CYNET_SYSTEMS_MAIN_LOGO.gif   Urology RN Skills Checklist
   NAME    
   LAST 4 OF SSN      
   DATE    
I hereby certify that ALL information I have provided to IMCS Group on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.  
Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.  
Proficiency Scale: 1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

  
       
Rating Stars (Click) General Urology 1 2 3 4  
Cystoscopy / Panendoscopy  
Insertion of ureteral catheters/stents  
TUR of prostrate  
Bladder biopsy  
Transurethral lithalopaxy  
Repair of uterovaginal fistula  
Ureterolysis  
Ureteropelvioplasty  
Ureteral anastomosis  
Urterolithotomy  
Nephropexy  
Pyelolithotomy  
Open renal biopsy  
Total cystectomy  
Suprapubic cystostomy  
Vesicourethropexy  
Cutaneous vesicostomy  
Meatotomy  
Uretherectomy  
Hypospadius repair  
Orchiectomy  
Hydrocelectomy  
Testicular biopsy  
Vasectomy  
Implanation of artificial sphincter  
Penile straightening  
Reanastomosis of vas deferens  
Retroperitoneal lymph node dissection  
Laparoscopic Urological procedures  
Microsurgery  
Percutaneous nephrostomy  
Percutaneous lithotripsy  
Ureterscopy  
Radical prostatectomy  
Rating Stars (Click) Urology 1 2 3 4  
Retrograde Pyelogram  
Stone manipulation  
TUR and fulguration of bladder tumor  
Transurethral ureteral meatotomy  
Perioneal urethrostomy  
Intubated ureterotomy  
Ureterectomy  
Ureteral reimplantation  
Transureteroureterostomy  
Segmental resection of ureter  
Nephrolitotomy  
Nephrostomy  
Partial cystectomy  
Vesical diverticulectomy  
Cystoplasty  
Repair vesicovaginal fistula  
Urethroplasty  
Urethral diverticulectomy  
Urethrostomy  
Circumcision  
Radical orchiectomy  
Spermatocelectomy  
Orchipexy  
Epididymectomy  
Penile prosthesis  
Varicocelectomy  
Vasoepidiymal anastomosis  
Incontigen injection  
Laser procedures  
Moderate Sedation  
Percutaneous stone manipulation  
Renal vascular surgery  
Transuretero lithrotripsy  
Nephrectomy  
Rating Stars (Click) CARDIAC 1 2 3 4  
Acute Coronary Syndrome  
Congestive Heart Failure  
Post Open Heart (12-24 hours)  
Carotid Endarterectomy  
Post Vascular Surgery  
Heart Transplant  
Pacemaker - Temporary/Permanent  
Pacemaker - Epicardial  
Sheath Removal  
Heart Sounds  
Rating Stars (Click) PULMONARY 1 2 3 4  
Pneumonia  
Respiratory Distress  
COPD  
Breath Sounds  
Post Thoracic Surgery  
Chest Tube Placement & Management  
Trach Management  
Modes of Ventilation (AC/PC/SIMV/CPAP)  
Intubation/Extubation  
External CPAP/BiPAP  
Interpretation of Arterial Blood Gases  
Rating Stars (Click) NEUROLOGIC & PSYCHIATRIC  1 2 3 4  
Stroke Scale Assessment  
CVA  
Brain Injury  
Post Craniotomy  
Spinal Cord Injury  
Seizure Disorders  
ETOH/Drug Withdrawal  
Rating Stars (Click) GASTROINTESTINAL 1 2 3 4  
GI Bleeding  
GI Surgery  
Liver Failure  
Pancreatitis  
Liver Transplant  
Pancreas Transplant  
Rating Stars (Click) RENAL/GENITOURINARY 1 2 3 4  
Renal Failure  
Renal Surgery  
Renal Transplant  
Arteriovenous Fistula/Shunt  
Nephrostomy Tubes  
Peritoneal Dialysis  
Rating Stars (Click) ENDOCRINE METABOLIC 1 2 3 4  
Diabetes - Hypo/Hyperglycemic Crisis  
Pituitary Disorders  
IV Insulin Protocols  
Indwelling Insulin Pumps  
Rating Stars (Click) MEDICATIONS 1 2 3 4  
Anti- Arrhythmics  
Anticoagulants (IV, oral & injection)  
Anti-Hypertensives  
Anti-Psychotics  
Anti-Seizure Medications  
Benzodiazepines  
Procedural Sedation  
Diuretics  
Emergency Medications  
Inhaled Medications  
Insulin  
Titrate Vasoactive Drips  
Manage Vasoactive Drips - No Titration  
Narcotics/Opioid Analgesics (IV, oral & injection)  
Nitrates (Oral & Topical)  
Non-Opioid Analgesics (IV, Oral & Injection)  
Reversal Agents  
Steroids (IV, Oral, Inhaled)  
Automated Medication Dispensing (i.e. Pyxis, Omnicell)  
Rating Stars (Click) IV THERAPY 1 2 3 4  
Starting Ivs  
Central Line Blood Draws  
Central Line/Implanted Line Care  
Arterial Line Management  
TPN & Lipids  
Blood Product Administration  
Administration of Chemotherapy  
Rating Stars (Click) CARDIAC MONITORING & EMERGENCY RESPONSE 1 2 3 4  
Dysrhythmia Interpretation  
Dysrhythmia Management  
Obtain 12 Lead EKG  
Interpret 12 Lead EKG  
Cardioversion  
Defibrillation  
Malignant Hyperthermia  
Rating Stars (Click) PROFESSIONAL KNOWLEDGE AND SKILLS 1 2 3 4  
National Patient Safety Goals/Core Measures  
Fall Risk Assessment/Prevention  
Pressure Ulcer Risk Assessment/Prevention  
Restraints/Use of Least Restrictive Device  
Patient/Family Teaching  
Age Specific/Population-Based Care  
Isolation Precautions  
Infection Prevention  
Pain Assessment & Management  
Charge Experience  
Interpretation and Communication of Lab Values  
Specialty Beds  
Rating Stars (Click) EMR 1 2 3 4  
Epic  
Cerner  
Eclipsys  
McKesson  
Meditech  
Other Computerized System  
Computerized Physician Order Entry  
Bar Coding for Medication Administration  
Rating Stars (Click) Age Specific Competencies 1 2 3 4  
Infant (Birth - 1 year)  
Preschooler (ages 2-5 years)  
Childhood (ages 6-12 years)  
Adolescents (ages 13-21 years)  
Young Adults (ages 22-39 years)  
Adults (ages 40-64 years)  
Older Adults (ages 65-79 years)  
Elderly (ages 80+ years)