Skills Checklist

Congratulations on your decision to apply for a Travel position with Med Travelers! Before we can offer you an employment opportunity, an electronic skills assessment must be completed. From the skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!

Cath Lab Technologist Skills Checklist

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This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
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E-Mail Address*	Phone Number*

 

1. No experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others

 

WORK SETTING

1

2

3

4

 

Electrophysiology Lab

 

lnterventional Cath Lab

 

Pre/Post Procedural Setting

 

Procedural Cath Lab

 

Other Setting (List)

 

EQUIPMENT

1

2

3

4

 

Automatic Implantable Cardiac Defibrillator

 

Intra Aortic Balloon Pump (IABP)

 

Topical Hemostasis (D-Stat, Chito-Seal, Syvek Patch, etc.)

 

Vascular Closure Systems (Perclose, StarClose, Vasoseal, etc.)

 

External Compression Devices (FemoStop, C-Clamp, Sandbags,etc.)

 

Sheath Removal and Monitoring

 

CARDIAC PROCEDURES

1

2

3

4

 

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

1

2

3

4

 

Baseline Measurements

 

Cardiac Ablation

 

Cardiac Mapping

 

Cardioversion

 

Conduction Study

 

Electrophysiology Evaluation

 

Internal Cardioverter Defibrillator Implant

 

Tilt Table Study

 

PROFESSIONAL KNOWLEDGE AND SKILLS

1

2

3

4

 

Fall Risk Assessment/Prevention

 

Infection Prevention

 

Isolation Precautions

 

National Patient Safety Goals

 

Universal Protocol Procedures

 

AGE SPECIFIC/POPULATION-BASED CARE

1

2

3

4

 

Neonate/Infant

 

Toddler/Preschool

 

School Age

 

Adolescents

 

Young/Middle Adults

 

Older Adults/Geriatrics

 

EMR

1

2

3

4

 

Allscripts

 

GE

 

Bar Coding for Medication Administration

 

Cerner

 

Computer Physician Order Entry

 

Eclipsys

 

Epic

 

McKesson

 

Meditech

 

Other: Specify

 

Other: Specify

 

EMR Conversion

YesNo

 

CERTIFICATIONS (Current at the time of completing this form)

 

BLS

YesNo

 

ACLS

YesNo

 

PALS

YesNo

 

ARRT

YesNo

 

Fluoroscopy

YesNo

 

RCIS

YesNo

 

Telemetry Certificate

YesNo

 

Arrhythmia Course

YesNo

 

State Licenses:

 

Other: Specify

Cath Lab Technologist Skills Checklist, version 6

You must agree with the statements at the bottom of the form before submitting your skills checklist.

Please read and agree to the statements below by marking the checkbox.

* I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.