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.
| Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Arteriogram/Radionuclide |
 |
||||||
| Abscess Localization Whole Body |
|
||||||
| Abscess Localization Individual Sites |
|
||||||
| CCK/Ejection Fraction |
|
||||||
| Cisternogram |
|
||||||
| CSF Leak Localization |
|
||||||
| Gallium Scan |
|
||||||
| Gastric Emptying |
|
||||||
| GI Bleed |
|
||||||
| HIDA Scan |
|
||||||
| Indium 111 WBC Scan Whole Body |
|
||||||
| Indium 111 WBC Scan Limited |
|
||||||
| Injection-Lymphatic |
|
||||||
| Lymphatic Scan-Melanoma |
|
||||||
| Meckels Scan |
|
||||||
| Morphine Augmentation |
|
||||||
| MUGA Scan |
|
||||||
| Radiopharmaceutical Prep |
|
||||||
| Radionuclide Arteriogram |
|
||||||
| Renagram |
|
||||||
| Parathyroid |
|
||||||
| Salivary Glands |
|
||||||
| Ventricular Shunt |
|
||||||
| Zevalin Treatment |
|
||||||
| Hyperthyroid Treatment |
|
||||||
| I 131 Therapy Thyroid Ablation |
|
||||||
| Therapy Pain |
|
||||||
| Bone Scan | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Whole Body |
|
||||||
| 3 Phase |
|
||||||
| Limited |
|
||||||
| Brain Scan | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Cerebral Blood Flow |
|
||||||
| Liver/Spleen Scan | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Liver/Spleen Scan |
|
||||||
| Liver Scan-Hemangioma |
|
||||||
| Liver Imaging |
|
||||||
| Liver Flow |
|
||||||
| Lung Scan | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| DTPA Aerosol |
|
||||||
| Perfusion |
|
||||||
| Ventilation/Perfusion |
|
||||||
| Renal Flow | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| With Lasix |
|
||||||
| Flow/Function |
|
||||||
| Three Phase |
|
||||||
| Captopril |
|
||||||
| Shunt | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Abdominal |
|
||||||
| Ventricular |
|
||||||
| Thyroid Studies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Cancer Survey |
|
||||||
| Uptake Scan |
|
||||||
| I 123 Scan |
|
||||||
| Tumor Localization | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Whole Body |
|
||||||
| Limited |
|
||||||
| NM Spect | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Bone |
|
||||||
| Brain |
|
||||||
| Liver |
|
||||||
| Liver Spect w/Flow |
|
||||||
| Renal |
|
||||||
| Myocardial | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Infarction |
|
||||||
| Exercise/Rest-Single |
|
||||||
| Exercise/Rest-Multiple |
|
||||||
| Pharmacological Stress |
|
||||||
| Thallium/Persantine |
|
||||||
| Professional Knowledge and Skills | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Quality Control Equipment |
|
||||||
| Daily Surveys/Wipe Testing |
|
||||||
| Hot Lab Management Dose Calibrators |
|
||||||
| Hot Lab Management Generators |
|
||||||
| Computerized Charting |
|
||||||
| National Patient Safety Goals |
|
||||||
| Universal Protocol Procedures/Core Measures |
|
||||||
| Isolation Precautions |
|
||||||
| Infection Prevention |
|
||||||
| Age Specific/Population-Based Care |
|
||||||
| Fall Risk Assessment/Prevention |
|
||||||
| Age Specific | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Under 12 Years Old |
|
||||||
| Adolescents (12 to 18 years) |
|
||||||
| Young Adults (18 to 39 years) |
|
||||||
| Middle Adults (40 to 64 years) |
|
||||||
| Older Adults (65 & up) |
|
||||||