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Infusion 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

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

Standard Precautions*

Isolation Precautions*

Pediatric Respiratory/Cardiac Arrest*

Adult Respiratory/Cardiac Arrest*

Crash Carts*

Defibrillators*

Participation on Code Teams*

Patient/Family Education*

Care of Patient in Restraints*

Automated Med Dispensing Systems*

Electronic Documentation*

Access/Management of Implanted Ports*

Access/Management of Central Lines*

Titration of Drips*

Administration of Blood/Blood Products*

Knowledge of Current IV Therapy Guidelines*

Knowledge of Anatomy*

Moderate Conscious Sedation*

Sedation Reversal Agents*

Knowledge Of Current IV Therapy Guidelines

INS*

ISMP*

CDC*

State*

Insertion Of

Peripheral IV – Adult*

Peripheral IV – Child*

Peripheral IV – Neonate*

Vein Selection – Peripheral IVs*

Interosseous Needles*

MidLine/PICC Lines

Midline Catheter Insertion – Adult*

Midline Catheter Insertion – Child*

Indications for Midline/PICC Placement*

Contraindications for Midline/PICC Placement*

Vein Selection*

Measuring Technique*

Catheter and Introducer Device Selection*

Correct Tip Placement*

Insertion Technique – Basic (Vein)*

Insertion Technique – Seldinger*

Insertion Technique – Ultrasound*

Assist with Insertion in Interventional Radiology*

Insertion Site Preparation*

Maintaining Sterile Field*

Securing Insertion Site Post Placement*

X-Ray Assessment for Tip Location*

Repositioning After X-Ray*

Care And Maintenance

Peripheral IV*

Scalp IV*

Heparin/Saline Lock*

Groshong PICC*

Groshong CVL*

Hickman/Broviac*

Port-a-Cath*

Vascath*

Multilumen Catheters*

Subclavian Line*

IJ Line*

Femoral Line*

Power PICC*

Power Port*

Dressing Changes*

Cap Changes*

Flushing Lines (Frequency/Solution)*

Medication Administration

Chemotherapy*

Heparin*

Streptokinase*

TPA (Alteplase)*

Lidocaine*

TPN/Lipids*

Ativan*

Valium*

Versed*

Fentanyl*

Equipment

Curlin Pump*

CADD Pump*

Vista Pump*

Syringe Pump*

Rate Flow Regulator*

Needleless Systems*

Blood Warmer*

PCA Pumps*

Pressure Lines*

Troubleshooting/Complications

Repair PICC*

Repair Midline*

Air Embolism*

Bleeding*

Brachial Plexus Injury*

Cardiac Arrhythmia*

Cardiac Tamponade*

Catheter Erosion*

Catheter Embolism*

Catheter Occlusion*

Catheter-Related Sepsis*

Endocarditis*

Exit Site Infection*

Exit Site Necrosis*

Extravasation*

Hematoma*

Laceration of Vessels or Viscus*

Myocardial Erosion*

Perforation of Vessels or Viscus*

Phlebitis*

Catheter Tip Malposition or Retraction*

Thromboembolism*

Venous Thrombosis*

Ventricular Thrombosis*

Vessel Erosion*

Declotting Peripheral Site*

Complications from Sedation*

Discontinuing IV Therapy

Peripheral IVs*

PICC/Midline*

Central Lines*

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.

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