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
Arteriogram/Radionuclide
Abscess Localization Whole Body
Abscess Localization Individual Sites
CCK/Ejection Fraction
Cisternogram
CSF Leak Localization
Gallium Scan
Gastric Emptying
GI Bleed
HIDA Scan
Indium 111 WBC Scan Whole Body
Indium 111 WBC Scan Limited
Injection-Lymphatic
Lymphatic Scan-Melanoma
Meckels Scan
Morphine Augmentation
MUGA Scan
Radiopharmaceutical Prep
Radionuclide Arteriogram
Renagram
Parathyroid
Salivary Glands
Ventricular Shunt
Zevalin Treatment
Hyperthyroid Treatment
I 131 Therapy Thyroid Ablation
Therapy Pain
Whole Body
3 Phase
Limited
Cerebral Blood Flow
Liver/Spleen Scan
Liver Scan-Hemangioma
Liver Imaging
Liver Flow
DTPA Aerosol
Perfusion
Ventilation/Perfusion
With Lasix
Flow/Function
Three Phase
Captopril
Abdominal
Ventricular
Cancer Survey
Uptake Scan
I 123 Scan
Bone
Brain
Liver
Liver Spect w/Flow
Renal
Infarction
Exercise/Rest-Single
Exercise/Rest-Multiple
Pharmacological Stress
Thallium/Persantine
Quality Control Equipment
Daily Surveys/Wipe Testing
Hot Lab Management Dose Calibrators
Hot Lab Management Generators
Computerized Charting
National Patient Safety Goals
Universal Protocol Procedures/Core Measures
Isolation Precautions
Infection Prevention
Age Specific/Population-Based Care
Fall Risk Assessment/Prevention
Under 12 Years Old
Adolescents (12 to 18 years)
Young Adults (18 to 39 years)
Middle Adults (40 to 64 years)
Older Adults (65 & up)
Copyright © Ambe Healthcare Staffing
