Skill Checklists
Cardiology
Name
Email
LAST 4 OF SSN
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
Cardiac & Diagnostic Cardiac Catheter
Cerebral Angiography
Peripheral Angiography
Simple Angioplasty
Complex Angioplasty
Arterial Puncture and Cannulation
Cardioversion
Central Line Insertion
Simple/Basic Intracardiac Readings
Limited Stimulation Studies
Arrythmic Induction and Mapping
Radiofrequency Ablation for Arrhythmias
Moderate Sedation
Pericardiocentesis
Spinal Tap
Pacemakers: Temporary
Pacemakers: AICD
Pacemakers: Complete
Pacemakers: Lead Position Only
Pacemakers: Permanent
Rotational Atherectomy
Stent Implantation (Non Cardiac – Non Cerebral)
Stent Implantation: Peripheral
Covered Stent Placement - Peripheral
Stent Implantation: Renal
Swan_Ganz Catheterization
Thoracentesis
Trans Esophageal Echocardiography (TEE)
TTE Interpretation
Stress Testing
Tilt Table
Intra-Aortic Balloon Pump Insertion
Cardiac Cathertization
Stent: Coronary
Intravascular Ultrasound
Cutting Balloon Atherectomy
Electrophysiology Studies
Radiofrequency Ablation
Closed Operation on Heart
Open Heart under Hypothermia
Open Heart requiring Partial By-Pass
Open Heart Requiring Oxygenator
Chest Wall Reconstruction
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.
