I hereby certify that
ALL information I have provided on this skills checklist and
all other documentation, is true and accurate. I understand and acknowledge
that any misrepresentation or omission may result in disqualification from
employment and/or immediate termination.
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
Rating Stars (Click)
Procedures
1
2
3
4
Assist with EGD’s
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 ERCP’s
Assist with PEG placements
Assist with liver BX
Assist with collection of
hot & cold BX’s
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