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Skills Checklists

Congratulations on your decision to apply for an allied position with ClubStaffing! Before we can offer you an allied employment opportunity, an electronic skills assessment must be completed. From the skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!

ClubStaffing
5901 Broken Sound Pkwy.
Suite 450
Boca Raton, Florida 33487
Fax: (561) 367-0884


Vascular Interventional Technologist Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
1. No experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others
 
WORK SETTING
1 2 3 4
 
Interventional Radiology
 
Outpatient
 
Regional Facility
 
Other Setting: Specify
 
EQUIPMENT
1 2 3 4
 
DSA Equipment
 
Other (Specify)
 
GASTROINTESTINAL STUDIES
1 2 3 4
 
Angioplasty
 
Chemoembolization
 
Cholecystostomy
 
Embolization
 
ERCP
 
Esophageal Stent Placement
 
Gastrojejunostomy
 
Gastrostomy Tube Placement
 
Liver Ablation
 
Percutaneous Hepatic Angiography
 
Pericentesis
 
TIPS
 
GENITOURINARY STUDIES
1 2 3 4
 
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
 
NEUROLOGIC STUDIES
1 2 3 4
 
Carotid Angiography
 
Cerebral Angiography
 
Neurologic Angioplasty
 
Neurologic Thrombolysis
 
Vertebroplasty
 
PERIPHERAL VASCULAR STUDIES
1 2 3 4
 
Abdominal Aortography
 
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
 
PULMONARY PROCEDURES
1 2 3 4
 
Chest Tube Placement
 
Pulmonary Embolization
 
Pulmonary Angiography
 
Thoracentesis
 
OTHER PROCEDURES
1 2 3 4
 
Abscess Drainage
 
Assist with Central Line/Venous Line Insertion
 
PICC Line Insertion
 
Radiofrequency Ablation
 
Venogram Study
 
Venous Filter Placement
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Fall Risk Assessment/Prevention
 
Infection Prevention
 
Isolation Precautions
 
National Patient Safety Goals/Core Measures
 
Universal Protocol Procedures
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computer Physician Order Entry
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
Other: Specify
 
Other: Specify
 
EMR Conversion
 
CERTIFICATIONS/LICENSURES/REGISTRATIONS(Current at the time of completing this form)
 
BLS
 
ACLS
 
PALS
 
ARRT
 
ARRT (vascular interventional)
 
Fluoroscopy
Vascular Interventional Technologist Skills Checklist, version 5

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

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