Operating Room Skills Checklist - HealthCare Staffing Network

Visit Your Travel Nurse Recruiting Station!

Refer a Travel Nursing Cadidate and Earn $500!

Operating Room Skills Checklist

The purpose of the following checklist is to assist in matching your skills with available assignments in order to meet both your needs and the needs of our client facilities. Please select the appropriate number for each skill level, patient care situation, or type of equipment.

Level of Experience:

Theory, No Practice
Intermittent Experience
One/Two Year Consistent Experience
Very Experienced, Able to Perform Without Supervision

Name:

Date:

AGE SPECIFIC CARE
Please indicate the level of experience with which you provide care for each age group in this specialty area.

	Scrub	Circulate	A	B	C	D
Infant (Birth to 1 year)
Toddler (1-3 years)
Pre-School (3-6 years)
School Age (6-12 years)
Adolescent (12-18 years)
Young Adult (18-30 years)
Mature Adult (30-60 years)
Elderly (>60 years)

SKILLS	Scrub	Circulate	A	B	C	D
GENERAL
Open Cases
Radical Neck Dessectomy/Neck Surgeries
Radical Mastectomy/Axillary Dissection
Esophageal Dilation/Esophagectomy
Roux and Y Procedure
Colo-rectal
Hepatic/Gastric Procedures
Laparoscopic Cases
Cholecystectomy
Appendectomy
Hernia Repair
Colostomy/Ileostomy
Central Line Placement/Vascular Access

PERIPHERAL VASCULAR
Carotid Endarterectomy
Axillo-Fem, Fem-Pop, Fem-Fem, Bypass
AAA
Vein Stripping
Valvulotomy

TRANSPLANTS
Kidney
Pancreas
Liver

A-V FISTULA/GRAFT
Declotting
Temp/Perm Hemodialysis Catheter
Peritoneal Dialysis

CARDIO-THORACIC
Open Heart (CABG, Valve Replacement)
Heart Transplant
Lung Transplant
Video Assisted Thoracoscopy
Umbrella Filter Placements
Pediatric-VSD, Tetrology of Fallot
Robotics