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Registered Nurse Endoscopy CheckList

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Procedures Rating Stars (Click) 1 2 3 4  
Assist with EGDs 
 
Assist with endoscopic ultrasound 
 
Assist with active GI bleed 
 
Cautery devices 
 
Assist with manometry studies 
 
Assist with variceal banding 
 
Assist with esophageal dilatations 
 
Assist with esophageal ballooning 
 
Assist with scelrotherapy 
 
Assist with TEE 
 
Assist with bronchoscopy 
 
Assist with colonoscopy 
 
Assist with polypectomy 
 
Assist with ERCPs 
 
Assist with PEG placements 
 
Assist with liver BX 
 
Assist with collection of hot & cold BXs 
 
Specimen collection & labeling 
 
Set up of scopes & video equipment 
 
Apply external abdominal pressure to assist with scope movement 
 
Scope cleaning 
 
Assist with mobile cases, ICU, ER, etc. 
 
Radiation safety 
 
Automated Medication Dispensing System, Pyxis, Omnicell, or other 
 
Takes call for emergency cases 
 
National Patient Safety Goals 
 
Awareness of HCAHPS 
 
Accurate patient identification 
 
Effective communication 
 
Interpretation & communication of lab values 
 
Medication administration 
 
Labeling (medications & specimens) 
 
Anticoagulation therapy 
 
Monitoring conscious sedation 
 
Pain assessment & management 
 
Infection control 
 
Universal precautions 
 
Isolation 
 
Minimize risk for falls 
 
Prevention of pressure ulcers 
 
Use of rapid response teams 
 
Administer Conscious Sedation Rating Stars (Click) 1 2 3 4  
Fentanyl 
 
Propofol 
 
Demerol 
 
Presedex 
 
Versed 
 
Reversal agents 
 
Pre Procedure Rating Stars (Click) 1 2 3 4  
Pre procedure phone calls 
 
Electronic documentation 
 
Patient assessment 
 
Colon prep or re-prep 
 
Pre procedure checklist/consent 
 
IV start, med admin 
 
Post Procedure Rating Stars (Click) 1 2 3 4  
Assess for air movement post colonoscopy 
 
Assess for pain 
 
Assess for bowel sounds 
 
Assess for gag reflex post EGD 
 
Assess for gag reflex post bronchoscopy 
 
Recover from MAC 
 
Recover from (moderate) conscious sedation 
 
Discharge outpatients to home 
 
Post procedure phone calls 
 
Age Specific Rating Stars (Click) 1 2 3 4  
Newborn/neonate (birth-30 days) 
 
Infant (31 days-1 year) 
 
Toddler (ages 2-3 years) 
 
Preschool (ages 4-5 years) 
 
School age (ages 6-12 years) 
 
Adolescent (ages 13-21 years) 
 
Young adult (ages 22-39 years) 
 
Adult (ages 40-64 years) 
 
Older adult (ages 65-79 years) 
 
Elderly (ages 80+ years)