Dialysis RN | Ikajuq Care

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Dialysis RN Skills Checklist

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only

1 = Limited Experience / Rarely Done (<6 times/year)

2 = May Need Some Review / Occasionally Done (1 - 2 times/month)

3 = Experienced / Frequently Done (daily or weekly)

AGE OF PATIENTS CARED FOR

Newborn/Neonate (birth to 30 days)

1

2

3

Infant (31 days to 12 months)

1

2

3

Toddler/Preschool (13 months to 5 years)

1

2

3

School Age Child/adolescent (6 years to 18 years)

1

2

3

Young Adults/Middle Adult (19 years to 64 years)

1

2

3

Older Adults/Elderly (65+ years)

1

2

3

GENERAL SKILLS

Care of Patient in Restraints

1

2

3

Automated Med Dispensing Systems

Accudose

Omnicell

Pyxis

Metro

Promanager Rx

N/A

Other Automated Med Dispensing Systems:

Electronic Documentation

Allscripts

eCLinicalWorks

McKesson

Soarian

Care360

EPIC

Meditech

N/A

Cerner

MACLAB

PACS

HEMODIALYSIS SETTING / PROCEDURES EXPERIENCE

Acute / Inpatient Dialysis

1

2

3

Apheresis

1

2

3

Chronic / Outpatient Dialysis

1

2

3

Dialysis Home Care

1

2

3

Pediatric Dialysis

1

2

3

Predialysis Nursing Assessment

1

2

3

Plasmapheresis

1

2

3

CARE OF PATIENT WITH

Nephrostomy Tube

1

2

3

A V Fistula / A V Graft

1

2

3

Tunneled / Non-Tunneled Catheter

1

2

3

Insertion of urinary catheter (straight cath or foley)

1

2

3

Ileal Conduit

1

2

3

Supra-Pubic Catheter

1

2

3

Renal Failure

1

2

3

TURP

1

2

3

Peritoneal Dialysis

1

2

3

Hemodialysis

1

2

3

SET UP / INITIATE DIALYSIS TREATMENT

Anticoagulation

1

2

3

Bicarbonate Dialysate

1

2

3

Conductivity Testing

1

2

3

Priming Dialyzer

1

2

3

Checks for Machine / Alarm Settings

1

2

3

Prep Vascular Access

1

2

3

Fistula Gortex / Bovine Graft

1

2

3

Dialysis

1

2

3

Collect Blood SpecimensCollect Blood Specimens

1

2

3

Cannulating Buttonholes

1

2

3

Continuous Renal Replacement Therapy (CRRT)

1

2

3

Peritoneal Dialysis

1

2

3

ASSESS PATIENT AND EQUIPMENT DURING DIALYSIS

Volume Status

1

2

3

Vascular Access Function

1

2

3

Arterial and Venous Pressures

1

2

3

Blood Flow Rate

1

2

3

Subjective Response to Treatment

1

2

3

Management of Anticoagulation

1

2

3

Conductivity

1

2

3

Ultrafiltration Calculation

1

2

3

Operation of Myron L. Meter

1

2

3

Administration of Mannitol

1

2

3

Sequential Ultrafiltration / PUF

1

2

3

Documentation of Dialysis Treatment

1

2

3

MANAGEMENT OF PATIENT WITH

Anticoagulation Emergency

1

2

3

Anemia

1

2

3

Air Embolus

1

2

3

Cardiopulmonary Arrest

1

2

3

Chest Pain

1

2

3

Clotted Access / Poor Blood Flow Rate from Catheter

1

2

3

Disequilibrium syndrome

1

2

3

Filter Blood Leak

1

2

3

Fluid Overload

1

2

3

Hemolysis

1

2

3

Hypertension

1

2

3

Hypotension

1

2

3

Hyperkalemia

1

2

3

Muscle Cramps

1

2

3

Neuropathy

1

2

3

Pericarditis

1

2

3

Pyrogenic Reaction

1

2

3

Seizures

1

2

3

MACHINE ALARM TROUBLESHOOTING PROCEDURES

Blood Leak Alarm

1

2

3

Arterial Pressure Alarm

1

2

3

Venous Pressure Alarm

1

2

3

Conductivity Alarm

1

2

3

Ultrafiltration Alarm

1

2

3

High Temperature Alarm

1

2

3

Air / Foam Detector Alarm

1

2

3

Power Failure Alarm

1

2

3

Blood Pump Alarm

1

2

3

LIST ANY CERTIFICATIONS HELD:

Other IV Pumps:

EQUIPMENT USED

Baxter

1

2

3

Fresnius

1

2

3

Cobe

1

2

3

Gambro

1

2

3

Phoenix

1

2

3

T Machine

1

2

3

Other:

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