Oncology RN Skills Checklist Personal InformationName(Required) First Middle Last Last 4 Digits of Social Security NumberEmail(Required) Date MM slash DD slash YYYY Proficiency Scale1 – No Experience 2 – Need Training 3 – Able to perform with supervision 4 – Able to perform independentlyRadiation TherapySkin Assessment 1 2 3 4 Total Body Irradiation 1 2 3 4 Side Effect Management 1 2 3 4 External Radiotherapy 1 2 3 4 Brachytherapy 1 2 3 4 Radiation Safety Precautions 1 2 3 4 Intraoperative Radiation 1 2 3 4 Oncology Patient CareRenal Failure 1 2 3 4 Fever 1 2 3 4 Pneumonia 1 2 3 4 Cardiac Arrhythmias 1 2 3 4 Hypercalcemia 1 2 3 4 Hyperkalemia 1 2 3 4 Pancreatitis 1 2 3 4 Pulmonary Embolism 1 2 3 4 Bowel Obstruction 1 2 3 4 Diabetes 1 2 3 4 Pneumothorax 1 2 3 4 Stress Fractures 1 2 3 4 Respiratory Distress 1 2 3 4 Spinal Cord Compression 1 2 3 4 GI Bleed 1 2 3 4 Pleural Effusion 1 2 3 4 Infection 1 2 3 4 Hypokalemia 1 2 3 4 DIC 1 2 3 4 Atlelectasis 1 2 3 4 Lymphedema 1 2 3 4 Vascular DevicesFlush Catheter 1 2 3 4 Punctured Catheter 1 2 3 4 Chemo Port 1 2 3 4 Omega-Port 1 2 3 4 S.E.A. Port 1 2 3 4 Port-A-Cath 1 2 3 4 Opti-Port 1 2 3 4 PICC Lines 1 2 3 4 Obtain Blood Specimens 1 2 3 4 Line Insertion Assistance 1 2 3 4 De-Clotting Ports 1 2 3 4 Groshong Catheters 1 2 3 4 Catheter Port 1 2 3 4 Site Care 1 2 3 4 Broviac Catheters 1 2 3 4 Patient/Teaching 1 2 3 4 Hickan Catheters 1 2 3 4 Care of Patients WithFoley Catheter Irrigations 1 2 3 4 CVP Line Insertion 1 2 3 4 Circumcision 1 2 3 4 Jejunostomy Tubes 1 2 3 4 Wound Care 1 2 3 4 Colostomy Care 1 2 3 4 TURP 1 2 3 4 Reverse Isolation 1 2 3 4 Liver Biopsy 1 2 3 4 Platelet Precautions 1 2 3 4 Accucheck 1 2 3 4 NG Tube Insertion 1 2 3 4 Suprapubic Catheter 1 2 3 4 Ileostomy 1 2 3 4 Thoracentesis 1 2 3 4 Isolation 1 2 3 4 Foley Catheter Irrigations 1 2 3 4 Bone Marrow Biopsy 1 2 3 4 Enterostomal Care 1 2 3 4 Chest Tube Care 1 2 3 4 Paracentesis 1 2 3 4 Gastrostomy Tube 1 2 3 4 Narcotic Infusion 1 2 3 4 Hemodialysis 1 2 3 4 Nephrostomy Tube 1 2 3 4 Pain Management 1 2 3 4 Pulse Oximetry 1 2 3 4 Fistulas/Shunts 1 2 3 4 Seizure Precautions 1 2 3 4 Peritoneal Dialysis 1 2 3 4 Nasotracheal Suctioning 1 2 3 4 PCA Pumps 1 2 3 4 CardiovascularHyperalimentation 1 2 3 4 Peripheral Blood Stem Cells 1 2 3 4 Packed RBC’s 1 2 3 4 IV Fluid Hydration 1 2 3 4 Venoclusive Disease 1 2 3 4 Fresh Frozen Plasma 1 2 3 4 Infections 1 2 3 4 Pneumonitis 1 2 3 4 Graft Rejection 1 2 3 4 Platelets 1 2 3 4 WBC/Lukocytes 1 2 3 4 Blood/Byproducts 1 2 3 4 Antivirals 1 2 3 4 Donor Education 1 2 3 4 Allogeneic BMT 1 2 3 4 GVHD Graft 1 2 3 4 Autologous BMT 1 2 3 4 Antifungals 1 2 3 4 Implantable Infusion Pumps 1 2 3 4 Medtronic 1 2 3 4 Infusaid 1 2 3 4 Ambulatory Infusion Pumps 1 2 3 4 Synchormed 1 2 3 4 Cormed 1 2 3 4 Pharmacia 1 2 3 4 Auto Syringe 1 2 3 4 Pancretec 1 2 3 4 Patency Maintenance 1 2 3 4 Patient Teaching 1 2 3 4 Psycho & Social CarePalliative Care 1 2 3 4 Hospice Care 1 2 3 4 Family Support 1 2 3 4 Counseling/Death/Dying 1 2 3 4 Identifying Support Groups 1 2 3 4 Advance Directives 1 2 3 4 Identifying Resources 1 2 3 4 Health Care Proxy 1 2 3 4 PharmacologyFloxuridine/FUDR 1 2 3 4 Doxorubicin/Adrianycin 1 2 3 4 Heparin/Coumadin 1 2 3 4 Carmustine/BiCNU 1 2 3 4 Dopamine 1 2 3 4 Cistplatin 1 2 3 4 Mitonycin/Mutanycin 1 2 3 4 Dilantin 1 2 3 4 Fluorouracil/-FU 1 2 3 4 Usulfan/Myleran 1 2 3 4 Neupogen/Epogen 1 2 3 4 Hydroxyurea/Hydrea 1 2 3 4 Corticosteroids 1 2 3 4 Vincristine/Oncovin 1 2 3 4 Methotrexate/Amethopterin 1 2 3 4 Morphine 1 2 3 4 Etoposide/VP-6- 1 2 3 4 Cyclophosphamide/Cytoxan 1 2 3 4 Decadron 1 2 3 4 Belomycin/Blenoxane 1 2 3 4 Vinblastine/Velban 1 2 3 4 Melphalan/Alkeran 1 2 3 4 IV Care/Skills 1 2 3 4 Chemotherapy Adm 1 2 3 4 IM/SQ 1 2 3 4 IVPB 1 2 3 4 IV Push/Intrathecal 1 2 3 4 Oncology & General CareThrombocytopenia 1 2 3 4 Stomatitis 1 2 3 4 Hemorrhabe 1 2 3 4 Oncology PCU 1 2 3 4 Neuropathy 1 2 3 4 Bone Marrow Transplant 1 2 3 4 Death /Dying 1 2 3 4 Venous Access Devices 1 2 3 4 Electrolyte Imbalance 1 2 3 4 Palliative/Hospice Care 1 2 3 4 Neutropenia 1 2 3 4 Pain Management 1 2 3 4 Telemetry 1 2 3 4 Nutritional Needs 1 2 3 4 Immunosuppression 1 2 3 4 IV Maintenance 1 2 3 4 Septic Shock 1 2 3 4 Vomiting/Diarrhea/Nausea 1 2 3 4 Skin Care 1 2 3 4 Blood/Blood Byproducts 1 2 3 4 Normal Serum Labs Values 1 2 3 4 Radiation Therapy 1 2 3 4 Surgical Patient Care 1 2 3 4 Chemotherapy Protocols 1 2 3 4 Implantable Vascular Ports 1 2 3 4 Patient Teaching 1 2 3 4 Implantable Infusion Pumps 1 2 3 4 Age Specific CompetenciesInfant (Birth - 1 year) 1 2 3 4 Preschooler (ages 2-5 years) 1 2 3 4 Childhood (ages 6-12 years) 1 2 3 4 Adolescents (ages 13-21 years) 1 2 3 4 Young Adults (ages 22-39 years) 1 2 3 4 Adults (ages 40-64 years) 1 2 3 4 Older Adults (ages 65-79 years) 1 2 3 4 Elderly (ages 80+ years) 1 2 3 4 AuthorizationsSignature(Required)The information I have given is true and accurate to the best of my knowledge. I hereby authorize Hired by Matrix, Inc. to release this Oncology RN Skills Checklist to Client facilities of Hired by Matrix, Inc. in consideration of my assignment to work at those facilities.
