GI/Endoscopy 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)

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)

"*" indicates required fields

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)

MM slash DD slash YYYY

Age Of Patients Cared For

Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler/Preschool (13 months to 5 years)
School Age Child/adolescent (6 years to 18 years)
Young Adults/ Middle Adult (19 years to 64 years)
Older Adults/Elderly (65+ years)

General Skills

Care of Patient in Restraints
Automated Med Dispensing Systems
Electronic Documentation
IV Pumps
Peripheral IV Insertion, Care and Maintenance
Access/Management of Implanted Ports
Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, etc.)
PCA/Epidural pumps
Administration of Blood/Blood Products
Assessment of heart/lung sounds
Assessment of bowel sounds
Knowledge of "Do Not Use Abbreviations"
Do you have charge/supervisor experience?
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores

Medication Administration

Moderate/Conscious Sedation
Sedation Reversal Agents
Antibiotics IM/IV
Contrast Medium
Antiemetics
Narcotic Pain Medications

Pre-procedure

EKG Lead Placement
Interpretation of Pre-Procedure Labs
Set up of Scopes and Video Equipment

Procedures/equipment

Enteroscopy
EGD/Gastroscopy
Endoscopic Ultrasound
Active GI Bleed
Cautery Devices
Variceal Banding, Gold Probe
Esophageal Dilatations(balloons, Maloney,Savory)
Esophageal Motility Tests
Esophageal Monometry Studies
Sclero Therapy
HALO
Colonoscopy
Flexible Sigmoidoscopy
Liver Biopsy
Polypectomy
ERCP
Gastrostomy tube/button or PEG Placement
Pediatric PEG
Video Capsule Endoscopy
Stretta
pH Probe 24 Hour Study
Foreign Body Aspiration/Retrieval

Post-procedure

Sedation Recovery Scales
Assess for Gag Reflex
Adbominal assessement, bowel sounds
Proper use of scope washers/Leak testers
Abdominal pain, recognizing s/sx of possible perforation