analysis of Imaging for Technical Quality
Demonstration of Correct Anatomic Regions
Evaluation Skills
Film Quality Control
Image Display
Networking Archiving
Parameter/Acquisition/Selections Protocol
Post Processing Documentation of Procedure and Patient Data
Proper Labeling
Recognition of Relevant Pathology
Selection of Imaging Coil
Administer/Supervise Contrast Media
Administer/Supervise Radiospecific Drugs
Administration of Radioactive Doses
Assess Client Allergies
Assess Prior Contrast Usage
Automatic Pressure Injectors
Contrast Allergy Assess/Treat
Contrast Warmers
Emergency Drugs
Induction Medications
Metformin Instructions
Radioisotopes
Safe Handling, Receiving, Use and Disposal of Contrast Media (PET/CT, SPECT/CT)
Injection of Contrast
Medications for Induction
Insertion Peripheral IV
Bio-Logic
Breast ACR/MQSA Quality Control
Cadwell
GE
Phillips
Siemens
Artifact Evaluation
Calibrate Diagnostic Equipment
Daily and/or Monthly Quality Assurance Measures
Proper Cleaning of Equipment
Equipment Inspection/Maintenance
General and Digital QC Testing
Image Management and Archiving
Image Processing and Evaluation
Infection Prevention Measures
Operating Imaging Equipment
Operation Power Injector
QC Procedures
Reporting Equipment Malfunctions
Screen Cleaning Procedure
Storage/Retrieval Patient Data
Technique Selection
Warm-Up Procedures
Bag-Valve-Mask
Nasal Cannula
Non-Rebreather Mask
Pulse Oximetry
Venturi Mask
Portable Oxygen
Tracheostomy
Usage of TLD and Ion Chambers
Thermoluminescent Dosimetry
Linear Accelerators
Radioactive Scatter
Gamma Knife
I-125 Seeds
P-103 Seeds
Treatment Planning with Radiographic and/or CT Simulations
Photo and Electron Dose Calculations and Distributions
Computer Generated 2D, 3D and IMRT Planning
Dose Limiting Structure Considerations
Dose Volume Histograms
Wedged, Weighted and Irregular Fields
Manipulation of Images and Data Sets, to Include Auto-Contouring, Segmentation, Image Fusion and DRR
Electron Beam Planning, Including Electron Monte Carlo
Parallel Opposed Fields with Field Shaping
Single, Open Field
Manipulate DICOM Image Data
Brachytherapy Planning Including Intracavitary, MammoSite and/or Image-Guided
Stereotactic Radiosurgery
Usage of TLD and Ion Chambers for Measurements
Usage of Films for Measurements
Simulation for Tumor Localization
Develop Treatment Plans and Field Arrangement
Design/Fabricate Immobilization Devices
Design/Fabricate Compensating Filters, Wedges and Various Beam Modification Devices
TG-51 Calibration
Accreditations (ACR)
NRC Requirements
Custom Blocks for Photon Beam
Custom Blocks for Electron Beam
Fabrication of Compensators, Wedges, Bolus
Half Value Thick Blocks
Multi-leaf Collimators
Internal Shields
Total Body Irradiation (TBI)
Total Scalp Irradiation
Craniospinal Treatments
Brachytherapy- MammoSite
Total Skin Irradiation
Brain
Primary
Metastatic
Head and Neck
Single Lateral Fields
Two Planes/Fields
Chest
AP/PA
Multiple Fields
Breast
Tangentiales
Supraclavicular
Boost
Abdomen
Para-Aortic
Pelvis
Multiple Field Supine
Multiple Field Prone
Inguinal
Skeletal
Spine
Extremity
Single
Abutting Fields
2D and 3D Planning
IMRT Planning
CT Simulation
MRI Imaging
PET Imaging
Image Fusion, Registration and DRR
Radiation Safety
Quality Assurance
NRC Regulations
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.
