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
(PROFICIENCY)
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
(FREQUENCY)
1 = Never performed observed only
2 = Less than 6 times per year
3 = 1-2 times per month
4 = Daily or Weekly
PROFICIENCY / FREQUENCY
PROFICIENCY
FREQUENCY
Assist with endoscopic ultrasound
Assist with active GI bleed
Assist with manometry studies
Assist with variceal banding
Assist with esophageal dilatations
Assist with esophageal ballooning
Assist with scelrotherapy
Assist with PEG placements
Assist with collection of hot & cold BX’s
Specimen collection & labeling
Set up of scopes & video equipment
Apply external abdominal pressure to assist with scope movement
Assist with mobile cases, ICU, ER, etc.
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Takes call for emergency cases
National Patient Safety Goals
Accurate patient identification
Interpretation & communication of lab values
Medication administration
Monitoring conscious sedation
Pain assessment & management
Prevention of pressure ulcers
Use of rapid response teams
Pre procedure phone calls
Pre procedure checklist/consent
Assess for air movement post colonoscopy
Assess for gag reflex post EGD
Assess for gag reflex post bronchoscopy
Recover from (moderate) conscious sedation
Discharge outpatients to home
Post procedure phone calls
Age Specific Competencies
Newborn/neonate (birth-30 days)
Preschool (ages 4-5 years)
School age (ages 6-12 years)
Adolescent (ages 13-21 years)
Young adult (ages 22-39 years)
Older adult (ages 65-79 years)