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.
RENAL/GENITOURINARY: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assessment of Renal/GU System |
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Insertion of Foley |
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Nephrostomy Tube |
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AV Fistula / AV Graft |
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Tunneled/Non-Tunneled Catheter |
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Ileal Conduit |
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Supra-Pubic Catheter |
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Chronic Renal Failure |
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Acute Renal Failure |
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Nephrectomy |
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Turp |
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Peritoneal Dialysis |
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Hemodialysis |
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HEMODIALYSIS / PROCEDURES | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Acute/Inpatient Dialysis |
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Chronic/Outpatient Dialysis |
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Dialysis Home Care |
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Pediatric Dialysis |
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Predialysis Nursing Assessment |
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Teaching the Dialysis Patient and Family |
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SET-UP / STARTING DIALYSIS TREATMENT | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Collect Blood Specimens |
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Anticoagulation |
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Dialysis |
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Fistula Gortex / Bovine Graft |
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Prep Vascular Access |
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Checking Alarm Settings/Machine |
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Priming Dialyzer |
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Conductivity Testing |
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Bicarbonate Dialysis |
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ASSESS PATIENT AND EQUIPMENT DURING DIALYSIS: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Systems Assessment of Patient |
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Volume Status |
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Vascular Access Function |
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Arterial and Venous Pressures |
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Blood Flow Rate |
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Subjective Response to Treatment |
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Management of Anticoagulation |
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Conductivity |
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Ultrafiltration Calculation |
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Operation of Myron L Meter |
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Administration of Blood/Blood Products |
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Administration of Mannitol |
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Sequential Ultrafiltration / PUF |
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Documentation of Treatment |
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CARE OF PATIENT WITH: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Fluid Overload |
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Hypertension |
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Hypotension |
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Disequilibrium Syndrome |
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Hyperkalemia |
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Seizures |
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Muscle Cramps |
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Clotted Access/Poor Blood Flow Rate From Catheter |
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Pyrogenic Reaction |
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Hemolysis |
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Air Embolus |
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Chest Pain |
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Anemia |
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Neuropathy |
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Pericarditis |
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Filter Blood Leak |
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Cardiopulmonary Arrest |
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DISCONTINUE DIALYSIS: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Dialysis Catheter |
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Fistula / Vein Graft |
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Return of Blood |
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Post Treatment Access Care |
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Equipment Clean Up |
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Sterilization Procedures |
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MISCELLANEOUS: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Care of Immunosupressed Patient |
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Care of Patient with AIDS |
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Isolation Techniques |
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Assessment of Wound Healing |
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Sterile Dressing Changes |
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Phlebotomy / Venous Blood Draw |
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Discussing Organ & Tissue Donation |
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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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