ADEX Medical Staffing - Telemetry Skills Checklist

Telemetry Skills Checklist

This assessment is for determining your experience in the below outlined clinical areas. This checklist will not be used as a determining factor in accepting your application for employment with ADEX Medical Staffing, LLC.

Proficency Scale:

1 = No Experience - Theory only

2 = Limited Experience - Infrequent

3 = Moderate Experience - Able to perform independently

4 = Proficient - Able to perform proficiently and instruct

Frequency Scale:

1 = Never Observed

2 = Less than 6 times a year

3 = 1 or 2 Times a Month

4 = Daily or Weekly

Personal Information
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	Proficiency				Frequency
Cardiac	1	2	3	4	1	2	3	4
Interpretation of Arrhythmias
Interpretation of Hemodynamic Monitoring
Pacemakers-Permanent
Cardiac Arrest/CPR
A-Line (Transducer setup-D/C)
Swan Ganz (Transducer setup-D/C)

	Proficiency				Frequency
Gastrointestinal	1	2	3	4	1	2	3	4
NG Tube Insertion
Gastronomy Tube
Jejunoostomy Tube
Enterostomal Care

	Proficiency				Frequency
Gastrourinary/Renal	1	2	3	4	1	2	3	4
Foley Catheter Insertion
GU Irrigations
Nephrostomy Tube
Suprapubic Tube
Electrolyte Imbalance/Replacement

	Proficiency				Frequency
Neurology	1	2	3	4	1	2	3	4
Assessment of Neuro Signs
Use of Glascow Coma Scale
Seizure Precautions
Assist with Lumbar Puncture
ICP Monitoring
Crutchfield Tongs
Halo Traction
Stryker Frame
Assessment of Sensory-Motor Function
Cervical Traction
Cranial Nerve Assessment
LOC Assessment
Pre/Post Neuro Surgical Care
Visual Acuity Measurement

	Proficiency				Frequency
Respiratory	1	2	3	4	1	2	3	4
Establishing an Airway
Pulse Oximetry
Interpretation of ABG
Drawing ABG Blood Sample from A-Line
Incentive Spirometer

	Proficiency				Frequency
Vascular	1	2	3	4	1	2	3	4
Peripheral Pulses
Fluid Overload
Starting IV's
Subcutaneous Central Line
Hickman/Broviac/Groshong Catheters
Mainenance of Heparin Lock
TPN/Hyperalimentation
Air Occlusive Dressing
Infusion Pump
Heparin Drip - Precautions and Maintenance

	Proficiency				Frequency
Care of patient with	1	2	3	4	1	2	3	4
Aneurysm
Angina
Cardiogenic/Hypovolemic Shock
Pre/Post Cardiac Surgery
Pre/Post Cardiac Cath
COPD
ARDS
Pulmonary Embolism
Pulmonary Edema
Pneumonia
Inhalation Injuries
CVA
Seizure Disorder
Overdose
Neuro Injury/Trauma
Pre/Post Neuro Surgery
Cranial Hemorrhage
Aphasia
Multiple Sclerosis
Pancreatitis
GI Bleed
Esophageal Bleeding
Bowel Obstruction
Liver Transplant
Paralitic Ileus
TURP
Shunts and Fistulas
Nephrectomy
Renal Transplant
Renal Trauma

	Proficiency				Frequency
Use and Administration of the following	1	2	3	4	1	2	3	4
Atropine
Bretylol
Bumex
Digoxin
Dopamine
Dobutrex
Inderal
Inocor
Isuprel
Lidocaine
Neosynephrine/Nipride
NTG
Pronestyl
Titrate Morphine
Verapamil
Thrombolitic Agents
Prep/Titration of Emergency Drugs
Aminophylline
Corticosteroids
Bronkosol
Ventolin
Alupent
Decadron
Dilantin
Magnesium Sulfate
Phenobarbital
Steroids
Valium
Versed

	Proficiency				Frequency
Equipment	1	2	3	4	1	2	3	4
Bear I
Bear II
Bear V
Bennett 7200
CPAP
Emerson
EMV
MA-I
MA-II
Monihan
Ohio 560
PEEP
Pressure Pre-Set
Servo 900b
Servo 900c
Servo 900e
Siemens
Hewlett-Packard
Spacelab
Marquette
Mennen
Lifecare
Nihon-Koder

	Proficiency				Frequency
Other	1	2	3	4	1	2	3	4
Oncology
Chemotherapy
Isolation Techniques
Hyperbaric Oxygenation
Fingerstick Blood Glucose monitoring

	Proficiency				Frequency
Age Specific Skills	1	2	3	4	1	2	3	4
Newborn (birth-30 days)
Adolescents (12 - 18 years)
Infant (30 days - 1 year)
Young Adults (18 - 39 years)
Toddler (1 - 3 years)
Middle Adults (39 - 64 years)
Preschooler (3 - 5 years)
Older Adults (64+ years)
School Age (5 - 12 years)

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The information represented above is true and correct to the best of my knowledge. I authorize ADEX Medical Staffing, LLC to share this skills checklist with its clients.
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Form Reviewed by ADEX Clinician - 11/16/2010