Cath Lab/Interventional Radiology Skills Checklist

Please mark your level of experience
1.  No theory and/or experience
2.  Limited experience/need supervision and/or support
3.  Experienced/minimal support needed to perform
4.  Proficient/can perform independently
WORK SETTING
 1234
Procedural Cath Lab
lnterventional Cath Lab
EP Lab
Interventional Radiology
Pre/Post Procedural Setting
Charge Experience
EQUIPMENT
 1234
Automatic Implantable Cardiac Defibrillator
Cardioversion
Defibrillation
Intra Aortic Balloon Pump (IABP)
SV02 Recording
Ventilator Management
CARDIAC CATH LAB PROCEDURES
 1234
AICD Placement
Aortography
Cardiac Biopsy
Cardiac Implant Closure Device
Cardiac Stent Placement
Diagnostic Cardiac Catheterization Adult
Diagnostic Cardiac Catheterization-Pediatric/Neonatal
Directional Coronary Atherectomy
IABP Placement/Removal
Internal Mammary Angiography
Laser Assisted Procedures
Percutaneous Transluminal Coronary Angioplasty
Pericardiocentesis
Permanent Pacemaker Placement
Pulmonary Angiography
Rotational Coronary Atherectomy
Saphenous Vein Graft Angiography
Transluminal Extraction Catheter
Valvuloplasty
Ventricular Assist Device Insertion
ELECTROPHYSIOLOGY PROCEDURES
 1234
Electrophysiology Evaluation
Baseline Measurements
Cardiac Ablation
Cardiac Mapping
Cardioversion
Conduction Study
Internal Cardioverter Defibrillator Implant
Tilt Table Study
IR-GASTROINTESTINAL STUDIES
 1234
Angioplasty
Chemoembolization
Cholecystostomy
Embolization
ERCP
Esophageal Stent Placement
Gastrojejunostomy
Gastrostomy Tube Placement
Liver Ablation
Pericentesis
Percutaneous Hepatic Angiography
TIPS
IR-GENITOURINARY STUDIES
 1234
Adrenal Angiography
Angiography of Female GU System
Angiography of Male GU System
Cystostomy
Embolization
Nephrostomy
Percutaneous Stone Extraction
Renal Angiography
Renal Artery Angioplasty
Renal Artery Stent Placement
Ureteral Stent
IR-NEUROLOGIC STUDIES
 1234
Cerebral Angiography
Carotid Angiography
Neurologic Angioplasty
Neurologic Thrombolysis
Vertebroplasty
IR-PERIPHERAL VASCULAR STUDIES
 1234
Abdominal Aortography
Angioplasty
Central Venous Access/Port Placement
Dialysis Graft Creation/Revision
Dialysis Graft lnterventional
Peripheral Vascular Embolization
Stent Graft Placement
SVC/IVC Venograph
Thoracic Aortography
Upper and Lower Extremity Angiography
IR-PULMONARY PROCEDURES
 1234
Chest Tube Placement
Pulmonary Embolization
Pulmonary Angiography
Thoracentesis
PROFESSIONAL KNOWLEDGE AND SKILLS
 1234
Conscious/Procedural Sedation
Assist w/Central Line/Venous Line Insertion
Venous Sampling
Topical Hemostasis (D-Stat, Chito-Seal, Syvek Patch, etc.)
Vascular Closure Systems (Perclose, StarClose, etc.)
External Compression Devices (C-Clamp, Sandbags,etc.)
Physiologic Monitoring/Recording
Sheath Removal and Monitoring
National Patient Safety Goals/Core Measures
Universal Protocol Procedures
Isolation Precautions
Infection Prevention
Age Specific/Population-Based Care
Fall Risk Assessment/Prevention
COMPUTERIZED CHARTING
 1234
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
 YesNo
EMR Conversion
By checking the "Agree" box and clicking “Submit” below you certify and acknowledge the information provided on this checklist is accurate to the best of your knowledge and an accurate representation of your abilities. *