Skill Checklists
ELECTROPHYSIOLOGY 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
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)
Standard Precautions
Isolation Precautions
Pediatric Respiratory/Cardiac Arrest
Adult Respiratory/Cardiac Arrest
Crash Carts
Defibrillators
Care of Patient in Restraints
Pain Management
Automated Med Dispensing Systems
Care Planning & Discharge Planning
Patient/Family Education
Electronic Documentation
Patient Head to Toe Assessment
Peripheral IV Insertion, Care and Maintenance
Calculate mcg/min and mcg/kg/min
Titrating Medications
Isuprel
Procainamide
Esmolol
Adenosine
Amiodarone
Antibiotics
Analgesics
Sedatives
Lead Placement
Basic 12 Lead EKG Interpretation
Cardiac Rhythm Interpretation
Doppler
Blood Pressure Invasive and Noninvasive
Art Line
Swan Ganz
Waveform Assessment
General Lab work Interpretation
ABG Interpretation
Cardiac Enzyme Interpretation
Chemistry Interpretation
Central Venous Access Device
Arterial Line
IABP
Sheaths
Removal of Sheath
Manual Pressure Hold
C-Clamp
FemStop
VasoSeal, Angioseal, PerClose
Hematoma Recognition/Management
Scrub EP Procedures
Circulate EP Procedures
Monitor EP Procedures
Ablation (Atrial/Ventricular)
Velocity Mapping
Cart/ Mapping
Rhythmia Mapping
Bloom Stimulator
Micropace Ep-4
Diagnostic Catheters
Bi-V
Stereotaxis
AICD Placement
Bovie
PPM
Baylis
Temporary Pacemaker
Peak Plasma Blade
Cardioversion
Internal Cardioversion Catheters / AICD Testing
NIPS Procedure
Pericardiocentesis
Demonstrate Proper Preservations of Tissue Specimen for Lead Extractions
ACT Machine
Lead Extractions - Spectranetics laser
Device Implants
Ablation Equipment (ie: Stockert, Maestro, Cool Flow, Tactisys)
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.