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Dialysis 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)

MM slash DD slash YYYY

AGE OF CLIENTS

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

Renal / Genitourinary

Assessment of Renal / GU System(Required)
Insertion of Foley(Required)

Care of Patient With

Nephrostomy Tube(Required)
AV Fistula / AV Graft(Required)
Tunneled / Non-Tunneled Catheter(Required)
Ileal Conduit(Required)
Supra-Pubic Catheter(Required)
Chronic Renal Failure(Required)
Acute Renal Failure(Required)
Nephrectomy(Required)
TURP(Required)
Peritoneal Dialysis(Required)
Hemodialysis(Required)

Types of Dialysis

Arteriovenous Hemofiltration(Required)
Venovenous Hemofiltration(Required)
Arteriovenous Hemodialysis(Required)
Venovenous Hemodialysis(Required)

Hemodynamic Monitoring

Acute / Inpatient Dialysis(Required)
Chronic / Outpatient Dialysis(Required)
Dialysis Homecare(Required)
Pediatric Dialysis(Required)
Pre-Dialysis Nursing Assessment(Required)
Teaching Patient and Family(Required)

Set Up / Initiate Dialysis Treatment

Bicarbonate Dialysate(Required)
Conductivity Testing(Required)
Priming Dialyzer(Required)
Checks for Machine / Alarm Settings(Required)
Prep Vascular Access(Required)
Fistula Gore-Tex / Bovine Graf(Required)
Dialysis(Required)
Collect Blood Specimens(Required)
Anticoagulation(Required)

Equipment During Dialysis

Systems Assessment of Patient(Required)
Volume Status(Required)
Vascular Access Function(Required)
Arterial / Venous Pressures(Required)
Blood Flow Rate(Required)
Subjective Response to Treatment(Required)
Management of Anticoagulation(Required)
Conductivity(Required)
Ultrafiltration Calculation(Required)
Administer Blood / Blood Products(Required)
Sequential Ultrafiltration / PUF(Required)
Operation of Myron L. Meter(Required)
Administration of Mannitol(Required)
Documentation of Dialysis Treatment(Required)

Management of a Patient With

Fluid Overload(Required)
Vascular Access Function(Required)
Hyperkalemia(Required)
Rate from Catheter(Required)
Hemolysis(Required)
Chest Pain(Required)
Anemia(Required)
Pericarditis(Required)
Cardiopulmonary Arrest(Required)
Cardiac Arrest(Required)
Air Embolus(Required)
Filter Blood Leak(Required)
Hypotension(Required)
Hypertension(Required)
Clotted Access / Poor Blood Flow Rate Catheter(Required)
Anemia(Required)
Neuropathy(Required)
Infiltration of an AV Access(Required)
Chest Trauma(Required)
Pyrogenic Reaction(Required)
Seizures(Required)

Machine Alarm Procedures

Blood Leak Alarm(Required)
Arterial Pressure Alarm(Required)
Venous Pressure Alarm(Required)
Conductivity Alarm(Required)
Ultrafiltration Alarm(Required)
High Temperature Alarm(Required)
Air / Foam Detector Alarm(Required)
Power Failure Alarm(Required)
Blood Pump Alarm(Required)

Discontinue Dialysis

Dialysis Catheter(Required)
Fistula / Vein Graft(Required)
Return of Blood(Required)
Post Treatment Access Care(Required)
Equipment Clean Up(Required)
Sterilization Procedures(Required)
Retransfusion Procedure(Required)
Biohazard Waste Procedures(Required)

Skilled Nursing Care

Charge Nurse / Management Experience(Required)
Cardiac Monitoring(Required)
Airway Management(Required)
Oxygen Therapy(Required)
Oral / Nasotracheal Suctioning(Required)
Pulse Oximetry(Required)
Start & Maintain Peripheral IVs(Required)
Assessment of Circulation / Peripheral Pulses(Required)
Foley Catheter Insertion / Maintenance(Required)
NG Tube Insertion / Maintenance(Required)
Administration of Blood / Blood Products(Required)
Management of Fluid / Electrolyte Balance(Required)
Seizure Precautions(Required)
Knowledge of Lab Values for ESRD Patients(Required)
Knowledge of ESRD Dietary Recommendations(Required)

Dialysis Equipment

Althin(Required)
Cobe(Required)
Fresenius(Required)
Prisma(Required)

Background Experience

Small Hospital(Required)
Large Hospital(Required)
Outpatient(Required)
Acute Care / Hospital(Required)
Cancer Center(Required)
Clinic(Required)
Managed Care(Required)
SNF / Long Term Care(Required)
Home Health(Required)

OTHER SKILLS

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