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.
WORK SETTINGS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Adult Acute Care |
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ED/ICU |
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Adult Outpatient |
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Pediatric Acute Care |
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Pediatric Outpatient |
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ADULT ECHO | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Routine |
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3-D Echo |
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Pedoff Probe |
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Transesophageal Echo |
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Stress Echo |
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Pharmacologic Stress Echo |
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Post-Cath Echo |
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Post-Surgical Echo |
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Imaging with Contrast Agents |
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Sterilization Procedures |
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SPECIAL VIEWS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Pulmonary Veins |
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Hepatic Veins |
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Suprasternal Notch |
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CALCULATIONS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Simpson's Rule |
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Proximal Isovelocity Surface Area |
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Distology with TDI |
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LV Strain/LV Volume |
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PEDIATRIC ECHO | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Routine |
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3-D Echo |
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Pedoff Probe |
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Transesophageal Echo |
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PEDIATRIC ANOMALIES | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Aortic Arch Abnormalities/Vascular Ring |
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Arch Sidedness |
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Coarctation of the Aorta |
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Coronary Artery Anomalies |
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Double Outlet Ventricle |
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Hypoplastic Heart Syndrome |
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Pulmonary Venous Return Anomalies |
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Tetralogy of Fallot |
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Transposition of the Great Vessels |
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Triscupid and Pulmonary Atresia |
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Truncus Arteriosis |
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Univentricular Heart Anomalies |
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PEDIATRIC POST-SURGICAL SCANS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Arterial Switch |
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Blalock - Taussig |
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Damus-Kaye-Stansel |
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Fontan |
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Glenn |
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Konno |
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Mustard |
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Norwood |
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Rastelli |
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Sano |
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Sennig |
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EQUIPMENT | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Phillips/ATL (List Types) |
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GE (List Types) |
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Siemens (List Types) |
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Toshiba (List Types) |
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Hitachi (List Types) |
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SonoSite (List Types) |
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Other: List |
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TECHNOLOGY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
McKesson |
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Epic |
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Horizon |
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SCI- Imaging |
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Online Reporting |
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EMR Conversion |
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MISCELLANEOUS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
12 Lead ECG |
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Stress Testing |
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Holter Monitor |
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PROFESSIONAL KNOWLEDGE AND SKILLS | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
National Patient Safety Goals |
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Supervisory /Management Experience |
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Isolation/Infection Prevention |
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Procedures for Patients on Ventilators |
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Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Infant (Birth - 1 year) |
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Preschooler (ages 2-5 years) |
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Childhood (ages 6-12 years) |
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Adolescents (ages 13-21 years) |
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Young Adults (ages 22-39 years) |
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Adults (ages 40-64 years) |
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Older Adults (ages 65-79 years) |
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Elderly (ages 80+ years) |
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