Transplant Coordinator RN Skills Checklist One program to handle all talent management needs from acquisition to development Personal Information HiddenOverall ScoreOut of 4Name(Required) First Middle Last Last 4 Digits of Social Security Number Email(Required) HiddenDate MM slash DD slash YYYY Proficiency Scale1 – No Experience 2 – Need Training 3 – Able to perform with supervision 4 – Able to perform independentlyAGE OF PATIENTS CARED FORNewborn/Neonate (birth to 30 days)(Required) 1 2 3 4 Infant (1 month to 1 year)(Required) 1 2 3 4 Toddler (1 year to 3 years)(Required) 1 2 3 4 Preschooler (3 years to 5 years)(Required) 1 2 3 4 School Age Child (5 years to 12 years)(Required) 1 2 3 4 Adolescents (12 years to 18 years)(Required) 1 2 3 4 Young Adults (18 years to 39 years)(Required) 1 2 3 4 Middle Adults (39 years to 64 years)(Required) 1 2 3 4 Older Adults (64 years to 79 years)(Required) 1 2 3 4 Elderly Adults (over 79+ years)(Required) 1 2 3 4 GENERAL SKILLSStandard Precautions(Required) 1 2 3 4 Isolation Precautions(Required) 1 2 3 4 Pediatric Respiratory/Cardiac Arrest(Required) 1 2 3 4 Adult Respiratory/Cardiac Arrest(Required) 1 2 3 4 Crash Carts(Required) 1 2 3 4 Defibrillators(Required) 1 2 3 4 Advanced Directives(Required) 1 2 3 4 Patient and Family Education(Required) 1 2 3 4 Electronic Documentation(Required) 1 2 3 4 Automated Med Dispensing Systems(Required) 1 2 3 4 PRE-TRANSPLANTTransplant Center Protocols(Required) 1 2 3 4 Absolute and Relative Contraindications to Transplant(Required) 1 2 3 4 Wait List Criteria(Required) 1 2 3 4 Pre-Transplant Evaluation Testing (Organ Specific)(Required) 1 2 3 4 Evaluation Process(Required) 1 2 3 4 Organ Allocation Process(Required) 1 2 3 4 Clinical Transplant Team Collaboration(Required) 1 2 3 4 POST TRANSPLANTTransplant Related Infections(Required) 1 2 3 4 Organ Rejection(Required) 1 2 3 4 Immunosuppressive Drug Monitoring(Required) 1 2 3 4 Immunosuppressive Regiments(Required) 1 2 3 4 Monitoring Drug Toxicity Levels(Required) 1 2 3 4 LIVING DONATIONMonitoring Organ-Specific Complications(Required) 1 2 3 4 PRE-TRANSPLANT CANDIDATESHeart(Required) 1 2 3 4 Lung(Required) 1 2 3 4 Kidney(Required) 1 2 3 4 Liver(Required) 1 2 3 4 Pancreas(Required) 1 2 3 4 Colon(Required) 1 2 3 4 Small Bowel(Required) 1 2 3 4 POST TRANSPLANT RECIPIENTSLiver(Required) 1 2 3 4 Split Liver(Required) 1 2 3 4 Reduced Liver(Required) 1 2 3 4 Kidney(Required) 1 2 3 4 Lung(Required) 1 2 3 4 Heart(Required) 1 2 3 4 Small Bowel(Required) 1 2 3 4 CARDIOVASCULAR: GENERALAbnormal Heart Sounds/Murmurs(Required) 1 2 3 4 Auscultation(Required) 1 2 3 4 Capillary Refill(Required) 1 2 3 4 CARDIOVASCULAR: PATIENT EXPERIENCEAcute MI(Required) 1 2 3 4 Angina(Required) 1 2 3 4 Cardiopulmonary Arrest(Required) 1 2 3 4 Congestive Heart Failure(Required) 1 2 3 4 Pacemaker(Required) 1 2 3 4 Pericarditis(Required) 1 2 3 4 AICD(Required) 1 2 3 4 CARDIOVASCULAR: MONITORINGEKG Monitoring(Required) 1 2 3 4 Arrythmia Interpretation(Required) 1 2 3 4 CARDIOVASCULAR: LABSCoagulation Studies(Required) 1 2 3 4 BNP(Required) 1 2 3 4 Troponin(Required) 1 2 3 4 PULMONARY: GENERALAdventitious Breath Sounds(Required) 1 2 3 4 Rate and Work of Breathing(Required) 1 2 3 4 PULMONARY: PATIENT EXPERIENCEAsthma(Required) 1 2 3 4 Chest Tubes(Required) 1 2 3 4 COPD(Required) 1 2 3 4 Cystic Fibrosis(Required) 1 2 3 4 Pneumonia(Required) 1 2 3 4 Pulmonary Embolism(Required) 1 2 3 4 PULMONARY: MONITORINGPulse Oximetry(Required) 1 2 3 4 PULMONARY: LABSInterpretation of ABGs(Required) 1 2 3 4 NEUROLOGY: GENERALLevel of Consciousness(Required) 1 2 3 4 Neurological Assessment(Required) 1 2 3 4 NEUROLOGY: PATIENT EXPERIENCEStroke(Required) 1 2 3 4 Intercranial Hemorrhage(Required) 1 2 3 4 Seizure Disorder(Required) 1 2 3 4 GASTROINTESTINAL: GENERALNutritional Status(Required) 1 2 3 4 GI Assessment(Required) 1 2 3 4 GASTROINTESTINAL: PATIENT EXPERIENCEBowel Obstruction(Required) 1 2 3 4 Colostomy(Required) 1 2 3 4 Cirrhosis(Required) 1 2 3 4 GI Bleeding(Required) 1 2 3 4 Hepatitis(Required) 1 2 3 4 Liver Failure(Required) 1 2 3 4 Pancreatitis(Required) 1 2 3 4 Paralytic Ileus(Required) 1 2 3 4 GASTROINTESTINAL: LABSLiver Function Tests(Required) 1 2 3 4 Serum Ammonia(Required) 1 2 3 4 Serum Amylase(Required) 1 2 3 4 Urine Amylase(Required) 1 2 3 4 RENAL/GENTOURINARY: GENERALFluid Status(Required) 1 2 3 4 RENAL/GENTOURINARY: PATIENT EXPERIENCEAcute Renal Failure(Required) 1 2 3 4 End Stage Renal Disease(Required) 1 2 3 4 Hemodialysis(Required) 1 2 3 4 Nephrostomy(Required) 1 2 3 4 Peritoneal Dialysis(Required) 1 2 3 4 RENAL/GENTOURINARY: MONITORINGMeasurement of Intake and Output(Required) 1 2 3 4 Fluid Balance(Required) 1 2 3 4 RENAL/GENTOURINARY: LABSBUN and Creatinine(Required) 1 2 3 4 Serum Electrolytes(Required) 1 2 3 4 ENDOCRINE/METABOLIC: GENERALDiabetes(Required) 1 2 3 4 Diabetic Ketoacidosis(Required) 1 2 3 4 ENDOCRINE/METABOLIC: LABSBlood Glucose(Required) 1 2 3 4 IMMUNOLOGY/HEMATOLOGY/ONCOLOGY: GENERALBlood Transfusions(Required) 1 2 3 4 IMMUNOLOGY/HEMATOLOGY/ONCOLOGY: PATIENT EXPERIENCECancer(Required) 1 2 3 4 Cytomegalovirus(Required) 1 2 3 4 HIV/AIDS(Required) 1 2 3 4 Acute Leukemia(Required) 1 2 3 4 Sepsis(Required) 1 2 3 4 IMMUNOLOGY/HEMATOLOGY/ONCOLOGY: LABSHematology(Required) 1 2 3 4 WOUNDS/INTEGUMENT: GENERALSigns/Symptoms of Infection(Required) 1 2 3 4 Skin Assessment(Required) 1 2 3 4 WOUNDS/INTEGUMENT: PATIENT EXPERIENCESurgical Wounds with Drains(Required) 1 2 3 4 Stasis Ulcers(Required) 1 2 3 4 Wounds(Required) 1 2 3 4 WOUNDS/INTEGUMENT: MONITORINGSkin Breakdown(Required) 1 2 3 4 WOUNDS/INTEGUMENT: MEDICATION ADMINISTRATIONAdminister IM and SQ(Required) 1 2 3 4 Administer PO(Required) 1 2 3 4 Administer IV(Required) 1 2 3 4 Bladder Irrigation and Installation(Required) 1 2 3 4 Immunosuppressive Therapy(Required) 1 2 3 4 WOUNDS/INTEGUMENT: IV THERAPYAdverse Reactions(Required) 1 2 3 4 Assess/Maintain IV(Required) 1 2 3 4 PCA Pumps(Required) 1 2 3 4 Syringe Pumps(Required) 1 2 3 4 Vascular Access Device Care/Maintenance(Required) 1 2 3 4 Infusion Pumps(Required) 1 2 3 4 Insert Peripheral IV(Required) 1 2 3 4 WOUNDS/INTEGUMENT: BLOODAdminister Blood/Blood Products(Required) 1 2 3 4 Albumin(Required) 1 2 3 4 WOUNDS/INTEGUMENT: NUTRITIONAL THERAPYEnteral Administration(Required) 1 2 3 4 TPN and Hyperalimentation(Required) 1 2 3 4 Tube Feeding Pumps(Required) 1 2 3 4 NGT Insertion(Required) 1 2 3 4 Dobhoff Insertion(Required) 1 2 3 4 PEG(Required) 1 2 3 4 WOUNDS/INTEGUMENT: OXYGEN ADMINISTRATIONAmbu-bag(Required) 1 2 3 4 Nasal Cannula(Required) 1 2 3 4 Non-Rebreather Mask(Required) 1 2 3 4 Venti Mask(Required) 1 2 3 4 Portable Oxygen(Required) 1 2 3 4 Tracheostomy(Required) 1 2 3 4 WOUNDS/INTEGUMENT: PAIN MANAGEMENTAssess Pain Level/Tolerance(Required) 1 2 3 4 Epidural Anesthesia/Analgesia(Required) 1 2 3 4 Patient Controlled Analgesia(Required) 1 2 3 4 Moderate Sedation(Required) 1 2 3 4 WOUNDS/INTEGUMENT: PERFORMChest Tube Drainage Systems(Required) 1 2 3 4 Doppler(Required) 1 2 3 4 Dressing Changes(Required) 1 2 3 4 Drains (JP-Hemovac-Penrose)(Required) 1 2 3 4 Suctioning (Oral-Naso-Pharynx)(Required) 1 2 3 4 Indwelling Urinary Catheter(Required) 1 2 3 4 Hyper/Hypothermia Blanket(Required) 1 2 3 4 Incentive Spirometry(Required) 1 2 3 4 Specialty Beds(Required) 1 2 3 4 WOUNDS/INTEGUMENT: SPECIMEN COLLECTIONSButterfly Stick(Required) 1 2 3 4 Central-Line Blood Draw(Required) 1 2 3 4 Clean Catch Urine(Required) 1 2 3 4 Blood Cultures(Required) 1 2 3 4 Finger Stick(Required) 1 2 3 4 Urine Dipstick(Required) 1 2 3 4 Sputum(Required) 1 2 3 4 Stool(Required) 1 2 3 4 Throat Swab(Required) 1 2 3 4 Venipuncture(Required) 1 2 3 4 WOUNDS/INTEGUMENT: ASSISTWOUNDS/INTEGUMENT: ASSIST(Required) 1 2 3 4 Bronchoscopy(Required) 1 2 3 4 Central Line Insertion(Required) 1 2 3 4 Chest Tube Insertion(Required) 1 2 3 4 Pericardiocentesis(Required) 1 2 3 4 Paracentesis(Required) 1 2 3 4 Thoracentesis(Required) 1 2 3 4 Lumbar Puncture(Required) 1 2 3 4 SETTINGSHospital(Required) 1 2 3 4 Medical Units(Required) 1 2 3 4 Surgical Units(Required) 1 2 3 4 Oncology(Required) 1 2 3 4 Clinic(Required) 1 2 3 4 Outpatient Clinic(Required) 1 2 3 4 AuthorizationsLegal Consent(Required) I agree to the terms and conditions.Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. 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