Dialysis Tech Skills Checklist - CrossMed Healthcare

Skills Checklist

Dialysis Tech 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 year to 5 years)*
- 1
- 2
- 3
- 4
School Age (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
General Skills
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
Crash Carts*
- 1
- 2
- 3
- 4
Defibrillators*
- 1
- 2
- 3
- 4
Patient/Family Education*
- 1
- 2
- 3
- 4
Electronic Documentation*
- 1
- 2
- 3
- 4
Admit and Assess Patients*
- 1
- 2
- 3
- 4
Obtain Vital Signs*
- 1
- 2
- 3
- 4
List Types*
Consent Forms*
- 1
- 2
- 3
- 4
Collection of Appropriate Data*
- 1
- 2
- 3
- 4
Collection of Appropriate Data*
- 1
- 2
- 3
- 4
Assess Patient and Equipment During Dialysis
Blood an Dialysate Flow Rates*
- 1
- 2
- 3
- 4
Documentation of Treatment*
- 1
- 2
- 3
- 4
Sequential Ultrafiltration/ PUF*
- 1
- 2
- 3
- 4
Ultrafiltration Calculation*
- 1
- 2
- 3
- 4
Vascular Access Function*
- 1
- 2
- 3
- 4
Volume Status*
- 1
- 2
- 3
- 4
Air Embolus*
- 1
- 2
- 3
- 4
Cardiopulmonary Arrest*
- 1
- 2
- 3
- 4
Clotted Access*
- 1
- 2
- 3
- 4
Disequilibrium Syndrome*
- 1
- 2
- 3
- 4
Filter Blood Leak*
- 1
- 2
- 3
- 4
Fluid Overload*
- 1
- 2
- 3
- 4
Hemolysis*
- 1
- 2
- 3
- 4
Hyperkalemia*
- 1
- 2
- 3
- 4
Hypertension*
- 1
- 2
- 3
- 4
Hypotension*
- 1
- 2
- 3
- 4
Muscle Cramps*
- 1
- 2
- 3
- 4
Neuropathy*
- 1
- 2
- 3
- 4
Pericarditis*
- 1
- 2
- 3
- 4
Poor Blood Flow from Catheter*
- 1
- 2
- 3
- 4
Pyrogenic Reaction*
- 1
- 2
- 3
- 4
Seizures*
- 1
- 2
- 3
- 4
Renal/Genitourinary
Acute Peritoneal Dialysis Catheter*
- 1
- 2
- 3
- 4
Acute Renal Failure*
- 1
- 2
- 3
- 4
AV Fistula/AV Graft*
- 1
- 2
- 3
- 4
Bleeding Disorder*
- 1
- 2
- 3
- 4
CAVH Dialysis*
- 1
- 2
- 3
- 4
Chronic Renal Failure*
- 1
- 2
- 3
- 4
End Stage Renal Disease*
- 1
- 2
- 3
- 4
Hemodialysis*
- 1
- 2
- 3
- 4
Hepatitis Positive*
- 1
- 2
- 3
- 4
HIV Positive*
- 1
- 2
- 3
- 4
Ileal Conduit*
- 1
- 2
- 3
- 4
Nephrectomy*
- 1
- 2
- 3
- 4
Nephrostomy Tube*
- 1
- 2
- 3
- 4
Peritoneal Dialysis*
- 1
- 2
- 3
- 4
Renal Rejection Syndrome*
- 1
- 2
- 3
- 4
Tunneled/Non-Tunneled Cathete*
- 1
- 2
- 3
- 4
Urostomy/Urinary Diversions*
- 1
- 2
- 3
- 4
V Fistula/Shunt*
- 1
- 2
- 3
- 4
Hemodialysis Skills/Procedures Experience
Set Up and Initiate Hemodialysis*
- 1
- 2
- 3
- 4
Review Physician Dialysis Orders*
- 1
- 2
- 3
- 4
ACT Range*
- 1
- 2
- 3
- 4
Anticoagulant Solution*
- 1
- 2
- 3
- 4
Blood Flow Rate (Qb)*
- 1
- 2
- 3
- 4
Dialysate*
- 1
- 2
- 3
- 4
Dialysate Flow Rate (Qd)*
- 1
- 2
- 3
- 4
Dialyzer (F-40, F-6, AV400S etc.)*
- 1
- 2
- 3
- 4
Ultrafiltration Rate (UF)*
- 1
- 2
- 3
- 4
Set Up / Initiate Dialysis Treatment
A/V Access*
- 1
- 2
- 3
- 4
Absence of Disinfectant in System*
- 1
- 2
- 3
- 4
Add Chemicals to Dialysate and Label*
- 1
- 2
- 3
- 4
Assessment of AV Fistula*
- 1
- 2
- 3
- 4
Assessment of CVC Access*
- 1
- 2
- 3
- 4
Attach Blood Lines to Dialyzer*
- 1
- 2
- 3
- 4
Attach Concentrate Lines*
- 1
- 2
- 3
- 4
Attach Heparin Infusion Pump(prn)*
- 1
- 2
- 3
- 4
Charcoal Hemoperfusion (REDY 2000)*
- 1
- 2
- 3
- 4
Check for Machine/Alarm Settings*
- 1
- 2
- 3
- 4
CRRT*
- 1
- 2
- 3
- 4
CVC Access*
- 1
- 2
- 3
- 4
Dialysate Conductivity Test/Document*
- 1
- 2
- 3
- 4
Dialysate pH Test/Document*
- 1
- 2
- 3
- 4
Hemchron Machine*
- 1
- 2
- 3
- 4
Initiate Treatment*
- 1
- 2
- 3
- 4
Inspect Dialyzer for Defects*
- 1
- 2
- 3
- 4
Irrigate Access Lines*
- 1
- 2
- 3
- 4
Obtain Activated Clotting Times*
- 1
- 2
- 3
- 4
Perform Recirculation Procedure*
- 1
- 2
- 3
- 4
Pre-Dialysis Assessment*
- 1
- 2
- 3
- 4
Pre-Dialysis Labs*
- 1
- 2
- 3
- 4
Pre-Dialysis Meds*
- 1
- 2
- 3
- 4
Prime Extracorporeal*
- 1
- 2
- 3
- 4
Circuit*
- 1
- 2
- 3
- 4
Priming Dialyzer*
- 1
- 2
- 3
- 4
Secure Lines to Arterial Access*
- 1
- 2
- 3
- 4
Stabilize Blood Lines*
- 1
- 2
- 3
- 4
Discontinuing Hemodialysis
Disconnect From A/V Fistula*
- 1
- 2
- 3
- 4
Disconnect From Dialysis Catheter*
- 1
- 2
- 3
- 4
Equipment Clean Up*
- 1
- 2
- 3
- 4
Patient Discharge*
- 1
- 2
- 3
- 4
Patient Stability*
- 1
- 2
- 3
- 4
Post-Dialysis Labs*
- 1
- 2
- 3
- 4
Post-Dialysis Meds*
- 1
- 2
- 3
- 4
Post-Treatment Access Care*
- 1
- 2
- 3
- 4
Return of Blood*
- 1
- 2
- 3
- 4
Sterilization Procedures*
- 1
- 2
- 3
- 4
Blood Leak Alarm*
- 1
- 2
- 3
- 4
Machine Alarm Troubleshooting Techniques
Air / Foam Detector Alarm*
- 1
- 2
- 3
- 4
Arterial Pressure Alarm*
- 1
- 2
- 3
- 4
Blood Leak Detector*
- 1
- 2
- 3
- 4
Conductivity Alarm*
- 1
- 2
- 3
- 4
Dialysate Pressure*
- 1
- 2
- 3
- 4
Power Failure Alarm*
- 1
- 2
- 3
- 4
Temperature Alarm*
- 1
- 2
- 3
- 4
Ultrafiltration Alarm*
- 1
- 2
- 3
- 4
Venous Pressure Alarm*
- 1
- 2
- 3
- 4
Oxygen Administration
Nasal Cannula*
- 1
- 2
- 3
- 4
General Procedures/ Equipment
Standard/Universal Precautions*
- 1
- 2
- 3
- 4
Peritoneal Dialysis*
- 1
- 2
- 3
- 4
Collect Blood Specimen*
- 1
- 2
- 3
- 4
Clinical Settings
Acute Care Dialysis Setting*
- 1
- 2
- 3
- 4
Acute Care Bedside*
- 1
- 2
- 3
- 4
Outpatient Clinic*
- 1
- 2
- 3
- 4
Other Skills
Please List
Terms and Agreement
*
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.*
Your Recruiter*
Name*
First Last
Email*
Phone*
TODAY'S DATE*
MM slash DD slash YYYY

Skills Checklist

Age of Patients Cared For

General Skills

Assess Patient and Equipment During Dialysis

Renal/Genitourinary

Hemodialysis Skills/Procedures Experience

Set Up / Initiate Dialysis Treatment

Discontinuing Hemodialysis

Machine Alarm Troubleshooting Techniques

Oxygen Administration

General Procedures/ Equipment

Clinical Settings

Other Skills

Terms and Agreement