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RADIOLOGY TECHNOLOGIST SKILLS CHECKLIST | ||||||
| NAME | |||||||
| LAST 4 OF SSN | |||||||
| DATE | |||||||
| I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination. | |||||||
| Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below. | |||||||
| Proficiency Scale: |
1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently |
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| Rating Stars (Click) | SETTING | 1 | 2 | 3 | 4 | ||
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Adult Inpatient | ||||||
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ER/Trauma | ||||||
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Adult Outpatient | ||||||
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Pediatric Inpatient | ||||||
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Pediatric Outpatient | ||||||
| Rating Stars (Click) | Procedures | 1 | 2 | 3 | 4 | ||
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Chest Studies | ||||||
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Abdominal Studies | ||||||
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Foreign Body/Soft Tissue Studies | ||||||
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Specimen Radiography | ||||||
| Rating Stars (Click) | Extremities | 1 | 2 | 3 | 4 | ||
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Upper | ||||||
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Lower | ||||||
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Pelvis Obls/Judet Views | ||||||
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Pelvis SI Joints | ||||||
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Pelvis Sacrum/Coccyx | ||||||
| Rating Stars (Click) | Spine | 1 | 2 | 3 | 4 | ||
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Cervical Spine-Obls/Flexion/Extension | ||||||
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Thoracic Spine-Swimmer’s View | ||||||
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Lumbar Spine-Obls/Flexion. Extension | ||||||
| Rating Stars (Click) | Head | 1 | 2 | 3 | 4 | ||
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Facial Bones | ||||||
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Mandible | ||||||
| Rating Stars (Click) | Head (cont.) | 1 | 2 | 3 | 4 | ||
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Mastoids | ||||||
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Orbits | ||||||
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Sinus Series | ||||||
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TMJ | ||||||
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Skull Series | ||||||
| Rating Stars (Click) | Tomography | 1 | 2 | 3 | 4 | ||
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Renal | ||||||
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TMJ | ||||||
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Spine | ||||||
| Rating Stars (Click) | Flouroscopy/Contrast Studies | 1 | 2 | 3 | 4 | ||
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Barium Swallow/Esophagram | ||||||
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Modified Barium Swallow/Protocol Swallow | ||||||
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Swallow Studies with Videotaping | ||||||
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Upper GI Series-Single Contrast | ||||||
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Upper GI Series-Air Contrast | ||||||
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Small Bowel Follow Through | ||||||
| Rating Stars (Click) | Enema Studies | 1 | 2 | 3 | 4 | ||
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Barium Enema-Single Contrast | ||||||
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Water Soluble Contrast Enema (e.g. Hypaque) | ||||||
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Barium Enema-Air Contrast | ||||||
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Lower GI Studies thru Colostomy | ||||||
| Rating Stars (Click) | Cystography | 1 | 2 | 3 | 4 | ||
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Cystogram | ||||||
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Voiding Cystogram | ||||||
| Rating Stars (Click) | Cystography (cont.) | 1 | 2 | 3 | 4 | ||
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Urethrography | ||||||
| Rating Stars (Click) | Contrast Injection Studies | 1 | 2 | 3 | 4 | ||
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IVP | ||||||
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IVP with Tomograms | ||||||
| Rating Stars (Click) | Myelograms | 1 | 2 | 3 | 4 | ||
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Cervical Spine | ||||||
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Thoracic Spine | ||||||
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Lumbar Spine | ||||||
| Rating Stars (Click) | Mobile C-Arm Flouroscopy | 1 | 2 | 3 | 4 | ||
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Broncoscopy with Fluoro Guidance | ||||||
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Bedside Line and Tube Placement | ||||||
| Rating Stars (Click) | OR Cases | 1 | 2 | 3 | 4 | ||
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Sterile Procedures in OR | ||||||
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Spine Work | ||||||
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Operative Cholangiography | ||||||
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Hip Studies | ||||||
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Extremity Studies | ||||||
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Cystography | ||||||
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Retrograde Urography | ||||||
| Rating Stars (Click) | Patient Safety | 1 | 2 | 3 | 4 | ||
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National Patient Safety Goals | ||||||
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Computerized Charting | ||||||
| Rating Stars (Click) | Age Specific Practice Criteria | 1 | 2 | 3 | 4 | ||
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Newborn/neonate (birth-30 days) | ||||||
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Infant (30 days-1 year) | ||||||
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Toddler (1-3 years) | ||||||
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Preschooler (3-5 years) | ||||||
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School age children (5-12 years) | ||||||
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Adolescents (12-18 years) | ||||||
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Young adults (18-39 years) | ||||||
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Middle adults (39-64 years) | ||||||
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Older adults (64+) | ||||||