Surgical Technologist Skills Checklist

WORKSETTING - My experience is in the following setting:
 Yrs
General OR
CVOR
Outpatient
Trauma
Peds-General OR
Peds-CVOR
First Assist
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
GENERAL SURGERY
 1234
Abdominal Perineal Resection
Appendectomy/Cholescystectomy
Breast Biopsy
Colon Resection/Surgery
Gastrectomy
Gastric Bypass/Roux-en-Y
Hemorrhoidectomy
Herniorrhaphy - Inguinal, Ventral, Femoral, Umbilical
Laparoscopic General Surgeries
Laparoscopic Nissen Fundoplication
Mastectomy
Splenectomy
Thyroidectomy
CARDIOVASCULAR
 1234
Aorta Repair
Aorto-Bifemoral/Femoral-Pop Bypass Graft
Cardiac Bypass Surgery
Carotid Endarterectomy
Endoscopic Vascular Procedures
Femoral Popliteal Bypass Graft
Laparascopic Cardiac Surgery
Robotic Assisted Cardiac Surgery
Valve Replacement/Repair
Ventricular Assist Device
THORACIC
 1234
Endoscopic Thoracic Procedures
Esophagogastrectomy
Mediastinotomy/Sternotomy
Thoracoscopy/Nuss Procedure
Thoracotomy
ORTHOPEDIC
 1234
Total Joint Replacement
Closed Reduction of Fracture
External Fixator
Cannulated Hip Screws
Bankhart Procedure
Birmingham Procedure
Carpal Tunnel Release
Arthroscopy
Anterior Cruciate Ligament Reconstruction
Open Reduction Internal Fixation
NEUROLOGICAL
 1234
Craniotomy
Steriotactic Guided Brain Biopsy
Laminectomy
Laparoscopic Anterior Laminectomy
Insertion of Vagal Nerve Stimulator
Insertion of VP Shunt
Spinal Fusion
Anterior Cervical Discectomy with Fusion
Posterior Cervical Laminectomy
GENITOURINARY
 1234
Vasicaurethropexy
Marshall Marchetti
Circumcision
Cystoscopy/Cystogram/Pyelogram
Prostatectomy
Nephrectomy
Orchidectomy/Orchidopexy
Ureterostomy
Laparoscopic Assisted GU Procedures
Robotic Assisted GU Procedures
GYNECOLOGICAL
 1234
Abdominal Hysterectomy
Anterior Posterior Repair
C-Section
D & C
Laparoscopic Assisted Hysterectomy
Laparotomy with Microtuboplasty
Robotic Assisted GYN Procedures
Vaginal Delivery
Vaginal Hysterectomy
EAR/NOSE/THROAT
 1234
Endoscopic ENT Procedures
Laryngectomy
Mastoidectomy
Myringotomy with Insertion of Tubes
Radical Neck
Septoplasty
Tonsillectomy & Adenoidectomy
Tracheostomy
Tympanoplasty
CRANIOFACIAL/ORAL/PLASTICS
 1234
Craniectomy
Craniofacial Reconstruction
Dental Surgery
Leforte 1 Maxillary/Sagittal Osteotomy
ORIF Mandibular Fracture
Otoplasty
Reconstruction of Ear
Removal of Arch Bars
Repair of Cleft Lip, Nose, Palate
Rhinoplasty
PLASTIC
 1234
Blephoroplasty
Breast Reconstruction with Implant
Breast Reduction Mammoplasty
Face Lift
Mastectomy with Tram Flap Reconstruction
Split Thickness Skin Graft
Suction Lipectomy
TRANSPLANTS
 1234
Heart
Lung
Liver
Pancreas
Eye
Organ Donation
OPHTHAMOLOGY
 1234
Cataract Extraction with Implant
Vitrectomy
Scleral Buckle
Cataract Aspiration; Anterior Vitrectomy
Corneal Transplant
If no PEDIATRICS Experience, skip to OR EQUIPMENT section
PEDIATRIC GENERAL SURGERY
 1234
Anal Fistulectomy/Anoplasty
Appendectomy/Cholecystectomy
Biopsy (Mass, Muscle, Lymph Node)
Bronchoscopy
Colostomy
Esophagogastroduodenoscopy w/ Biopsy
Esophagoscopy
Exploratory Laparotomy
Flexible Sigmoidoscopy
Fundoplication
Gastrostomy
Herniorrhaphy
Insertion of Port-a-Cath, Hickman, Broviac
Laparascopic General Surgery Procedures
Liver Biopsy
Percutaneous Endoscopic Gastrostomy
Thoracoscopy/Nuss Procedure
PEDIATRIC GENITOURINARY
 1234
Circumcision
Cystoscopy/Cystogram/Pyelogram
Hydrocelectomy
Nephrectomy
Orchidectomy/Orchidopexy
Repair of Hypospadias
Retrograde Pyelogram
Ureterostomy
PEDIATRIC NERUO
 1234
Craniotomy
Insertion of Vagal Nerve Stimulator
Insertion of VP Shunt
Laminectomy
PEDIATRIC CARDIAC/VASCULAR
 1234
Arterial Switch
ASD/VSD Repair
Atrial Septectomy
Bidirectional Glenn
BT Shunt
ECMO Insertion/Decannulation
Fontan Procedure
Norwood Procedure
Pacemaker
PDA Ligation
Repair of Coarctation of Aorta
Ross Procedure
Tetralogy of Fallot Repair
Valve Repair/Replacement
Ventricular Assist Device
PEDIATRIC TRANSPLANT
 1234
Heart
Kidney
Liver/Pancreas
Lung
Organ Donation
PEDIATRIC OPHTHAMOLOGY
 1234
Corneal Transplant
Dacrocystorhinostomy
Excision of Chalazion
Eye Muscle Surgery
Levator Resection
Orbitotomy of Eye
Repair of Ptosis
PEDIATRIC EAR/NOSE/THROAT
 1234
Cochlear Implant
Laryngotracheoplasty
Myringotomy with Tubes
Septoplasty
Suspension Microlaryngoscopy
Tonsillectomy & Adenoidectomy
Tracheostomy
Turbinate Reduction
Tympanoplasty/Typanomastoidectomy
PEDIATRIC CRANIOFACIAL/ORAL/PLASTICS
 1234
Craniectomy
Craniofacial Reconstruction
Dental Surgery
Leforte 1 Maxillary/Sagittal Osteotomy
Mandibular Osteotomy
ORIF Mandibular Fracture
Otoplasty
Reconstruction of Ear
Repair of Cleft Lip, Nose, Palate
Rhinoplasty
Skin Graft
PEDIATRIC ORTHOPEDICS
 1234
Acetabuloplasty/Triple Innominate
Arthroscopy of Knee, Wrist, Shoulder
Closed Reduction, Percutaneous Pin
External Fixator (Ilizarov/Orthofix)
ORIF Shoulder, Humerus, Tibia, Femur
Osteotomy/VDRD/Calcaneal/Metatarsal
Spinal Fusion/Spinal with Instrumentation
Tendoachilles Lengthening
OR EQUIPMENT
 1234
Electrocautery (ESU)
Laparoscopy Systems
Neuro
OR Fracture Tables
Orthopedic Total Joint Systems
Power Equipment
Robotics Systems
Spinal Fusion Instrumentation
PROFESSIONAL KNOWLEDGE AND SKILLS
 1234
Malignant Hyperthermia Protocol
Infection Prevention
Isolation Precautions
National Patient Safety Goals/Core Measures
Universal Protocol
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. *