Skill Checklists

Cath Lab / Interventional Radiology Nursing

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

Procedural Cath Lab

lnterventional Cath Lab

EP Lab

Interventional Radiology

Pre/Post Procedural Setting

Charge Experience

Other Setting (List)

Equipment

Automatic Implantable Cardiac Defibrillator

Cardioversion

Intra Aortic Balloon Pump (IABP)

SV02 Recording

Ventilator Management

Cardiac Cath lab Procedures

AICD Placement

Aortography

Cardiac Biopsy

Cardiac Implant Closure Device

Cardiac Stent Placement

Diagnostic Cardiac Catheterization Adult

Diagnostic Cardiac Catheterization-Pediatric/Neonatal

Directional Coronary Atherectomy

Internal Mammary Angiography

IABP Placement/Removal

Laser Assisted Procedures

Percutaneous Transluminal Coronary Angioplasty

Pericardiocentesis

Permanent Pacemaker Placement

Pulmonary Angiography

Rotational Coronary Atherectomy

Saphenous Vein Graft Angiography

Transluminal Extraction Catheter

Valvuloplasty

Ventricular Assist Device Insertion

Electrophysiology Procedures

Electrophysiology Evaluation

Baseline Measurements

Cardiac Ablation

Cardiac Mapping

Cardioversion

Conduction Study

Internal Cardioverter Defibrillator Implant

Tilt Table Study

IR-Gastroinstestinal Studies

Angioplasty

Chemoembolization

Cholecystostomy

Embolization

ERCP

Esophageal Stent Placement

Gastrojejunostomy

Gastrostomy Tube Placement

Liver Ablation

Pericentesis

Percutaneous Hepatic Angiography

TIPS

IR-Gentiourinary Studies

Adrenal Angiography

Angiography of Female GU System

Angiography of Male GU System

Cystostomy

Embolization

Nephrostomy

Percutaneous Stone Extraction

Renal Angiography

Renal Artery Angioplasty

Renal Artery Stent Placement

Ureteral Stent

IR-Neurologic Studies

Cerebral Angiography

Carotid Angiography

Neurologic Angioplasty

Neurologic Thrombolysis

Vertebroplasty

IR-Peripheral Vascular Studies

IR-Peripheral Vascular Studies

Angioplasty

Central Venous Access/Port Placement

Dialysis Graft Creation/Revision

Dialysis Graft lnterventional

Peripheral Vascular Embolization

Stent Graft Placement

SVC/IVC Venograph

Thoracic Aortography

Upper and Lower Extremity Angiography

IR-Pulmonary Procedures

Chest Tube Placement

Pulmonary Embolization

Pulmonary Angiography

Thoracentesis

Professional Knowledge and Skills

Conscious/Procedural Sedation

Assist w/Central Line/Venous Line Insertion

Venous Sampling

Topical Hemostasis (D-Stat, Chito-Seal, Syvek Patch, etc.)

Vascular Closure Systems (Perclose, StarClose, etc.)

External Compression Devices (C-Clamp, Sandbags,etc.)

Physiologic Monitoring/Recording

Sheath Removal and Monitoring

National Patient Safety Goals/Core Measures

Universal Protocol Procedures

Isolation Precautions

Infection Prevention

Age Specific/Population-Based Care

Fall Risk Assessment/Prevention

EMR

Cerner

Eclipsys

Epic

GE

McKesson

Meditech

Other Computerized System

Computerized Physician Order Entry

Medication Administration using Bar Coding Technology

EMR Conversion

Certifications

BLS

ACLS

PALS

CCRN

Telemetry Certificate

Arrhythmia Course

Other: Specify

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)

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.