Cardiac Invasive Specialist Skills Checklist

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Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

Email Address: *

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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 *

HIPAA Regulations	123
National Patient Safety Goals	123
Awareness of HCAHPS scores	123
Electronic Medical Record	123
Accurate Patient Identification	123
Demonstrates knowledge of anatomy	123
Proper body mechanics	123
Technique to preserve respect and dignity for patients	123
Introduction of self prior to providing care	123
Therapeutic communications	123
Radiation safety	123
Supervisor/Lead experience	123
Fall Risk/prevention	123

PATIENT CARE:

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 *

Vital signs (HR, BP, Resp, Temp)	123
Oxygen saturation (pulse ox)	123
Weight	123
Manual BP (cuff and stethoscope)	123
Auscultation (heart sounds, apical pulse)	123
Palpation for pulse	123
Carotid pulse	123
Brachial pulse	123
Radial pulse	123
Femoral pulse	123
Skin prep (shaving, alcohol prep, diaphoretic patients, etc)	123
Topical hemostasis	123
Vascular closure systems	123
External compression devices	123
Sheath removal and monitoring	123

CARDIOVASCULAR:

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 *

Coronary circulation	123
Vascular system	123
Congestive Heart Failure	123
Ischemia	123
Pulmonary hypertension	123
Systemic hypertension	123
Diseases of aorta	123

CARDIOVASCULAR ELECTROPHYSIOLOGY:

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 *

Cardiac cycle	123
Electoral conduction system	123
Refractory	123
Transmembrane potential	123
Polarization	123
Depolarization	123
Repolarization	123
Action potential	123
Phase 0 – phase 4	123

EKG INTERPRETATION:

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 *

Ventricular tachycardia	123
Ventricular fibrillation	123
Atrial tachycardia	123
Atrial fibrillation	123
Atrial flutter	123
Junctional escape rhythms	123
Asystole	123
PEA (pulseless electrical activity)	123
Normal sinus rhythm	123
Sinus tachycardia	123
Sinus bradycardia	123
Acute myocardial infarction patterns	123
Cardiac pacemakers	123
Wolff-Parkinson-white	123
First-degree heart block	123
Second-degree heart block	123
Second-degree heart block Type 1	123
Second-degree heart block Type 2	123
Third-degree heart block	123

CARDIAC CATH LAB PROCEDURES:

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 *

AICD Placement	123
Aortography	123
Cardiac biopsy	123
Cardiac implant closure device	123
Cardiac stent placement	123
Diagnostic cardiac cath – neonatal/peds	123
Diagnostic cardiac cath – adult	123
Directional coronary atherectomy	123
Intra-aortic balloon pump (IABP) placement	123
IABP removal	123
Internal mammary angiography	123
Laser assisted procedures	123
Percutaneous transluminal coronary angioplasty	123
Pericardiocentesis	123
Permanent pacemaker placement	123
Pulmonary angiography	123
Rotational coronary atherectomy	123
Saphenous vein graft angiography	123
Transluminal extraction catheter	123
Valvuloplasty	123
Ventricular assist device insertion	123

ELECTROPHYSIOLOGY PROCEDURES:

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 *

Electrophysiology Eval	123
Baseline measurements	123
Cardiac ablation	123
Cardiac mapping	123
Cardioversion	123
Conduction study	123
Internal cardioverter defibrillator implant	123
Tilt table study	123

ELECTRONIC 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 *

Allscripts	123
Care360	123
Cerner	123
CPSI	123
eClinicalWorks	123
Eclipsys	123
EPIC	123
MACLAB	123
McKesson/Paragan	123
Meditech	123
PACS	123
Quadramed	123
Soarian	123

CARDIAC MEDICATIONS:

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 *

Antihypertensives	123
Nitrates	123
Calcium channel blockers	123
Beta blockers	123
Cardiac glycosides	123
Antiarrhythmics	123
Emergency medications	123
Epinephrine	123
Atropine	123
Verapamil	123
Lidocaine	123
Oxygen	123
Isuprel	123

INFECTION CONTROL:

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 *

Hand hygiene	123
Precautions associated with PPE (transmission, contact, airborne, droplet)	123
Universal Precautions	123
Negative-pressure room	123
Prevention and protocols for HAIs (CAUTI, CLABSI, VAP)	123
Prevention and protocols for MRSA, C.DIFF, Sepsis, etc.	123
Sterile technique	123

WORK SETTING 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 *

Acute care hospital	123
Pre/Post procedural setting	123
Procedural cath lab	123
Interventional cath lab	123
EP lab	123
Outpatient clinic/lab	123
Long term care	123
Rehabilitation center	123
Home health/private duty	123
Hospice	123

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 *

Infant (birth to 1 year)	123
Toddler (1-3 years)	123
Preschooler (4-5 years)	123
Childhood (6-12 years)	123
Adolescent (13-17 years)	123
Young Adult (18-30 years)	123
Adults (31-64 years)	123
Older Adults (65-79 years)	123
Elderly (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. *