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Dialysis Skills Checklist

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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.

 1 = Never Performed     2 = Limited Experience     3 = Comfortable Performing     4 = Proficient


BASIC NURSING CARE  1   2   3   4 
Airway Management
Oxygen Therapy Administration
   a. Bag & mask
   b. ET tube
   d. Face mask
   e. Nasal cannula
   f. Trach Collar
   g. BiPAP
   h. Ambu bag
Fluid & Electrolye Balance/Management
Pulse Oximetry
Oral Suctioning - Yankauer
BASIC NURSING CARE  1   2   3   4 
Nasotracheal Suctioning
IV Insertion
Venipuncture
Blood Glucose Monitoring
Foley Catheter Insertion
Intake & Output Monitoring
Seizure Precautions
CPR
NG Tube Insertion/Maintenance
Assess Circulation/Peripheral Pulses
Interpretation of Labs
Dietary needs for ESRD patients
CARE OF PATIENTS WITH  1   2   3   4 
Air Emboli
Anemia
Cardiac Arrest
Chest Pain
Clotted Access/Poor Flow Rate
Disequilibrium Syndrome
Filter Blood Leak
Fluid Overload
Hemolysis
CARE OF PATIENTS WITH  1   2   3   4 
Hypertension
Hypotension
Infiltration of an AV access
Muscle Cramps
Neuropathy
Pericarditis
Pyogenic Reactions
Seizures
DIALYSIS EXPERIENCE - GENERAL  1   2   3   4 
Acute/Inpatient Dialysis
Chronic/Outpatient Dialysis
Pediatric Dialysis
Peritoneal Dialysis
Dialysis Home Care
DIALYSIS EXPERIENCE - GENERAL  1   2   3   4 
Predialysis RN Assessment
Patient/Family Teaching re: Dialysis
CVVH
CAPD
Cycled PD
INITIATE DIALYSIS  1   2   3   4 
Bicarbonate Dialysate
Conductivity and pH Testing
Priming the Dialyzer
Check Machine/Alarm Settings
Prep Vascular Access
Catheter Vascular Access
INITIATE DIALYSIS  1   2   3   4 
Fistula/Graft Vascular Access
Collect Blood Specimen
Anticoagulation
Set up for Cycler PD Machine
Set up for CVHD
MANAGEMENT DURING DIALYSIS  1   2   3   4 
Patient Assessment by System
Volume Status Assessment
Vascular Access Function Assessment
Arterial/Vascular Function Assessment
Blood Flow Rate
Response to Treatment (Subjective)
Anticoagulant Management
Conductivity
Ultra Filtration Calculation
Administration of Blood/Blood Products
MANAGEMENT DURING DIALYSIS  1   2   3   4 
Epogen
Vitamin D Derivative
Iron Replacement
Antiobiotic Administration
IV Push Medications
IV Pump Medications
Mannitol Administration
Sequential Ultra Filtration/PUF
Documentation of Dialysis Treatment
MACHINE/ALARM TROUBLESHOOTING  1   2   3   4 
Air/Foam Detector Alarm
Blood Leak Alarm
Blood Pump Alarm
Air/Foam Detector Alarm
Ultra Filtration Alarm
High Temperature Alarm
Conductivity Alarm
Arterial Pressure Alarm
Venous Pressure Alarm
DISCONTINUATION OF DIALYSIS  1   2   3   4 
Retransfusion Procedure
Dialysis Catheter Procedure
Fistual/Graft Procedure
Post Treatment Access Care
Equipment Clean Up
Sterilization Procedure
Biohazard Procedures




   


Age Specific Skills

Check the box under EACH age
group that you have experience
with and are comfortable with for each skill below.		 Neonates
(0-30 days)		 Infants
(1 mo-1 yr)		 Toddlers
(1-3 yrs)		 Preschool
(4-6 yrs)		 School Age
(7-12 yrs)		 Adolescent
(13-18 yrs)		 Young Adult
(19-39 yrs)		 Middle Adults
(40-64 yrs)		 Older Adults
(65+ yrs)
Understands the different communication needs for the age group & changes communication methods and terminology accordingly
Understands the different medications, dosages and possible side effects for the age group and administers medications appropriately
Understands the different safety risks for the age group and alters the environment accordingly
Understands the normal growth and development for the age group and adapts care accordingly





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