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
Pediatric Echocardiography
Adult Echocardiography
Fetal Echocardiography
Trauma Echocardiography
Stress Echocardiography
Treadmill Testing
Dobutamine
Pharmacologic Stress Echo
Transesophageal Echocardiography (TEE)
Intraoperative Echocardiography
Contrast Echocardiography
Myocardial Contrast
Echo-Guided Procedures
Plethysmography
Doppler Vascular Procedures
Pressure Measurements
Two-Dimensional Mode
Three-Dimensional Mode
M-Mode
Ped Off Probe
Pulsed Wave Doppler
Continuous Wave Doppler
Color Doppler Mapping
Portable Studies
Invasive Procedure Guidance
EKG/ECG
Parasternal Long Axis View
RVIT
RVOT
Parasternal Short Axis View
4 Chamber View
2 Chamber View
Apical Long
Subcostal View
Subcostal Short Axis of RV Inflow and Outflow
IVC
Hepatic Veins
Abdominal Aorta
Suprasternal Notch
Simpson’s Rule
Proximal Isovelocity Surface Area
Diastolgy with TDI
Continuity Equation
Inverted Apical 4 Chamber View
Inverterd Apical 5 Chamber View
Subcostal Long View
Subcostal Long with Sweep
Subcostal Short with Sweep (Bi Caval View)
Subcostal Aortic Arch
Subcostal Abdominal Aorta
Subcostal Situs View
Suprasternal Notch View- Long
Suprasternal Notch View- Short
Pulmonary Artery Branches
Ductal View
Arch Sidedness
Scanning Complex Anomolies
Scanning Post-Surgical Repairs
Diastology
Stress Echo
Phillips
Siemens
Toshiba
Hitachi
General Electric
HP
Other
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 to 64 years)
Geriatric Adults (65+ years)
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