Dialysis Clinical
Proficiency Scale
1 =
No Experience
2 =
Need Training
3 =
Able to perform with supervision
4 =
Able to perform independently
| Renal/Genitourinary | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Assessment of Renal/GU System | |||||
| Insertion of Foley | |||||
| Nephrostomy Tube | |||||
| AV Fistula / AV Graft | |||||
| Tunneled/Non-Tunneled Catheter | |||||
| Ileal Conduit | |||||
| Supra-Pubic Catheter | |||||
| Chronic Renal Failure | |||||
| Acute Renal Failure | |||||
| Nephrectomy | |||||
| Turp | |||||
| Peritoneal Dialysis | |||||
| Hemodialysis | |||||
| Hemodialysis |
| Hemodialysis / Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Acute/Inpatient Dialysis | |||||
| Chronic/Outpatient Dialysis | |||||
| Dialysis Home Care | |||||
| Pediatric Dialysis | |||||
| Predialysis Nursing Assessment | |||||
| Teaching the Dialysis Patient and Family |
| Set-Up / Starting Dialysis Treatment | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Collect Blood Specimens | |||||
| Anticoagulation | |||||
| Dialysis | |||||
| Fistula Gortex / Bovine Graft | |||||
| Prep Vascular Access | |||||
| Checking Alarm Settings/Machine | |||||
| Priming Dialyzer | |||||
| Conductivity Testing | |||||
| Bicarbonate Dialysis | |||||
| Bicarbonate Dialysis |
| Assess Patient and Equipment During Dialysis | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Systems Assessment of Patient | |||||
| Volume Status | |||||
| Vascular Access Function | |||||
| Arterial and Venous Pressures | |||||
| Blood Flow Rate | |||||
| Subjective Response to Treatment | |||||
| Management of Anticoagulation | |||||
| Conductivity | |||||
| Ultrafiltration Calculation | |||||
| Operation of Myron L Meter | |||||
| Administration of Blood/Blood Products | |||||
| Sequential Ultrafiltration / PUF | |||||
| Administration of Mannitol | |||||
| Documentation of Treatment |
| Care of Patient With | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Fluid Overload | |||||
| Hypertension | |||||
| Hypotension | |||||
| Disequilibrium Syndrome | |||||
| Hyperkalemia | |||||
| Seizures | |||||
| Muscle Cramps | |||||
| Clotted Access/Poor Blood Flow Rate From Catheter | |||||
| Pyrogenic Reaction | |||||
| Hemolysis | |||||
| Air Embolus | |||||
| Chest Pain | |||||
| Anemia | |||||
| Neuropathy | |||||
| Pericarditis | |||||
| Filter Blood Leak | |||||
| Cardiopulmonary Arrest |
| Discontinue Dialysis | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Dialysis Catheter | |||||
| Fistula / Vein Graft | |||||
| Return of Blood | |||||
| Post Treatment Access Care | |||||
| Equipment Clean Up | |||||
| Sterilization Procedures | |||||
| Sterilization Procedures |
| Miscellaneous | Rating Stars (Click) | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Care of Immunosuppressed Patient | |||||
| Care of Patient with AIDS | |||||
| Isolation Techniques | |||||
| Assessment of Wound Healing | |||||
| Sterile Dressing Changes | |||||
| Phlebotomy / Venous Blood Draw | |||||
| Discussing Organ & Tissue Donation |
| Age Specific Competencies | Rating Stars (Click) | 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) |