DIALYSIS NURSING KNOWLEDGE & SKILLS CHECKLIST

NAME:       DIRECTIONS: Please indicate your level of experience by

ID #:       placing a check (√) in the box. Experience level:
DATE:       1 NO EXPERIENCE
2 MINIMAL EXPERIENCE-requires supervision/assistance
This Skills Checklist is for use by nurses with more than 3 MODERATELY EXPERIENCED-requires initial review,
one year experience in their discipline and specialty. then performs independently
Please be accurate with your assessment. 4 VERY EXPERIENCED- proficient

DESCRIPTION 1 2 3 4 DESCRIPTION 1 2 3 4
RENAL/GENITOURINARY a. Systems Assessment of Patient
1. Assessment of Renal/ GU system b. Volume Status
2. Insertion of foley c. Vascular Access Function
3. Care of the Patient with: d. Arterial and Venous Pressures
a. Nephrostomy tube e. Blood Flow Rate
b. AV Fistula/ AV Graft f. Subjective Response to Treatment
c. Tunneled/Non-Tunneled Catheter g. Management of Anticoagulation
d. Ileal Conduit h. Conductivity
e. Supra-pubic Catheter i. Ultrafiltration Calculation
f. Chronic Renal Failure j. Operation of Myron L. Meter
g. Acute Renal Failure k. Administration of Blood & Blood
h. Nephrectomy Products
i. Turp l. Administration of Mannitol
j. Peritoneal Dialysis m. Sequential Ultrafiltration/PUF
k. Hemodialysis n. Documentation of Dialysis Treatment
HEMODIALYSIS SKILLS/PROCEDURES 4. Management of the patient with:
1. Experience: a. Fluid Overload
a. Acute/Inpatient Dialysis b. Hypertension
b. Chronic/Outpatient Dialysis c. Hypotension
c. Dialysis Home Care d. Disequilibrium syndrome
d. Pediatric Dialysis e. Hyperkalemia
e. Predialysis Nursing Assessment f. Seizures
f. Teaching the Dialysis Patient and Family g. Muscle Cramps
2. Set Up/Initiate Dialysis Treatment: h. Clotted Access/Poor blood flow rate
a. Bicarbonate Dialysate from catheter
b. Conductivity Testing i. Pyrogenic reaction
c. Priming Dialyzer j. Hemolysis
d. Checks for machine/Alarm Settings k. Air embolus
e. Prep Vascular Access l. Chest pain
f. Fistula Gortex/Bovine Graft m. Anemia
g. Dialysis n. Neuropathy
h. Collect Blood Specimens o. Pericarditis
i. Anticoagulation p. Filter blood leak
3. Assess Patient and Equipment During Dialysis q. Cardiopulmonary Arrest

1|Page
 DIALYSIS NURSING KNOWLEDGE & SKILLS CHECKLIST

Name:       ID #:      

DESCRIPTION 1 2 3 4
HEMODIALYSIS SKILLS/PROCEDURES (CONT)
5. Machine Alarm Troubleshooting Procedures
a. Blood leak alarm
b. Arterial Pressure Alarm
c. Venous Pressure Alarm
d. Conductivity Alarm
e. Ultrafiltration Alarm
f. High Temperature Alarm
g. Air/Foam Detector Alarm
h. Power Failure Alarm
i. Blood Pump Alarm
6. Discontinue Dialysis
a. Dialysis Catheter
b. Fistula/ Vein Graft
c. Return of Blood
d. Post Treatment Access Care
e. Equipment Clean Up
f. Sterilization Procedures
COMPUTERIZED CHARTING
1. Cerner
2. Eclipsys
3. Epic
4. McKesson
5. Meditech
6. Other:

2|Page
 DIALYSIS NURSING KNOWLEDGE & SKILLS CHECKLIST

Name:       ID #:      

Please check the boxes below for each age group for I HAVE CURRENT CERTIFICATIONS FOR:
which you have expertise in providing age-appropriate
nursing care. TYPE EXPIRATION DATE (MM/DD/YY)
ARRHYTHMIA      
A. Newborn/Neonatal (birth – 30 days) CRITICAL CARE      
B. Infant (30 days – 1 year) ACLS      
C. Toddler (1 – 3 years) BLS      
D. Preschool (3 – 5 years) TNCC      
E. School Age Children (5 – 12 years) NRP      
F. Adolescent (12 – 18 years) PALS      
G. Young Adults (18 – 39 years) NALS      
H. Middle Adults (40 – 64 years) CCRN      
I. Older Adults (64 + years) Other            
Other            
EXPERIENCE WITH AGE GROUPS:
1. Able to assess age appropriate behavior, motor skills
and physiological norms. The information I have provided in this knowledge and
skills checklist it true and accurate to the best of my
A B C D E F G H I knowledge.

           
2. Able to adapt care according to normal growth and Signature (Written/Electronic) Date
development. ID #:      

A B C D E F G H I This skills checklist has been reviewed and approved by

Nicole Bloxham, RN.

3. Able to communicate and instruct patient according to            

their age, maturity and comprehension ability. Signature (Written/Electronic) Date
ID #:      
A B C D E F G H I
Please return to: Northwest Nurse Staffing Company, PA
ATTN: Records Dept.
Fax: (866) 352-4338
4. Able to provide a safe environment according to the
specific needs of various age groups. Email: records@nns-ic.com

A B C D E F G H I

3|Page