Cath Lab Skill Checklist

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.

PROCEDURES/SKILLS


	Never Performed	Limited Experience	Comfortable Performing	Proficient
Obtain & Interpret 12 Lead EKG
Defibrillation/Cardioversion

Interpretation of Arrhythmias

Perform Physiologic Monitoring:

Record Aortic/Mitral Valve Cases

Record EP/Ablation Cases

Record Perm. Pacemaker Insertions

Circulate for:

LHC/RHC

PCI (Interventional)

EP/Ablatins

Permanent Pacemaker Insertions

IABP Insertions

Place Leads & Pads for Cardiac Mapping

Scrub for:

LHC/RHC

PCI (Interventional)

EP/Ablations

Permanent Pacemaker Insertions

IABP Insertions

Knowledge of/Practice Radiation Safety

Check and Mark Distal Pulses

Perform Allen Test

Restraints during Procedure:

Placement

Monitoring

Review of Pre-Procedure Checklist

Operation of Portable Monitor

Operation of Portable Defibrillator

MEDICATION ADMINISTRATION


	Never Performed	Limited Experience	Comfortable Performing	Proficient
Antiarrthymics
Antibiotics

Atropine

Anticoagulants

Beta Blockers

Conscious Sedation

Conscious Sedation

Sedation Reversal Agent

Thrombolytics

Emergency Medications

Ergonovine

Nitrates

Vasopressors

Thrombolytics

Contrast Medium

Antihistamines

Blood & Blood Products

EQUIPMENT


	Never Performed	Limited Experience	Comfortable Performing	Proficient
Hemachron
Medication Dispensing Systems

ABG Analysis Machines

ACT Machine

PTCA Balloons

Stents

Athrectomy

Laser

Power Injectors

Doppler

Computer Charting Systems

POST-PROCEDURE TEACHING


	Never Performed	Limited Experience	Comfortable Performing	Proficient
Monitoring & Documentation of:
Vital Signs

EKG

Level of Consciousness

Insertion Site

Distal Pulses

Use of Aldrete Sedation Recovery Scale

Maintain A/V Sheaths in Place

Set-up & Maintain:

Arterial Sheaths to Pressure & Monitor

Swan Ganz via Venous Sheath to Monitor

Obtain & Monitor ACT

Removal of AV Sheaths

Manual Pressure Hold

Clamp Hold

Radial Hemoband

Vascular Closure Device:

Application

Monitoring

Sterile Pressure Dressing Application

Maintain IABP

Maintain Temporary Pacemaker

Crash Cart Use

Suction

O2 Administration

Emergency Meds

Education of Patients/Family

PULMONARY


	Never Performed	Limited Experience	Comfortable Performing	Proficient
Airway Management
Ventilator Management

O2 Therapy & Delivery Systems

Pulse Oximetry

ABG Interpretation

PRE-PROCEDURE TEACHING


	Never Performed	Limited Experience	Comfortable Performing	Proficient
Obtain IV Access
Complete Pre-Procedure Checklist

O2 Therapy & Delivery Systems

Skin Prep & Shave

Lead Placements

Pre-Procedure Teaching

Do you speak any languages other than
English?

Yes

No

If yes, which language(s)?

Age Specific Skills

Check the box under EACH age group that you have experience with and are comfortable with for each skill below.

Neonates(0-30 days)

Infants(1 mo-1 yr)

Toddlers(1-3 yrs)

Preschool(4-6 yrs)

School Age(7-12 yrs)

Adolescent(13-18 yrs)

Young Adult(19-39 yrs)

Middle Adults(40-64 yrs)

Older Adults(65+ yrs)

Understands the different communication needs for the age group & changes communication methods and terminology accordingly

Neonates(0-30 days)

Infants(1 mo-1 yr)

Toddlers(1-3 yrs)

Preschool(4-6 yrs)

School Age(7-12 yrs)

Adolescent(13-18 yrs)

Young Adult(19-39 yrs)

Middle Adults(40-64 yrs)

Older Adults(65+ yrs)

Understands the different medications, dosages and possible side effects for the age group and administers medications appropriately

Neonates(0-30 days)

Infants(1 mo-1 yr)

Toddlers(1-3 yrs)

Preschool(4-6 yrs)

School Age(7-12 yrs)

Adolescent(13-18 yrs)

Young Adult(19-39 yrs)

Middle Adults(40-64 yrs)

Older Adults(65+ yrs)

Understands the different safety risks for the age group and alters the environment accordingly

Neonates(0-30 days)

Infants(1 mo-1 yr)

Toddlers(1-3 yrs)

Preschool(4-6 yrs)

School Age(7-12 yrs)

Adolescent(13-18 yrs)

Young Adult(19-39 yrs)

Middle Adults(40-64 yrs)

Older Adults(65+ yrs)

Understands the normal growth and development for the age group and adapts care accordingly

Neonates(0-30 days)

Infants(1 mo-1 yr)

Toddlers(1-3 yrs)

Preschool(4-6 yrs)

School Age(7-12 yrs)

Adolescent(13-18 yrs)

Young Adult(19-39 yrs)

Middle Adults(40-64 yrs)

Older Adults(65+ yrs)

*

I hereby certify that ALL information I have provided to Clover Health Services, 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.