Ultrasound Skills Checklist

    Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

    Proficiency Scale: 1 = No Experience, 2 = Need Training, 3 = Able to perform with supervision, 4 = Able to perform independently

    AGE OF PATIENTS CARED FOR:

    GENERAL SKILLS:

    ABDOMEN/ PELVIS:

    SUPERFICIAL STRUCTURES STUDIES:

    GYNECOLOGICAL STUDIES:

    Obstetrics:

    Interventional Procedures:

    Abdomen/ Pelvis:

    Upper Extremity:

    Lower Extremity:

    STRESS/ PRESSURE TESTING:

    UPPER EXTREMITY VENOUS:

    LOWER EXTREMITY VENOUS:

    NECK:

    POST INTERVENTION PROCEDURES:

    BREAST SONOGRAPHY:

    EMR:

    PACS:

    EQUIPMENTS:

    POSITION CATEGORY:

    TOTAL YEARS OF EXPERIENCE:

    CERTIFICATIONS