CVOR RN Skills Checklist

Skills Checklist

Let’s assess your clinical skills and experience. Fill out this checklist to get one step closer to your next opportunity.

1

= No theory and/or experience
2

= Limited Experience
3

= Experienced/minimal support needed to perform
4

= Proficient

Age of Patients Cared For
Newborn/Neonate (birth to 30 days)*
- 1
- 2
- 3
- 4
Infant (1 month to 1 year)*
- 1
- 2
- 3
- 4
Toddler (1 year to 3 years)*
- 1
- 2
- 3
- 4
Preschooler (3 years to 5 years)*
- 1
- 2
- 3
- 4
School Age Child (5 years to 12 years)*
- 1
- 2
- 3
- 4
Adolescents (12 years to 18 years)*
- 1
- 2
- 3
- 4
Young Adults (18 years to 39 years)*
- 1
- 2
- 3
- 4
Middle Adults (39 years to 64 years)*
- 1
- 2
- 3
- 4
Older Adults (64 years to 79 years)*
- 1
- 2
- 3
- 4
Elderly Adults (over 79+ years)*
- 1
- 2
- 3
- 4
SETTINGS
Operating Room*
- 1
- 2
- 3
- 4
Clinic*
- 1
- 2
- 3
- 4
GENERAL SKILLS
Crash Cart*
- 1
- 2
- 3
- 4
Universal Protocol*
- 1
- 2
- 3
- 4
Patient Identification*
- 1
- 2
- 3
- 4
Hand-off Communication*
- 1
- 2
- 3
- 4
Standard Precautions*
- 1
- 2
- 3
- 4
Isolation Precautions*
- 1
- 2
- 3
- 4
Pediatric Respiratory/Cardiac Arrest*
- 1
- 2
- 3
- 4
Adult Respiratory/Cardiac Arrest*
- 1
- 2
- 3
- 4
Adult Respiratory/Cardiac Arrest*
- 1
- 2
- 3
- 4
Automated Med Dispensing Systems*
- 1
- 2
- 3
- 4
List Types:
ASSESSMENT AND PATIENT CARE
Circulating Duties
Develop Plan of Care*
- 1
- 2
- 3
- 4
Informed Consent*
- 1
- 2
- 3
- 4
Level of Consciousness*
- 1
- 2
- 3
- 4
Patient/Family Teaching*
- 1
- 2
- 3
- 4
Perioperative Assessment*
- 1
- 2
- 3
- 4
Skin Assessment*
- 1
- 2
- 3
- 4
Time-Out Procedure*
- 1
- 2
- 3
- 4
Chest/Thoracic
A-F Bypass*
- 1
- 2
- 3
- 4
Abdominal Aortic Aneurysm (open)*
- 1
- 2
- 3
- 4
A-V Access Graft*
- 1
- 2
- 3
- 4
Aortic Stent Insertion*
- 1
- 2
- 3
- 4
Ascending/Thoracic Aneurysm*
- 1
- 2
- 3
- 4
Biopsy*
- 1
- 2
- 3
- 4
Carotid Endarterectomy*
- 1
- 2
- 3
- 4
Chest Trauma*
- 1
- 2
- 3
- 4
Coronary Artery Bypass Graft*
- 1
- 2
- 3
- 4
Embolectomy*
- 1
- 2
- 3
- 4
Fem-Fem*
- 1
- 2
- 3
- 4
Fem-Pop Bypass*
- 1
- 2
- 3
- 4
Heart Transplant*
- 1
- 2
- 3
- 4
Implantable Cardioverter Defibrillator*
- 1
- 2
- 3
- 4
Mitral or Aortic Valve Replacement/Repair*
- 1
- 2
- 3
- 4
Pacemaker Insertion*
- 1
- 2
- 3
- 4
Patent Ductus Arteriosus*
- 1
- 2
- 3
- 4
Pneumonectomy*
- 1
- 2
- 3
- 4
Rib Resection*
- 1
- 2
- 3
- 4
Septal Defect Repairs*
- 1
- 2
- 3
- 4
Thorocotomy*
- 1
- 2
- 3
- 4
Vena Cava Filter*
- 1
- 2
- 3
- 4
Thoracic Stent Insertion*
- 1
- 2
- 3
- 4
Vena Cava Ligation*
- 1
- 2
- 3
- 4
MEDICATIONS/THERAPEUTIC INTERVENTIONS
IV Therapy
Admin Blood/ Blood Products*
- 1
- 2
- 3
- 4
Assist with IA/IV Therapy*
- 1
- 2
- 3
- 4
Starting IVs*
- 1
- 2
- 3
- 4
Vascular Access Device Management*
- 1
- 2
- 3
- 4
Assist with Insertion of Invasive Devices (Arterial/CVP/Swan Ganz)*
- 1
- 2
- 3
- 4
Oxygen Administration
Ambu-Bag*
- 1
- 2
- 3
- 4
Nasal Cannula*
- 1
- 2
- 3
- 4
Non-Rebreather mask*
- 1
- 2
- 3
- 4
Portable Oxygen*
- 1
- 2
- 3
- 4
Trach Collar*
- 1
- 2
- 3
- 4
Tracheostomy*
- 1
- 2
- 3
- 4
Venturi Masks*
- 1
- 2
- 3
- 4
Ventillator*
- 1
- 2
- 3
- 4
Pain Management/Anesthesia
Assess Pain Level/Tolerance*
- 1
- 2
- 3
- 4
Epidural Anesthesia/Anagelsia*
- 1
- 2
- 3
- 4
Anesthesia Toxcitiy*
- 1
- 2
- 3
- 4
General*
- 1
- 2
- 3
- 4
Regional*
- 1
- 2
- 3
- 4
Spinal*
- 1
- 2
- 3
- 4
Signs and Symptoms of Dural Puncture*
- 1
- 2
- 3
- 4
Positioning Patients*
- 1
- 2
- 3
- 4
Moderate Sedation*
- 1
- 2
- 3
- 4
Induction*
- 1
- 2
- 3
- 4
PROCEDURES/EQUIPMENT
PROCEDURES
Airway Maintenance*
- 1
- 2
- 3
- 4
Arterial Line Monitoring*
- 1
- 2
- 3
- 4
Aseptic Technique*
- 1
- 2
- 3
- 4
Cricoid Pressure*
- 1
- 2
- 3
- 4
Donning of Surgical Attire*
- 1
- 2
- 3
- 4
Foley Catheterization*
- 1
- 2
- 3
- 4
Hemodynamic Monitoring*
- 1
- 2
- 3
- 4
IABP*
- 1
- 2
- 3
- 4
Implantable Cardioverter Defibrillator*
- 1
- 2
- 3
- 4
Pacemaker Insertion*
- 1
- 2
- 3
- 4
Patient Charge Capture Systems*
- 1
- 2
- 3
- 4
Patient Positioning*
- 1
- 2
- 3
- 4
Patient Prep*
- 1
- 2
- 3
- 4
Procedure Set Up*
- 1
- 2
- 3
- 4
Equipment, Sponge and Lab Counts*
- 1
- 2
- 3
- 4
EQUIPMENT
Bair Hugger*
- 1
- 2
- 3
- 4
Blood and Fluid Warmer*
- 1
- 2
- 3
- 4
Bovie*
- 1
- 2
- 3
- 4
Cell Saver/Auro-Transfuser*
- 1
- 2
- 3
- 4
Chest Drainage System*
- 1
- 2
- 3
- 4
Defibrillator/Internal Paddles*
- 1
- 2
- 3
- 4
Electrosurgical Unit*
- 1
- 2
- 3
- 4
Emerson Thoracic Pump*
- 1
- 2
- 3
- 4
Flexible Bronchoscope*
- 1
- 2
- 3
- 4
Laser*
- 1
- 2
- 3
- 4
Pneumatic Tourniquet*
- 1
- 2
- 3
- 4
Suction Units (Neptune, Wall)*
- 1
- 2
- 3
- 4
Ultrasonic Cleaner*
- 1
- 2
- 3
- 4
Sterad Machine*
- 1
- 2
- 3
- 4
Please list the EMR systems you have used*
*
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.*
*
I hereby consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*
Name*
First Last
Email*
Phone*
TODAY'S DATE*
MM slash DD slash YYYY

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Skills Checklist

Age of Patients Cared For

SETTINGS

GENERAL SKILLS

ASSESSMENT AND PATIENT CARE

Circulating Duties

Chest/Thoracic

MEDICATIONS/THERAPEUTIC INTERVENTIONS

IV Therapy

Oxygen Administration

Pain Management/Anesthesia

PROCEDURES/EQUIPMENT

PROCEDURES

EQUIPMENT