RESPIRATORY SKILLS CHECKLIST

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Job Description: Registered Respiratory Therapist Assists in the diagnosis, treatment, and management of patients with pulmonary disorders. Collects and analyzes sputum, blood, and breath specimens to determine levels of oxygen, carbon dioxide, and other gases. Also measures the lung capacity of a patient to determine if there is impaired function. Requires an associate's degree and a credential of Registered Respiratory Therapist (RRT). May be expected to maintain a CPR certification. Familiar with standard concepts, practices, and procedures within a particular field. Relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks. A certain degree of creativity and latitude is required. Typically reports to a manager.

KEY: For each criteria Score 1: Two plus years Expert Experience Score 2: One-Two Years Current Experience Score 3: Less than one year or Intermittent Experience Score 4: Theory, no experience

CRITERIA	SCORE
	1 2 3 4
FLOOR THERAPY
CRITICAL CARE
Names of ventilators with which you have the most experience:
1. 2. 3. 4. 5.
CARDIOVASCULAR
Cardio/Resp. Arrest Team
Arterial Monitoring
Pulmonary Artery Monitoring
CVP
EKG's
Holter EKG
Stress Testing
Cardiac Output Monitoring
IABP
PEDIATRIC
Resuscitation
Intubation
Extubation
Ventilators most experienced with
1. 2. 3. 4. 5.
NEONATAL
Resuscitation
Intubation
Extubation
Assist in High Risk Delivery
Aerosol Treatment
CPT
Ventilators most experienced with
1. 2. 3. 4. 5.
OTHER SKILLS
Ambulance Transport
Portable Respiratory Equipment
Ventilators most experienced with
1. 2. 3. 4. 5.
Pulmonary Function Testing
Arterial Blood Gases
Drawing
Analysis
Insertion of A-Lines
Adult Intubation
Adult Extubation
Certified EKG Technician
Arterial Blood Gas Tech
Certification Eligible (date: )
CRTT#
Registry Eligible (date: )
RRT#
SETTING
Hospital
Mobile Unit
Research
Home Health
Clinic
Other

AGE SPECIFIC CARE
Please indicate the frequency with which you provide care for each age group inthis specialty area.	1	2	3	4
Infant (Birth to 1 year)
Toddler (1-3 years)
Pre-school (3-6 years)
School Age (6-12 years)
Adolescent ( 12-18 years)
Young Adult ( 18-30 years)
Mature Adult (30-60 years)
Elderly (>60 years)

JCAHO: I acknowledge and understand JCAHO's list of "Do Not Use Abbreviations" : Yes No

The information I have given is true and accurate to the best of my knowledge. I have read and fully understand the job description. By signing below or submitting electronically, I attest that the information provided within this skills checklist represents a full and complete disclosure of information, and is true and correct to the best of my knowledge and belief. I hereby authorize Sagent Healthstaff to release this skills checklist to client facilities for employment purposes.

* I agree with the above statements. : Yes

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* Date: (mm/dd/yyyy) :