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CVOR RN

This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Fusion Medical Staffing.

  • 0 = Not Applicable
  • 1 = No Experience
  • 2 = Some Experience
  • 3 = Intermittent Experience
  • 4 = Experienced
  • 5 = Very Experienced
*Required
n/a
1
2
3
4
5

* Required

Experience With Ages

Newborn/Neonate (birth to 30 days)*

Infant (1 month to 1 year)*

Toddler (1 year to 3 years)*

Preschooler (3 years to 5 years)*

School Age Child (5 years to 12 years)*

Adolescents (12 years to 18 years)*

Young Adults (18 years to 39 years)*

Middle Adults (39 years to 64 years)*

Older Adults (64 years to 79 years)*

Elderly Adults (over 79+ years)*

Settings

Operating Room*

Clinic*

General Skills

Crash Cart*

Fire Safety*

Latex Allergy*

Malignant Hyperthermia*

Universal Protocol*

Patient Identification*

Hand-off Communication*

Standard Precautions*

Isolation Precautions*

Pediatric Respiratory/Cardiac Arrest*

Adult Respiratory/Cardiac Arrest*

Computerized Documentation*

Develop Plan of Care*

Informed Consent*

Level of Consciousness*

Patient/Family Teaching*

Perioperative Assessment*

Skin Assessment*

Time-Out Procedure*

Automated Med Dispensing Systems*

Electronic Documentation*

Assessment and Patient Care: Circulate

Cardiovascular/Thoracic

A-F Bypass*

Abdominal Aortic Aneurysm (open)*

A-V Access Graft*

Aortic Stent Insertion*

Ascending/Thoracic Aneurysm*

Biopsy*

Carotid Endarterectomy*

Chest Trauma*

Coronary Artery Bypass Graft*

Embolectomy*

Fem-Fem*

Fem-Pop Bypass*

Heart Transplant*

Implantable Cardioverter Defibrillator*

Mitral or Aortic Valve Replacement/Repair*

Pacemaker Insertion*

Patent Ductus Arteriosus*

Pneumonectomy/Lobectomy*

Rib Resection*

Septal Defect Repairs*

Thoracotomy*

Vena Cava Filter*

Thoracic Stent Insertion*

Vena Cava Ligation*

Ventricular Assist Device (VAD)*

A-V Shunts*

Bronchoscopy*

Chest Tube Set-Up*

Endarterectomy-Femoral*

Esophagectomy*

Graft Insertion*

Heller Procedure*

Hiatal Hernia*

Intra-Aortic Balloon Pump Catheter*

Patent Ductus Repair*

Pericardial Windows*

Port-A-Cath Insertion*

Portasystemic Shunt*

Sternal Splitting*

Lung/Wedge Resection*

Thrombectomy*

Tracheal Resection*

Transplants: Circulate

Heart*

Lung*

Multiorgan*

Harvest*

Pancreas*

Liver*

Kidney*

Assessment and Patient Care: Scrub

Cardiovascular/Thoracic

A-F Bypass*

Abdominal Aortic Aneurysm (open)*

A-V Access Graft*

Aortic Stent Insertion*

Ascending/Thoracic Aneurysm*

Biopsy*

Carotid Endarterectomy*

Chest Trauma*

Coronary Artery Bypass Graft*

Embolectomy*

Fem-Fem*

Fem-Pop Bypass*

Heart Transplant*

Implantable Cardioverter Defibrillator*

Mitral or Aortic Valve Replacement/Repair*

Pacemaker Insertion*

Patent Ductus Arteriosus*

Rib Resection*

Septal Defect Repairs*

Thoracotomy*

Vena Cava Filter*

Thoracic Stent Insertion*

Vena Cava Ligation*

Pneumonectomy/Lobectomy*

Ventricular Assist Device (VAD)*

A-V Shunts*

Chest Tube Set-Up*

Hiatal Hernia*

Sternal Splitting*

Bronchoscopy*

Lung/Wedge Resection*

Endarterectomy-Femoral*

Esophagectomy*

Graft Insertion*

Heller Procedure*

Intra-Aortic Balloon Pump Catheter*

Patent Ductus Repair*

Pericardial Windows*

Port-A-Cath Insertion*

Portasystemic Shunt*

Thrombectomy*

Tracheal Resection*

Transplants: Scrub

Heart*

Lung*

Multiorgan*

Harvest*

Pancreas*

Liver*

Kidney*

Medications/Therapeutic Interventions

IV Therapy

Admin Blood/ Blood Products*

Assist with IA/IV Therapy*

Starting IVs*

Vascular Access Device Management*

Assist with Insertion of Invasive Devices (Arterial/CVP/Swan Ganz)*

Oxygen Administration

Ambu-Bag*

Nasal Cannula*

Non-Rebreather mask*

Portable Oxygen*

Trach Collar*

Tracheostomy*

Venturi Masks*

Ventilator*

Pain Management/Anesthesia

Assess Pain Level/Tolerance*

Epidural Anesthesia/Anagelsia*

Anesthesia Toxcitiy*

General*

Regional*

Spinal*

Signs and Symptoms of Dural Puncture*

Positioning Patients*

Moderate Sedation*

Induction*

Procedures/Equipment

Procedures

Airway Maintenance*

Arterial Line Monitoring*

Aseptic Technique*

Cricoid Pressure*

Donning of Surgical Attire*

Foley Catheterization*

Hemodynamic Monitoring*

IABP*

Implantable Cardioverter Defibrillator*

Pacemaker Insertion *

Patient Charge Capture Systems*

Patient Positioning *

Patient Prep *

Procedure Set Up *

Equipment, Sponge and Lab Counts*

Equipment

Bair Hugger*

Blood and Fluid Warmer*

Bovie*

Cell Saver/Auro-Transfuser*

Chest Drainage System*

Defibrillator/Internal Paddles*

Electrosurgical Unit*

Emerson Thoracic Pump*

Flexible Bronchoscope*

Laser*

Pneumatic Tourniquet*

Suction Units (Neptune, Wall)*

Ultrasonic Cleaner*

Sterad Machine*

Application Agreement

The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Fusion Medical Staffing. Submit this skills evaluation with your initial application. To be updated annually.

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