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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


Interventional Radiology Nursing Skills Checklist

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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*
 
 
WORK SETTING
1 2 3 4
 
Procedural Cath Lab
 
lnterventional Cath Lab
 
EP Lab
 
Interventional Radiology-Special Procedures Room
 
Interventional Radiology-Special Procedures Room
 
Interventional Radiology- Endovascular Lab
 
Interventional Radiology -CT Scan Suite
 
Interventional Radiology -US Suite
 
Pre/Post Procedural Setting
 
Other Setting (List)
 
EQUIPMENT
1 2 3 4
 
Defibrillation
 
Dye Injector
 
Radiation Safetey Procedures
 
Ventilator Management
 
ADMIT PATIENT TO PREPROCEDURE HOLDING AREA
1 2 3 4
 
Pre-Procedure Care/Groin Care
 
Ensure consent is signed/Patient is clear to begin procedure
 
RASS SCORING SYSTEM
 
INTERVENTIONAL PROCEDURES
1 2 3 4
 
AV Fistula/Shunt Declotting – Preparation/Procedure Assistance
 
Abscess dye test– Preparation/Procedure Assistance
 
Chemo-Embolization– Preparation/Procedure Assistance
 
CT Scan Guided Biopsy – Preparation/Procedure Assistance
 
CT Scan Guided Procedures- Preparation/Procedure Assistance
 
Liver Biopsy and Embolization – Preparation/Procedure Assistance
 
Lower Extremity Angiogram – Preparation/Procedure Assistance
 
Lumbar Puncture – Preparation/Procedure Assistance
 
Myelogram – Preparation/Procedure Assistance
 
NG-Tube Insertion Under Fluroscopy
 
Perm HD Shunt Placement- Prep/Procedure Assistance
 
Prepare and Assist with Line Placement
 
Provide care for the post-procedure patient
 
Specimen Collection and Preparation
 
T-Tube Cholangiogram
 
Temp HD Shunt Placement- Prep/Procedure Assistance
 
Ultrasound Guided Biopsy – Preparation/Procedure Assistance
 
Upper Extremity Angiogram – Preparation/Procedure Assistance
 
Uterine Fibroid Embolization – Preparation/Procedure Assistance
 
Other Procedures (please list):
 
IR-GASTROINTESTINAL STUDIES
1 2 3 4
 
Angioplasty
 
Chemoembolization
 
Cholecystostomy
 
Embolization
 
ERCP
 
Esophageal Stent Placement
 
Gastrojejunostomy
 
Gastrostomy Tube Placement
 
Liver Ablation
 
Paracentesis
 
Percutaneous Hepatic Angiography
 
TIPS
 
IR-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
 
IR-NEUROLOGIC STUDIES
1 2 3 4
 
Cerebral Angiogram
 
Carotid Angiography
 
Kyphoplasty
 
Neurologic Angioplasty
 
Neurologic Thrombolysis
 
Vertebroplasty
 
IR-PERIPHERAL VASCULAR STUDIES
1 2 3 4
 
Abdominal Aortography
 
Angioplasty
 
Central Venous Access/Port Placement
 
Dialysis Graft Creation/Revision
 
Dialysis Graft lnterventional
 
Peripheral Vascular Laser Treatment
 
Peripheral Vascular Athrectomy
 
Peripheral Vascular Stent Placement
 
Peripheral Vascular Embolization
 
Placement/Retrieval of IVC Filter
 
Stent Graft Placement
 
SVC/IVC Venograph
 
Thoracic Aortography
 
Upper and Lower Extremity Angiography
 
IR-PULMONARY PROCEDURES
1 2 3 4
 
Assist with chest tube insertion
 
Assist with intubation
 
Interpret ABG
 
Provide care for the patient with mechanical ventilation
 
Pulmonary Angiography
 
Pulmonary Embolization
 
Thoracentesis
 
CARDIOVASCULAR
1 2 3 4
 
Interpret arrhythmias
 
Manage hyptertension/hypotension
 
Run Cardiac Arrest/Respiratory Arrest Code Situations
 
MEDICATIONS
1 2 3 4
 
Administer Emergency Medications in a Code Situation
 
Administer IV atropine
 
Administer IV benzodiazepines (Valium, Versed, Ativan)
 
Administer IV diltiazem (Cardizem)
 
Administer IV dobutamine (Dobutrex)
 
Administer IV dopamine
 
Administer IV epinephrine
 
Administer IV heparin
 
Administer IV lidocaine
 
Administer IV narcotics (morphine, fentanyl)
 
Administer IV neuromuscular blocking agents (Pavulon, Norcuron)
 
Administer IV nitroglycerine
 
Administer IV propofol (Diprivan)
 
Administer Reversal Agents (Narcan/Flumazenil)
 
Administer TPA
 
Titrate vasoactive drugs (Heparin is not a Vasoactive drug)
 
Use IV infusion pump to calculate drug doses
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
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
 
Universal Protocol Procedures
 
Infection Prevention
 
Fall Risk Assessment/Prevention
 
AGE SPECIFIC/POPULATION BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age Children
 
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
 
BLS
 
ACLS
 
PALS
 
CCRN
 
Telemetry Certificate
 
Other: Specify
 
Other: Specify
Interventional Radiology Nursing Skills Checklist, version 1

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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