Skills Checklist

This Skills Checklist is a self-evaluation to assess your recent experience in various clinical settings focusing on the past 2 years.

0 = No Experience
1 = Some Experience
2 = Intermittent Experience
3 = Experienced
4 = Very Experienced

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AGE OF PATIENTS CARED FOR

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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)
Elderly Adults (over 79+ years)

GENERAL SKILLS

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Venipuncture/IV Placement
Standard Precautions
Isolation Precautions
Pediatric Respiratory/ Cardiac Arrest
Adult Respiratory/ Cardiac Arrest
Crash Carts
Defibrillators
Quality Control Equipment
Daily Surveys/ Wipe Testing
Hot Lab Management Dose Calibrators
Hot Lab Management Generators
National Patient Safety Goals
Universal Protocol Procedures/ Core Measures
Infection Prevention
Age Specific/ Population-Based Care
Fall Risk Assessment/ Prevention
Nuclear Med Imaging Systems

WORK SETTING

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Adult Acute Care
Adult Outpatient
Pediatric Inpatient/ Outpatient
Nuclear Cardiology

PROCEDURES

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Arteriogram/ Radionuclide
Abscess Localization Whole Body
Abscess Localization Limited
CCK/ Ejection Fraction
Cisternogram
CSF Leak Localization
Gallium Scan
Gastric Emptying
GI Bleed
HIDA Scan
Indium 111 WBC Scan Whole Body
Indium 111 WBC Scan Limited
Injection-Lymphatic
Lymphatic Scan-Melanoma
Meckels Scan
HIDA with Morphine
MUGA Scan
Radiopharmaceutical Prep
Resting and Exercise Radionuclide Angiogram
Renagram
Parathyroid
Salivary Glands
Ventricular Shunt
Zevalin Treatment
Hyperthyroid Treatment
I-131 Therapy Thyroid Ablation
Pain Therapy

BONE SCAN

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Whole Body
3 Phase
Limited

BRAIN SCAN

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Cerebral Blood Flow

LIVER/ SPLEEN SCAN

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Liver/ Spleen Scan
Liver Scan-Hemangioma
Liver Flow

LUNG SCAN

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DTPA Aerosol
Perfusion
Ventilation/ Perfusion

RENAL FLOW

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With Lasix
Flow/ Function
Three Phase
Captopril

SHUNT

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Abdominal
Ventricular

THYROID STUDIES

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Cancer Survey
Uptake Scan
I 123 Scan

TUMOR LOCALIZATION

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Whole Body I 131 or Octreoscan
Limited I 131 or Octreoscan

NM SPECT

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Bone
Brain
Liver
Liver Spect w/Flow
Renal

MYOCARDIAL

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2 Day Rest/Stress MIBI
Exercise/Rest/Stress MIBI
Exercise
Pharmacological Stress
Thallium/Viability

EMR

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eClinicalworks
EPIC
McKesson
Care 360
Allscripts
Cerner
GE
Optum Insight
NextGen
Greenway

PACS

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Ambra Health
Sectra
Infinitt
IBM Merge
McKesson
Philips
FujiFilm
Impax
Centricity
Carestream Vue
Clarity
eRad PACS
Syngo

EQUIPMENT

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Siemens Computer
Siemens Diacam
Siemens Orbiter Camera
Siemens Spect
ADAC Computer
ADAC Camera
3D Reconstruction Packet
Centiview
Digital Computer
Elscint Camera
GE LFOV
GE Star Cam SPECT
Genesis
Hitachi
Philips

Position Category

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Total Years of Experience

First Name

Last Name

Social Security #

Date of Birth

Email

Phone

Attestation

I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified, particularly within the last 2 years. I hereby authorize Alliant Personnel Resources (The Company) to collect, store, and release any information that I have provided in this Skills Checklist and/or any other documentation and information they have collected or that I have submitted in any form to its parent company(s), its subsidiaries, or other subcontractors/its service providers as it deems necessary in its business operations as well as to individuals and companies in relation to consideration of employment as a Healthcare Professional with those companies and individuals. I acknowledge that The Company will take precaution and care to protect my personal information that is collected/stored/shared but cannot guarantee permanent data security and I release The Company from all related liability for damages or punitive liability.

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Skills Checklist - Nuclear Medicine Technologist