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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

EXPERIENCE WITH AGES
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
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
Care of Patient in Restraints*
- 1
- 2
- 3
- 4
Pain Management*
- 1
- 2
- 3
- 4
Automated Med Dispensing Systems*
- 1
- 2
- 3
- 4
List Types:
Care Planning & Discharge Planning*
- 1
- 2
- 3
- 4
Patient/Family Education*
- 1
- 2
- 3
- 4
Patient Head to Toe Assessment*
- 1
- 2
- 3
- 4
Peripheral IV Insertion, Care and Maintenance*
- 1
- 2
- 3
- 4
MEDICATIONS
Calculate mcg/min and mcg/kg/min*
- 1
- 2
- 3
- 4
Titrating Medications*
- 1
- 2
- 3
- 4
Isuprel*
- 1
- 2
- 3
- 4
Adenosine*
- 1
- 2
- 3
- 4
Amiodarone*
- 1
- 2
- 3
- 4
ASSESSMENT AND MONITORING
Lead Placement*
- 1
- 2
- 3
- 4
Basic 12 Lead EKG Interpretation*
- 1
- 2
- 3
- 4
Cardiac Rhythm Interpretation*
- 1
- 2
- 3
- 4
Doppler*
- 1
- 2
- 3
- 4
Blood Pressure Invasive and Noninvasive*
- 1
- 2
- 3
- 4
HEMODYNAMIC MONITORING
Art Line*
- 1
- 2
- 3
- 4
Swan Ganz*
- 1
- 2
- 3
- 4
Waveform Assessment*
- 1
- 2
- 3
- 4
General Lab work Interpretation*
- 1
- 2
- 3
- 4
ABG Interpretation*
- 1
- 2
- 3
- 4
Cardiac Enzyme Interpretation*
- 1
- 2
- 3
- 4
Chemistry Interpretation*
- 1
- 2
- 3
- 4
CARE AND MAINTENANCE
Central Venous Access Device*
- 1
- 2
- 3
- 4
Arterial Line*
- 1
- 2
- 3
- 4
Swan Ganz*
- 1
- 2
- 3
- 4
IABP*
- 1
- 2
- 3
- 4
Sheaths*
- 1
- 2
- 3
- 4
Removal of Sheath*
- 1
- 2
- 3
- 4
Manual Pressure Hold*
- 1
- 2
- 3
- 4
FemStop*
- 1
- 2
- 3
- 4
C-Clamp*
- 1
- 2
- 3
- 4
VasoSeal, Angioseal, PerClose*
- 1
- 2
- 3
- 4
Hematoma Recognition/Management*
- 1
- 2
- 3
- 4
PROCEDURE EQUIPMENT
Scrub EP Procedures*
- 1
- 2
- 3
- 4
Circulate EP Procedures*
- 1
- 2
- 3
- 4
Monitor EP Procedures*
- 1
- 2
- 3
- 4
Ablation (Atrial/Ventricular)*
- 1
- 2
- 3
- 4
Velocity Mapping*
- 1
- 2
- 3
- 4
Cart/ Mapping*
- 1
- 2
- 3
- 4
Rhythmia Mapping*
- 1
- 2
- 3
- 4
Bloom Stimulator*
- 1
- 2
- 3
- 4
Micropace Ep-4*
- 1
- 2
- 3
- 4
Diagnostic Catheters*
- 1
- 2
- 3
- 4
Bi-V*
- 1
- 2
- 3
- 4
Stereotaxis*
- 1
- 2
- 3
- 4
AICD Placement*
- 1
- 2
- 3
- 4
PPM*
- 1
- 2
- 3
- 4
Bovie*
- 1
- 2
- 3
- 4
Baylis*
- 1
- 2
- 3
- 4
Temporary Pacemaker*
- 1
- 2
- 3
- 4
Peak Plasma Blade*
- 1
- 2
- 3
- 4
Cardioversion*
- 1
- 2
- 3
- 4
Internal Cardioversion Catheters / AICD Testing*
- 1
- 2
- 3
- 4
NIPS Procedure*
- 1
- 2
- 3
- 4
Pericardiocentesis*
- 1
- 2
- 3
- 4
Demonstrate Proper Preservations of Tissue Specimen for Lead Extractions*
- 1
- 2
- 3
- 4
ACT Machine*
- 1
- 2
- 3
- 4
Lead Extractions - Spectranetics laser*
- 1
- 2
- 3
- 4
Device Implants*
- 1
- 2
- 3
- 4
Ablation Equipment (ie: Stockert, Maestro, Cool Flow, Tactisys)*
- 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.*
Your Recruiter*
Name*
First Last
Email*
Phone*
TODAY'S DATE*
MM slash DD slash YYYY