PROCEL Operating Room Technician Skills Competency Checklist
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- Lorin Day
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1 DIRECTIONS Please place a check mark next to each question to provide us and the interested facilities with an assessment of your clinical experience. One box must be checked for each skill listed. Last 4 Digits of Social Security Number: SERVICE: CARDIOVASCULAR Abdominal Aneurysm Axillary-Femoral Bypass Carotid Endarterectomy Creation/Revision AV Fistula Graft Femoral-Popliteal Bypass Insertion Chest Tubes Insertion of Intra-aortic Balloon Mediastinoscopy SERVICE: OPEN HEART AICD CABG VALVES Thoracomtomy Lobectomy Transvenous Pacemaker SERVICE: ENT Caldwell-Luc Laryngo-Tracheoplasty Mastoidectomy Myringotomy ORIF Nasal Fractures Pharyngoplasty Septoplasty/Rhinoplasty Sinus Scope Procedures Sphenoidectomy Stapedectomy T & A Transnasal Polypectomy, Ethmoidectomy Triple Endoscopies SERVICE: ENDOSCOPY Colonoscopy Bronchoscopy EGD Sigmoidoscopy ERCP
2 SERVICE: GENERAL PROCEDURES Abdominal Perineal Resection Appendectomy Axillary Node Dissection Breast Biopsy/Lumpectomy Colon/Small Bowel Resection Colostomy/Ileostomy Epigastric/Vental Hernia Repair Exploratory Laparotomy Gastrectomy Hemorrhoidectomy Incisional Hernia Repair Inguinal Hernia Repair Laparoscopic Appendectomy Laparoscopic Bowel Resection Laparoscopic Cholecystectomy Laparoscopic Hernia Repair Modified/Radical Mastecomy Pilonidal Cystectomy/Fistulectomy Pyeloroplasty Vagotomy Sigmoidoscopy Splenectomy Umbilical Hernia Repair Vein Ligation and Stripping SERVICE: GENITO-URINARY Circumcision Creation Ileal Loop Cyctectomy Insertion Penile Prosthesis Nephrectomy Open Renal Biopsy Orchiectomy/Orchiopexy Prostatectomy - Suprapubic/Retropubic Retroperitoneal Lymphadenectomy Ureterolithotomy/Pyelolithotomy Vasectomy ORT Skills Page 2
3 SERVICE: GYNECOLOGY Abdominal Hysterectomy Anterior/Prosterior Repair Cervical Cone Biopsy/LEEP Circlage Culdoscopy/Culposcopy D & C C/S LAPAROSCOPIC PROCEDURES: Diagnostic Laparoscopy Endometrial Ablation/Myomectomy Hysterectomy Laparoscopic Assisted Vaginal Hysterectomy Pelviscopy Marshall Marchetti Myomectomy Post Partum Tubal Ligation Salpingoplasty/Tuboplasty Vaginal Hysterectomy SERVICE: LASER CASES Bronchoscopy Cholecystectomy Craniotomy for Tumors Hemorrhoidectomy/Pilonidalcyst Laparoscopy/Pelviscopy Laryngoscopy/Base of Tongue Spinal Tumors Tonsillectomy Turbinectomy SERVICE: HEAD & NECK - MICROVASCULAR Glossectomy Laryngectomy Mandibular/Maxillary Resection MICROVASCULAR RECONSTRUCTION (FACIAL) Adbominus-Rectus Graft Gracillus Muscle Graft Lattisimus Dorsi Graft Myocutaneous Graft Osteocutaneous Graft ORT Skills Page 3
4 SERVICE: HEAD & NECK - MICROVASCULAR cont. Parascapular Graft Serrtus Muscle Graft Oral Resection Tumors Palatectomy Parotidectomy Pharyngectomy Radical Neck Dissection Thyriodectomy/Parathyriodectomy Tracheostomy SERVICE: MAXILLO - FACIAL Arch Bars Application Mandibular/Maxillary Osteotomies Surgical Extraction of Teeth TMJ Arthroscopy SERVICE: NEUROSURGERY Burr Holes Craniofacial Reconstruction Craniotomy for Aneurysm Craniotomy for Tumor Implantation of Deep Brain Stimulators Insertion of VP Shunt Posterior Occipital Craniotomy Steriotactics SERVICE: OPTHALMIC Anterior Vitrectomy Blepharoplasty Dacrocystorhinostomy Entropian Repair Enucleation Irridectomy KPE with IOL Implant Penetrating Keratoplasty Pterygium Repair Radical Keratotomy Scleral Buckle Strabismus Repair Trabeculectomy Vitrectomy ORT Skills Page 4
5 SERVICE: ORTHOPEDICS MAJOR PROCEDURES ACL Reconstruction AKA/BKA Ankle Fractures Arthrodesis & Tendon Repair Bankhart Acrioplasty Bunionectomy Clubfeet Repair Correction Hammertoes Femoral Rodding (IM) Humeral Rodding ORIF of Ankle, Supracondylar ORIF of Forearm, Carpals & Metacarpals ORIF Hip Fractures: AMBI Synthes Osteonics Gamma ORIF Pelvic Fracture Patellectomy Rotator Cuff Repair Total Athroplasty Hip Total Athroplasty Knee Total Athroplasty Shoulder Triple Athrodesis MINOR PROCEDURES: Carpal Tunnel Release Closed Reduction Dupuytron's Contracture Release Hip Spica Adult/Infant Matrixectomy Trigger Finger Release ORTHO-NEURO PROCEDURES: Cervical Fusions Laminectomy/Discectomy w/neuro Lumbar Fusions Thoracic Fusions ORT Skills Page 5
6 SERVICE: ORTHOPEDICS continued: SCOPE PROCEDURES: Ankle Arthroscopy Athroscopic Carpal Tunnel Knee Arthoscopy Shoulder Arthroscopy Wrist Arthroscopy SPECIAL EQUIPMENT OSI Fracture Table Andrews Table Zimmer Tourniquets Space Suits Laminar Flow Jackson Table Four Poster Frame Mayfield Head Rest Dyonics Arthroscopy Pump Hip Positioner Knee Positioner Judet Table Shoulder Suspension Four Poster Frame Mayfield Head Rest Dyonics Arthroscopy Pump Hip Positioner Judet Table Shoulder Suspension SERVICE: PLASTIC SURGERY Cleft Palate/Lip Repair OFIF Zygomatic Fracture ORIF Facial Fracture ORIF Orbital Fracture Scar Revision Split Thickness Skin Graft ORT Skills Page 6
7 SERVICE: GI-LAB Colon (50cm), biopsy Colonoscopy ERCP Internal Auditory Canal Mesentery Mass of Sall Bowel Rectum, biopsy Small Intestine, biopsy Sigmoidoscopy Credentialing and Expiration Dates Are you BCLS Certified? YES NO Exp Date: Are you a Certified Surgical Technologist? YES NO Exp Date: Additional Certifications: Certification: Certification: Exp Date: Exp Date: Have had ONE year of experience in this area within the last THREE years. YES NO Technician Signature Date Agency (Name/Title) Date ORT Skills Page 7
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