Skill Checklists
X-Ray 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
Standard Precautions
Isolation Precautions
Pediatric Respiratory/ Cardiac Arrest
Adult Respiratory/ Cardiac Arrest
Adult Acute Care
Adult Outpatient
Pediatric Acute Care
Pediatric Outpatient
Bedside/ Portable Procedures
ER/ Trauma
OR
Chest Routine
Chest SP
Ribs
Chest Lateral Decubitus
Sternum
Upper Airway (Soft-Tissue Neck)
Thumb or Finger
Hand
Wrist
Forearm
Elbow
Humerus
Shoulder
Trauma
Clavicle
Scapula
AC Joints
Toes
Foot
Ankle
Knee
Tibia-Fibula
Femur
Patella
Calcaneus
Skull
Paranasal Sinuses
Facial Bones
Orbits
Zygomatic Arches
Nasal Bones
Mandible
TMJ
Cervical Spine
Thoracic Spine
Sacrum and/ or Coccyx
Cross-Table Lateral Spine
Pelvis
Hip
Cross-Table Lateral Hip
Scoliosis Series
Sacroiliac Joints
Abdomen Supine (KUB)
Abdomen Upright
Abdomen Decubitus
Upper GI Series, Single or Double Contrast
Contrast Enema, Single or Double Contrast
Small Bowel Series
Esophagus
Cystography/ Cystourethrography
ERCP
Myelography
Arthrography
Hysterosalpingography
Chest
Abdomen
Orthopedic
GE
Fuji
Siemens
Toshiba
Hitachi
Portables
C-Arm
eClinicalworks
EPIC
McKesson
Care 360
Allscripts
Cerner
Optum Insight
NextGen
Greenway
Ambra Health
Sectra
Infinitt
IBM Merge
Philips
FujiFilm
Impax
Centricity
Carestream Vue
Clarity
eRad PACS
Syngo
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.
