Skill Checklists
Ultrasound Tech
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
Hospital Experience
Clinic Experience
Teaching/Educational Facility
Vital Signs
Care of patients in restraints
Use of transfer/lifting devices
Care of patients in isolation
Knowledge of "Do Not Use Abbreviations"
Do you have charge/supervisor experience?/td>
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores
Aorta
Appendix
Biliary Tract
Gall Bladder
Intra Operative Ultrasound
Liver
Lung Biopsy
Pancreas
Paracentesis,thoracentesis
Renal/Cyst Aspiration
Pelvic male
Ultrasound Guided Biopsy
GE
Hitachi
HP
Phillips
Picker
Siemens
Toshiba
Adnexa
Endometrial
Ovaries
Transvaginal
Uterus
Amniotic fluid (normal and abnormal)
Crown rump length
Fetal demise
Left Ventricular outflow tract
Right Ventricular outflow tract
Multiple pregnancy
Lower uterine segment
Nuchal Translucency
Placenta Previa
High Risk OB
Saline Infused Sonohysterography (SIS)
Amniocentesis
Holter Monitors
Carotid Ultrasound
Venous (arm/leg)
Arterial (arm/leg)
Hysterosonography
Biopsy
Testicular
Gallbladder
Renal
Abdominal/Pelvis
OB/GYN exams
Drainage
Arterial - Aorta
Arterial/Venous - Superior Mesenteric
Arterial - Celiac
Arterial/Venous - Iliacs
Arterial/Venous Renal
Arterial/Venous - Splenic
Venous - Inferior Vena Cava
Venous - Portal
Upper Extremity
Digital
Dialysis Graft
Lower Extremity
Graft Patency
Vein Mapping
Reflux Testing (valve competence)
Color Doppler imaging
Cardiac Vasculature
Stress/pressure Testing
Segmental Pressures
Volume Pulse recording
Pulse Cuff recording
Digital pressure
Reactive Hyperemia/Post exercise
Neck Vasculature
Carotid Arteries
Vertebral Arteries
Subclavian Arteries
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)
Epic
Cerner
Eclipsys
McKesson
Meditech
Allscripts
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
EMR Conversion
BLS
5
CNRN
ACLS
CCRN
Other:
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.
