Loading

Dialysis Tech

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

Age of Patients Cared For

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)*

General Skills

Pediatric Respiratory/Cardiac Arrest*

Adult Respiratory/Cardiac Arrest*

Crash Carts*

Defibrillators*

Patient/Family Education*

Electronic Documentation*

Admit and Assess Patients*

Obtain Vital Signs*

Consent Forms*

Collection of Appropriate Data*

Collection of Appropriate Data*

Assess Patient and Equipment During Dialysis

Blood and Dialysate Flow Rates*

Documentation of Treatment*

Sequential Ultrafiltration/PUF*

Ultrafiltration Calculation*

Vascular Access Function*

Volume Status*

Air Embolus*

Cardiopulmonary Arrest*

Clotted Access*

Disequilibrium Syndrome*

Filter Blood Leak*

Fluid Overload*

Hemolysis*

Hyperkalemia*

Hypertension*

Hypotension*

Muscle Cramps*

Neuropathy*

Pericarditis*

Poor Blood Flow from Catheter*

Pyrogenic Reaction*

Seizures*

Renal/Genitourinary

Acute Peritoneal Dialysis Catheter*

Acute Renal Failure*

AV Fistula/AV Graft*

Bleeding Disorder*

CAVH Dialysis*

Chronic Renal Failure*

End Stage Renal Disease*

Hemodialysis*

Hepatitis Positive*

HIV Positive*

Ileal Conduit*

Nephrectomy*

Nephrostomy Tube*

Peritoneal Dialysis*

Renal Rejection Syndrome*

Renal Transplant*

Tunneled/Non-Tunneled Catheter*

Urostomy/Urinary Diversions*

V Fistula/Shunt*

Hemodialysis Procedures

Set Up and Initiate Hemodialysis*

Review Physician Dialysis Orders*

ACT Range*

Anticoagulant Solution*

Blood Flow Rate (Qb)*

Dialysate*

Dialysate Flow Rate (Qd)*

Dialyzer (F-40, F-6, AV400S etc.)*

Ultrafiltration Rate (UF)*

Setup and Initiate Hemodialysis

A/V Access*

Absence of Disinfectant in System*

Add Chemicals to Dialysate and Label*

Assessment of AV Fistula*

Assessment of CVC Access*

Attach Blood Lines to Dialyzer*

Attach Concentrate Lines*

Attach Heparin Infusion Pump(prn)*

Charcoal Hemoperfusion (REDY 2000)*

Check for Machine/Alarm Settings*

CRRT*

CVC Access*

Dialysate Conductivity Test/Document*

Dialysate pH Test/Document*

Hemchron Machine*

Initiate Treatment*

Inspect Dialyzer for Defects*

Irrigate Access Lines*

Obtain Activated Clotting Times*

Perform Recirculation Procedure*

Pre-Dialysis Assessment*

Pre-Dialysis Labs*

Pre-Dialysis Meds*

Prime Extracorporeal*

Circuit*

Priming Dialyzer*

Secure Lines to Arterial Access*

Stabilize Blood Lines*

Discontinuing Hemodialysis

Disconnect From A/V Fistula*

Disconnect From Dialysis Catheter*

Equipment Clean Up*

Patient Discharge*

Patient Stability*

Post-Dialysis Labs*

Post-Dialysis Meds*

Post-Treatment Access Care*

Return of Blood*

Sterilization Procedures*

Blood Leak Alarm*

Machine Alarm Troubleshooting Techniques

Air / Foam Detector Alarm*

Arterial Pressure Alarm*

Blood Leak Detector*

Blood Pump Alarm*

Conductivity Alarm*

Dialysate Pressure*

Power Failure Alarm*

Temperature Alarm*

Ultrafiltration Alarm*

Venous Pressure Alarm*

Oxygen Administration

Nasal Cannula*

General Procedures/Equipment

Standard/Universal Precautions*

Peritoneal Dialysis*

Collect Blood Specimen*

Clinical Settings

Acute Care Dialysis Setting*

Acute Care Bedside*

Outpatient Clinic*

Other Skills
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.

By completing this Skills Checklist, you agree to receive calls, AI-generated calls, text messages, or emails from and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at Privacy Policy.