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Departments & Programs,UW Health,Ambulatory Education,Checklists - Core and Department Specific,Resources

Cardiology - Nuclear Tech

Cardiology - Nuclear Tech - Departments & Programs, UW Health, Ambulatory Education, Checklists - Core and Department Specific, Resources


CARDIOLOGY – NUCLEAR TECHNOLOGIST CLINICAL TRAINING CHECKLIST ----- This is due three months from hire date------

Employee Name: __________________________________ Employee Credentials:________ Hire Date: ____________

Clinic Location/ number: _______________________ Employee Number ________________________

*** N/A on checklist indicates that it is not indicated for the employee***
*Refer to appropriate UWMF policy ***Each area should either be discussed or observed by preceptor***

AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Employee is able to gather data relevant to the following:
Patient’s personal and family health history
Patient’s perception of current problem
Onset of precipitating factors, to worsening symptoms or alleviating factors and

Accompanying factors to patient’s conditions (such as SOB to chest pain )
Obtains vital signs, smoking history and EKG when indicted *
Ability to extract and assemble pertinent clinical information from the patient
and/or patient record

S/S ANGINA - pain or pressure in chest, arms back or jaw comes w/ exertion,
relieved w/rest

S/S UNSTABLE ANGINA - chest pain or discomfort along with weakness,
feeling sick to stomach or fainting, feeling of impending doom Unrelieved with 3
nitro’s tabs

S/S CHF - SOB, swelling legs and stomach, Wt gain, fatigue, nausea or anorexia.
Sleeping on 2 or more pillows

S/S ATRIAL FIBRILLATION – SOB, Racing heart, palpitation, fatigue
dizziness and chest pain

S/S DYSRHYTHMIA – syncopal episodes, palpitations, skipped or fast heart rate
Able to elicit patient’s expectations in medical care
Able to determine patient’s knowledge level/deficit and ability to understand
Able to identify cultural practices related to care
Able to elicits info regarding relationships with significant others

AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Employee has knowledge and education in the following areas
Field of nuclear medicine technology and related aspects of chemistry,
mathematics, physics, and other biomechanical sciences

Biological effects of radiation exposure, principles of radiation protection and
personal monitoring devices to assure minimal radiation exposure

Principles involved in radiation detection, especially those connected with gas
ionization chambers and scintillation detectors for use with radiation safety

Radioactive decay with special emphasis on beta-decay, electron capture,
metastable states, gamma emission and internal conversion

Interactions of radiation with matter with special emphasis on photoelectric effect
and Compton interactions

Pharmaceuticals including aseptic technique, labeling parameters quality controls,
route of administration, half life (physical, biological and effective), mechanism of
localization and metabolism, potential adverse reactions, dosimetry and therapeutic

Anatomy and physiology with special emphasis on abnormalities as it applies
patient exams, including structure, function and location or major organ systems,
anatomical position and proper identification of organs on film

Employee has knowledge and is competent to perform the following:
Collimated radiation detectors with special emphasis on the characteristics of flat
field focused, parallel-hole and pin-hole collimators in response to point, line and
plane sources

Quality control and quality assurance principles of nuclear medicine detection and
imaging devices including field uniformity, linearity, spatial and energy resolution,
and sensitivity

Quality control principles of compounding radiopharmaceuticals using reference
standards and particle separation techniques

Counting equipment for preparing, collecting and analyzing patient data such as a
dose calibrator, gamma camera, well counter and probe


AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Employee has knowledge and is competent to perform the following:
Computer systems and data collection and analysis parameters used to interpret
patient exams, as well as for generating reports or scheduling patient studies and
radiopharmaceutical tracking, compounding, dispensing and disposal

Logarithms and exponential functions to support quality control and data reduction
Nuclear medicine operational procedures including: obtaining supplies and
radiopharmaceuticals/ pharmaceuticals, scheduling patients for exams and
coordinating personnel work activities

Basic operation of equipment to perform minor repairs and maintenance
Ability to teach new techniques and procedures to personnel
Administer IM, SQ, ID, and sublingual medications *IV Meds

Equipment and Supplies
Assure all equipment/supplies are available based on patient needs –
Assure all equipment functions before use – IMED, EKB, TM, Pulse Ox

Assure all emergency equipment/supplies are current and available at all times

Procedures- Demonstrate competence to assist/set-up/patient care/follow-up,

Ability to formulate radiopharmaceuticals including the use of radionuclide
generators considering chemical properties, quality control and sterility

Ability to set up and operate a variety of ancillary equipment (e.g. auto-gamma
counter, EKG machine, infusion pump, etc.).

Knowledge of regulatory, licensing and accrediting agency requirements,
mediolegal responsibilities and status governing nuclear medicine operations, such
as the regulations and guidelines of the Radiation Safety Committee, NRC, FDA,
OSHA, CLIA and US Pharmacopia requirements, to assure compliance with their
standards of operation. ICANL

Knowledge of radiation safety procedures and regulations as established within the
department and outside regulatory agencies

Knowledge of CLIA Laboratory License and standards of license
Knowledge of nursing procedures concerning IV’s, urinary catheters, blood
pressure, heart rate, seizures, transfer of patients, CPR, etc. *

Proper and complete labeling of specimens and paperwork (in needed)


AREA OF ORIENTATION Discussed Observed Preceptor’s Signature Completed date
Knowledge of ICANL Accreditation Requirements

Provides URGENT Patient Care – Employee is able to:
Initiates EKG monitoring (when indicted) *
Initiates LifePack 12 Defibrillation (if indicted)
Appropriately care for patient requiring an EKG interpretation
Appropriately care for patient requiring anti-arrhythmic medication
Initiate Chest Pain Protocol appropriately (see Emergency Procedures Manual)
Appropriately care for patient requiring anit-anginal medication
Appropriately care for patient with cardiopulmonary arrest (until advanced help

Understands and can appropriately set-up the crash cart

I, _________________________________________ (employee name) have completed the NUCLEAR TECHNOLOGIST CLINICAL TRAINING CHECKLIST and attest the
information is true and valid. I have demonstrated or discussed these skills and I am responsible for performing patient care as a Certified Medical Assistant / Licensed Practical
Nurse / Registered Nurse (circle one).

__________________________________________________ ___________________
Preceptor Date

____________________________________________________ ___________________
Supervisor Date

__________________________________________________ ___________________
Provider Date

Additional Preceptor Signatures/initials:
1. _________________________________________________
2. _________________________________________________
Initially Completed 2.2007; updated 2/11, 9/11, 3/12, 2/14, 6/14, 3/17

 Send the original signed Clinical Training Checklist to Clinical Staff Education - 1035.
 One copy of the signed Clinical Training Checklist should be placed in the clinic’s staff employee’s file, and a copy given to the employee.

Brener, T., Doyle, R.M. (Ed.). (2008). Nursing 2008 drug handbook. Philadelphia, PA: Lippincott Williams & Wilkins.
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby Elsevier.