Neurodiagnostic Technologist Skills Checklist

Requested by:

Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

Email Address: *

Confirm email: *

GENERAL SKILLS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Advanced directives	123
Supervisory or Charge experience	123
National Patient Safety Goals/Core Measures	123
Awareness of HCAHPS	123
Accurate Patient Identification	123
Maintain Sterile Field	123
Use proper body mechanics	123
Use of transfer/lifting devices	123
Infection Control	123
Universal Precautions	123
Isolation Precautions	123
Minimize fall risks	123
Crash Cart	123
Defibrillator	123
Care of patient in restraints	123
Obtain Vital Signs	123
Patient /Family education	123
Electronic Documentation	123
Ensures HIPAA compliance	123

BASIC SKILLS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Following facility policy for sedation monitoring	123
Adjusting electrode placement for anatomical defects or anomalies	123
10-20 Electrode Placement	123
Portable Recording in Adult ICU	123
Portable Recording in Pediatric ICU	123
Portable Recording in NICU	123
EMG	123
ECI-Brain Death Recording	123
Sleep EEG	123
Sleep-Deprived EEG	123
Ambulatory EEG	123
Identify abnormal awake and asleep patterns for each age range	123
Photic Stimulation	123

EVOKED POTENTIALS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Motor Evoked Potential	123
Auditory Evoked Potential	123
Visual Evoked Potential	123
Somatosensory Evoked Potential	123
Assist with Nerve Conduction studies/ EMG	123

EQUIPMENT:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Precautions to ensure electrical safety	123
Calibrating and maintaining testing equipment	123
Monitoring and recording significant events during the study for physician review	123
Maintain instrument/equipment in working order	123
Cadwell	123
Nicolet	123
Digital Machine Experience	123
Paper Machine Experience	123
Grass	123
Nihon Kohden	123

DOCUMENTATION:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Obtain Patient History	123
Monitor Changes in Patient Status	123
Stimulation	123
Hyperventilation	123
Post hyperventilation	123
Interpreting EEG patterns	123
Document unusual or inappropriate behavior suggestive of seizure of psychogenic nonepileptic event	123

WORK SETTING:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Acute Hospital Setting	123
Sleep Lab	123
Research Facility	123
Large/Regional Teaching Facility	123
Outpatient Clinic	123
Epilepsy Monitoring Unit	123

CERTIFICATIONS:

Rank each of the following sections on a scale of 1 to 2:
1) Yes
2) No *

BLS	12
ACLS	12
PALS	12
ARRT	12

AGE-SPECIFIC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Newborn / neonate (birth-30 days)	123
Infant (31 days-1 year)	123
Toddler (ages 2-3 years)	123
Preschool (ages 4-5 years)	123
School age (ages 6-12 years)	123
Adolescent (ages 13-21 years)	123
Young adult (ages 22-39 years)	123
Adult (ages 40-64 years)	123
Older adult (ages 65-79 years)	123
Elderly (ages 80+ years)	123

Attestation

ATTESTATION: *

I certify that the information provide above accurately reflects my experience in each of the clinical areas identified within the past three years.

If you agree with the Attestation above, please electronically sign your name. *