Dialysis Skills Checklist Please enable JavaScript in your browser to complete this form.Personal InformationName *FirstLastPlease enter your full legal name as it appears on your Social Security Card.Email *Phone No experience: requires education, training and supervision Intermittent experience: may need support or supervise Proficient: consistent experience, independent Expert level: can teach/supervise others. Work Settings:Acute Care Inpatient Dialysis1234Chronic Outpatient Dialysis1234Dialysis Home Care1234Pediatric Dialysis1234Care of the Patient With :Acute renal failure1234Acute kidney injury1234CAVH dialysis (continuous arteriovenous hemofiltration)1234Chronic renal failure (ESRD)1234CRRT (Continuous Renal Replacement Therapy)1234Fluid/ electrolyte imbalance1234Hemodialysis1234Kidney Transplant1234Nephrectomy1234Nephrotic syndrome1234Peritoneal Dialysis1234Renal rejection syndrome1234Dialysis TreatmentAdministration of Anti-infective1234Administration of blood/blood products during treatment1234Administration of IV pushes medications1234Administration of Mannitol/albumin/ 23.4% NaCL1234Apheresis1234Arterial pressure1234Blood flow rates (Qb)1234Conductivity meters1234Dialysate flow rate (Qd)1234Documentation of dialysis treatment1234Management of anticoagulation1234Operation of Myron L. Meter1234Peritoneal catheter malfunction1234Plasmapheresis1234Ultrafiltration calculation1234Ultrafiltration rate1234Vascular access malfunction1234Venous pressure1234EquipmentB. Braun Dialog 1234Baxter1234Cobe1234Fresenius J/K1234Gambro1234HomeChoice Peritoneal Dialysis system1234Phoenix1234Prismaflex machine for CRRT1234T Machine1234Initiate/ Set Up Dialysis TreatmentAbsence of disinfectant in system1234Ability to cannulate AV graft1234Ability to cannulate AV fistula1234Add chemicals to Dialysate and Label1234Attach blood lines to dialyzer1234Attach concentrate lines1234Check for machine/alarm settings1234Collect blood specimens1234Dialysate Conductivity testing1234Dialysate PH testing1234Inspect dialyzer for defects1234Irrigate access lines1234Perform recirculation procedure1234Prep AV Fistula1234Prime extracorporeal circuit1234Priming dialyzer1234Secure lines to arterial access1234Stabilize blood lines1234Tunneled/ Non Tunneled Catheter1234Machine Alarm Troubleshooting ProceduresAir Foam Detector Alarm1234Arterial Pressure Alarm1234Blood Leak Detector1234Blood pump alarm1234Conductivity Alarm1234Dialysate Pressure1234Power failure alarm1234Temperature alarm1234Ultrafiltration alarm1234Venous pressure alarm1234Post dialysis treatmentBlood return1234Disconnect from AV Fistula1234Disconnect from dialysis catheter1234Equipment clean up1234Post treatment access care1234Sterilization procedure1234Professional Knowledge and SkillsAirway management1234Blood glucose monitoring1234Cardiac monitoring1234HIPPA guidelines (Health Insurance Portability and Accountability Act)1234Infection Control1234Interpretation and communication of lab values1234JACHO guidelines (Joint Commission on the Accreditation of Healthcare Organization)1234OSHA guidelines (Occupational Safety and Health Administration)1234Oxygen therapy1234Pain assessment & management1234Personal Protective Equipment1234Standard Precautions1234Start and Maintain IV1234Symptom managementAir emboli1234Cardiac arrest1234Chest pain1234Clotted access/poor blood flow rate1234Disequilibrium syndrome1234Filter blood leak1234Fluid overload1234Hemolysis1234Hyperkalemia1234Hypotension1234Muscle cramps1234Pericarditis1234Pyrogenic reaction1234Seizures1234COMPUTERIZED CHARTINGCerner1234EPIC1234McKesson1234Meditech1234Allscripts1234OASIS1234MIDAS1234Other:1234If Other Please SpecifyAge Specific CompetencyNeonate1234Infant1234Child1234Adolescent1234Young Adult1234Middle Adult1234Older Adult1234Submit