Skill Checklists

Acute Dialysis

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

Work Settings

Acute/Inpatient Dialysis

Chronic Outpatient Dialysis

Dialysis Home Care

Pediatric Dialysis

Apheresis

Plasmapheresis

Predialysis Nursing Assessment

Charge Experience

Set Up/Initiate Dialysis Treatment

Bicarbonate Dialysate

Conductivity Testing

Priming Dialyzer

Prep Vascular Access

Fistula Gortex/Bovine Graft

Anticoagulation Management

Apheresis

Plasmapheresis

Cannulating Buttonholes

Continuous Renal Replacement Therapy

Peritoneal Dialysis

Assessment During Dialysis

Vascular Access Function

Arterial and Venous Pressures

Blood Flow Rate

Management of Anticoagulation

Conductivity

Ultra Filtration Calculation

Operation of Myron L. Meter

Administration of Blood and Blood Products

Administration of Mannitol

Sequential Ultrafiltration/PUF

Patient Management

Fluid Overload

Hypertension

Hypotension

Disequilibrium Syndrome

Hyperkalemia

Seizures

Muscle Cramps

Clotted Access/Poor Blood Flow Rate from Catheter

Pyrogenic Reaction

Hemolysis

Air Embolus

Chest Pain

Anemia

Neuropathy

Pericarditis

Filter Blood Leak

Cardiopulmonary Arrest

Anticoagulation Emergencies

Dialysis Equipment

Baxter

Cobe

Fresenius H/K

Gambro

Phoenix

T Machine

Other

Professional Knowledge and Skills

National Patient Safety Goals

Patient Isolation/Infection Prevention

Management of Dialysis Equipment Alarms

Bedside Blood Glucose Monitoring

Pyxis Medication Admin. System

Computerized Charting

Proton Charting Experience

AMI Charting Experience

Ecube Charting Experience

Age Specific Competencies

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)

Certifications

BLS

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.