Tele Tech/EKG Skills Checklist

SKILLS CHECKLIST

Tele Tech/EKG All the fields are mandatory

Name

Telephone (999-999-9999)

Who is your recruiter?

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 : -	1 = Never Performed	2 = Limited Experience	3 = Comfortable Performing	4 = Proficient
Frequency : -	1 = Never	2 = Sometimes	3 = Often	4 = Always

Cardiovascular Electrophysiology

Transmembrane potentialProficiencyFrequency

GeneralProficiencyFrequency

Action potentialProficiencyFrequency

EKG interpretation

GeneralProficiencyFrequency

Heart blocksProficiencyFrequency

ECG Techniques and Recognition

ECG measurementProficiencyFrequency

Here is the corrected General section with proper sequential name values starting from p1f70:

GeneralProficiencyFrequency

ECG, Holter, and Stress Testing Instrumentation

GeneralProficiencyFrequency

Stress Test Techniques and Contraindications

ProtocolsProficiencyFrequency

GeneralProficiencyFrequency

Pharmacologic

GeneralProficiencyFrequency

Emergency medicationsProficiencyFrequency

Vital Signs

PulseProficiencyFrequency

PalpationProficiencyFrequency

Blood pressureProficiencyFrequency

TemperatureProficiencyFrequency

Here is the corrected Recognition of Recording Errors/Artifacts, Ergometers, ECG Leads, Skin preparation, and Age Specific sections with proper sequential name values starting from p1f150:

Recognition of Recording Errors/ Artifacts

GeneralProficiencyFrequency

Ergometers

GeneralProficiencyFrequency

ECG Leads

GeneralProficiencyFrequency

Skin preparation

GeneralProficiencyFrequency

Age Specific:ProficiencyFrequency

Years Experience in Clinical Specialty :

Most recent facility worked at :

I hereby certify that ALL information I have provided to Clover Health Services, on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.