Skills Checklist

Congratulations on your decision to apply with TravelNursing! Before we can offer candidates allied health employment, a skills assessment must be performed. Please find the appropriate skills checklist below and download it. Once the form has been completed, it will need to be sent to TravelNursing. Thank you for taking the time to complete this valuable step in the application process.



Endoscopy Nursing 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.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
 
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 Dilation
 
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
 
EQUIPMENT AND PROCESS
1 2 3 4
 
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
 
Labeling (medications & specimens)
 
Specimen collection and labeling
 
Anticoagulation therapy
 
Monitoring conscious sedation
 
Management of an Emergency Resuscitation situation
 
ADMINISTER CONSCIOUS SEDATION
1 2 3 4
 
Fentanyl
 
Propofol
 
Demerol
 
Presedex
 
Versed
 
Reversal agents
 
Insulin
 
PRE-PROCEDURE
1 2 3 4
 
IV insertion/Fluid Administration
 
Colon prep or re-prep
 
Pre Procedure Checklist and Criteria for Procedure
 
Time Out Protocols
 
Consent verification
 
POST PROCEDURE
1 2 3 4
 
Assess for air movement post colonoscopy
 
Assess for bowel sounds
 
Assess for gag reflex post EGD
 
Assess for gag reflex post bronchoscopy
 
Recover from (moderate) conscious sedation
 
Patient Teaching/Discharge Criteria
 
Managing Patient calls for Concerns
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Fall Risk Assessment/Prevention
 
National Patient Safety Goals/Core Measures
 
Patient/Family Teaching
 
Phase 1
 
Pressure Ulcer Risk Assessment/Prevention
 
Recover and Care for ICU Patients
 
Restraints/Use of Least Restrictive Device
 
Universal Protocol Procedures (Time Out)
 
AGE SPECIFIC/POPULATION BASED-CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age Children
 
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
 
CERTIFICATIONS * (Current at time of completing this form)
 
BLS
 
ACLS
 
PALS
 
CCRN
 
Telemetry Certificate
 
Other: Specify
Endoscopy Nursing Skills Checklist, version 1

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.