RN Endoscopy Skills Checklist

Personal Information

MM slash DD slash YYYY

Proficiency Scale

1 – No Experience
2 – Need Training
3 – Able to perform with supervision
4 – Able to perform independently


Assist with EGD’s
Assist with endoscopic ultrasound
Assist with active GI bleed
Cautery devices
Assist with manometry studies
Assist with variceal banding
Assist with esophageal dilatations
Assist with esophageal ballooning
Assist with scelrotherapy
Assist with TEE
Assist with bronchoscopy
Assist with colonoscopy
Assist with polypectomy
Assist with ERCP’s
Assist with PEG placements
Assist with liver BX
Assist with collection of hot & cold BX’s
Specimen collection & labeling
Set up of scopes & video equipment
Apply external abdominal pressure to assist with scope movement
Scope cleaning
Assist with mobile cases, ICU, ER, etc.
Radiation safety
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Takes call for emergency cases
National Patient Safety Goals
Awareness of HCAHPS
Accurate patient identification
Effective communication
Interpretation & communication of lab values
Medication administration
Labeling (medications & specimens)
Anticoagulation therapy
Monitoring conscious sedation
Pain assessment & management
Infection control
Universal precautions
Minimize risk for falls
Prevention of pressure ulcers
Use of rapid response teams

Administer Conscious Sedation

Reversal agents

Pre Procedure

Pre procedure phone calls
Electronic documentation
Patient assessment
Colon prep or re-prep
Pre procedure checklist/consent
IV start, med admin

Post Procedure

Assess for air movement post colonoscopy
Assess for pain
Assess for bowel sounds
Assess for gag reflex post EGD
Assess for gag reflex post bronchoscopy
Recover from MAC
Recover from (moderate) conscious sedation
Discharge outpatients to home
Post procedure phone calls

Age Specific Competencies

Newborn/neonate (Birth - 30 days)
Infant (31 days - 1 year)
Toddler (ages 2-3 years)
Preschooler (ages 4-5 years)
School age (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)


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 RN Endoscopy Skills Checklist to Client facilities of Hired by Matrix, Inc. in consideration of my assignment to work at those facilities.
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