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The skills checklist, required by hospital hiring managers, is an important tool we use to help match you to an ideal assignment. This self-assessment form gives us an overview of your nursing experience and proficiencies so our recruiters are better able to find the positions that suit you. Select the appropriate checklist below and submit your completed form to us with one simple click. If your specialty is not listed below, or if you need additional information or assistance, please contact your local O'Grady Peyton International representative.

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Operating Room Nursing Skills Checklist

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This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Passport.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
(Country Code - Area Code - Local)
 
 
Please mark your level of experience
1. No experience; requires education, training and supervision 2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent 4. Expert level; can teach/supervise others
 
WORK SETTING
1 2 3 4
 
CVOR
 
First Assist
 
General OR
 
Ambulatory OR
 
Peds-General OR
 
Peds-CVOR
 
Trauma
 
Scrub Experience
 
SURGERY CASES
1 2 3 4
 
Bariatrics
 
Cardiac
 
Endo/Laparoscopic
 
ENT
 
General
 
GYN
 
Neuro
 
Neuro/Spine
 
Ophthalmology
 
Ortho
 
Ortho/Spine
 
Ortho/Total Joints
 
Plastics
 
Robotics
 
Thoracic
 
Transplant
 
Urology
 
Vascular
 
BARIATRICS
1 2 3 4
 
Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
 
Gastric Bypass
 
Gastric Sleeve
 
Lap Band
 
Laparoscopic Assisted Cases
 
Scrub Bariatric Surgery
 
TRAUMA
1 2 3 4
 
Amputations
 
Burns
 
Gunshot/Stab Wounds
 
MVA (multiple injuries)
 
Scrub Trauma Surgery
 
VASCULAR
1 2 3 4
 
Abdominal Aortic Aneurysm Repair
 
Aortocaval Fistula Repair
 
Aortoenteric Fistula Repair
 
Arteriovenous Fistula Repair
 
Arteriovenous malformation surgery
 
Atherectomy
 
Carotid Angioplasty
 
Carotid Artery Stenting
 
Carotid Endarterectomy
 
Endovascular Aneurysm Repair
 
Femoral Popliteal Bypass Graft
 
Renal Artery Bypass Surgery
 
TEVAR (Thoracic Endovascular Aortic Repair)
 
Vein Stripping
 
Scrub Vascular Surgery
 
ENDOSCOPIC PROCEDURES
1 2 3 4
 
Bronchoscopy
 
Colonoscopy
 
EGD
 
Peg Tube Placement/Exchange
 
Sigmoidoscopy
 
Scrub Endoscopic Surgery
 
GENERAL SURGERY
1 2 3 4
 
Abdominal Perineal Resection
 
Appendectomy/Cholecystectomy
 
Breast Biopsy
 
Colon Resection/Surgery
 
Fundoplication
 
Gastrectomy
 
Gastric Bypass
 
Laparoscopic General Surgeries
 
Mastectomy
 
Splenectomy
 
Thyroidectomy
 
Scrub General Surgery
 
CARDIAC/VASCULAR
1 2 3 4
 
Aortic Bypass Surgery
 
Cardiac Bypass/Valve Replacement
 
Carotid Endarterectomy
 
Endoscopic Vascular Procedures
 
Endovascular Aneurysm Repair
 
Laparoscopic Cardiac Surgery
 
Robotic Assisted Cardiac Surgery
 
Ventricular Assist Device
 
ECMO Insertion/Decannulation
 
Transcatheter Aortic Valve Replacement (TAVR)
 
Intra-Aortic Balloon Pump (IABP)
 
Pericardial Window
 
MAZE Procedure
 
Scrub CV Surgery
 
THORACIC
1 2 3 4
 
Esophagogastrectomy
 
Lobectomy
 
Thoracotomy-Lung Resection
 
Mediastinotomy/Sternotomy
 
Robotic Assisted Thoracic Surgery
 
Thoracoscopy
 
Video Assisted Thoracoscopic Surgery
 
Scrub Thoracic Surgery
 
ORTHOPEDIC
1 2 3 4
 
Arthroscopy
 
Arthrotomy
 
Birmingham Procedure
 
Laminectomy/Discectomy
 
External Fixators
 
Foot Procedures
 
Hand Procedures
 
Intramedullary Rodding Procedure
 
Knee Ligament Repair
 
ORIF Hip Fractures
 
ORIF Other Fractures
 
Total Joint Replacement
 
Scrub Orthopedics
 
SPINAL
1 2 3 4
 
Laminectomy/Discectomy
 
Lumbar Fusion
 
Cervical/Anterior Cervical Fusions
 
XLIF (Extreme Lateral Interbody Fusion)
 
Kyphoplasty
 
Spinal Fusion
 
NEUROLOGICAL
1 2 3 4
 
Minimally Invasive Surgery (MIS)
 
Microvascular Neurosurgery
 
Cerebral Aneurysm Clipping
 
Craniotomy
 
Insertion of Vagal Nerve Stimulator
 
Insertion of VP Shunt
 
Stereotactic Guided Brain Biopsy
 
Electroconvulsive Therapy (ECT)
 
Scrub Neurological Surgery
 
GENITOURINARY
 
Cystoscopy
 
TURP
 
Circumcision
 
Cystectomy
 
Laparoscopic GU Procedures
 
Nephrectomy
 
Orchidectomy/Orchidopexy
 
Prostatectomy
 
Robotic GU Procedures
 
Ureterostomy
 
Scrub GU Surgery
 
GYNECOLOGICAL
1 2 3 4
 
Abdominal/Vaginal Hysterectomy
 
Vulvectomy
 
Anterior Posterior Repair
 
C-Section
 
Laparoscopic Assisted Gynecological Procedures
 
Dilation & Curettage
 
Bilateral Tubal Ligation
 
Therapeutic Abortion
 
Laparotomy with Microtuboplasty
 
Scrub Gyn Surgery
 
EAR/NOSE/THROAT
1 2 3 4
 
Endoscopic ENT Procedures
 
Laryngectomy
 
Mastoidectomy/Tympanoplasty/Stapedectomy
 
Radical Neck
 
Septoplasty/Rhinoplasty
 
Tonsillectomy & Adenoidectomy
 
Tracheostomy
 
Laparoscopic Assisted Procedures
 
Scrub ENT Surgery
 
CRANIOFACIAL/ORAL
1 2 3 4
 
Lefort Procedures
 
ORIF Facial Fractures
 
Adult Dentistry
 
Deciduous Teeth Extraction
 
Closed Reduction Facial Fractures/Wiring
 
Excision Odontoma
 
Impacted Molar Extraction
 
Maxillary Procedure with Graft
 
Repair of Fractured Jaws, Mandibular and Zygomatic
 
Sagittal Osteotomy
 
Temporomandibular Joint (TMJ) Arthroplasty
 
TMJ Exploration
 
Scrub Craniofacial/Oral
 
PLASTIC
1 2 3 4
 
Blepharoplasty
 
Breast Augmentation
 
Breast Reconstruction
 
Breast Reduction Mammoplasty
 
Mastectomy with Tram Flap Reconstruction
 
Abdominoplasty
 
Fat Grafting
 
Rhinoplasty
 
Rhytidectomy (Face Lift)
 
Skin Graft
 
Sex Reassignment Surgery (SRS)
 
Scrub Plastics
 
TRANSPLANTS
1 2 3 4
 
Corneal
 
Heart
 
Liver
 
Lung
 
Kidney
 
Intestinal
 
Multiviseral
 
Organ Donation
 
Pancreas
 
Scrub Transplants
 
OPHTHALMOLOGY
1 2 3 4
 
Cataract Surgery
 
Eye Trauma
 
Glaucoma Surgery
 
Vitrectomy
 
Scrub Ophthalmology
 
PEDIATRICS GENERAL SURGERY
1 2 3 4
 
Anal Fistulectomy/Anoplasty
 
Gastroschisis Repair
 
Kasai Procedure (Hepato-Portoenterostomy)
 
Shuster Procedure (Omphalocele Repair)
 
Tracheoesophageal Fistula Repair
 
Appendectomy
 
Breast Mass Excisional Biopsy
 
Central Venous Line Insertion/Removal
 
Cholecystectomy
 
Colon Resection
 
Colostomy/Ileostomy Creations/Closure/Reversal
 
Epigastric Hernia Repair
 
Excision of Hemangiomas
 
Exploratory Laparotomy
 
Inguinal Hernia Repair
 
Laparoscopic scrub surgery
 
Nissen fundoplication
 
Scrub Peds General Surgery
 
PEDIATRICS BARIATRICS
1 2 3 4
 
Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
 
Gastric Bypass
 
Gastric Sleeve
 
Laminectomy
 
Lap Band
 
Laparoscopic Assisted Cases
 
Scrub Bariatric Surgery
 
PEDIATRICS ENDOSCOPIC PROCEDURES
1 2 3 4
 
Bronchoscopy
 
EGD
 
Flexible Sigmoidoscopy
 
Peg Tube Placement/Exchange
 
Scrub Endoscopic Surgery
 
PEDIATRICS GYNECOLOGY
1 2 3 4
 
Congenital Anomalies
 
Labia Reduction
 
Labial Adhesions
 
Pelvic Masses
 
Vulvar Lesions/Masses
 
Scrub Pediatrics Gynecology Surgery
 
PEDIATRICS PODIATRY
1 2 3 4
 
Club Foot
 
Juvenile Bunion
 
Scrub Pediatrics Podiatry Surgery
 
PEDIATRICS GENITOURINARY
1 2 3 4
 
Circumcision
 
Hydrocelectomy
 
Orchiectomy/Orchidopexy
 
Pyeloplasty
 
Repair of Hypospadias
 
Nephrectomy
 
Cystoscopy/Cystogram/Pyelogram
 
Ureteral Procedures
 
Scrub Peds GU
 
PEDIATRICS NEURO
1 2 3 4
 
Craniotomy
 
Insertion of VP Shunt
 
Rhizotomy
 
Spinal Fusion
 
Endovascular Neurosurgery
 
Endovenous Ablation
 
Neruoendoscopy for Brain/Spinal Tumors
 
Spinal Bifida Repair
 
Vagus Nerve Stimulator
 
Craniectomy
 
Scrub Peds Neuro
 
PEDIATRICS CARDIAC/VASCULAR
1 2 3 4
 
Arterial Switch
 
ASD/VSD Repair
 
Atrial Septectomy
 
Bidirectional Glenn
 
Blalock-Taussig Shunt
 
Fontan Procedure
 
Norwood Procedure
 
PDA Ligation
 
Repair of Coarctation of Aorta
 
Ross Procedure
 
Tetralogy of Fallot Repair
 
ECMO Insertion/Decannulation
 
Epsteins’s Anomaly Repair
 
Valve Repair/Replacement
 
Ventricular Assist Device Implant
 
Scrub Peds Cardiac/Vascular
 
PEDIATRICS TRANSPLANT
1 2 3 4
 
Heart
 
Kidney
 
Liver
 
Lung
 
Intestinal
 
Multiviseral
 
Organ Donation
 
Pancreas
 
Scrub Peds Transplant
 
PEDIATRICS OPHTHALMOLOGY
1 2 3 4
 
Corneal Transplant
 
Eye Muscle Surgery
 
Orbitotomy of Eye
 
Repair of Ptosis
 
Eye Trauma
 
Levator Resection
 
Vitrectomy
 
Scrub Peds Ophthalmology
 
PEDIATRICS EAR/NOSE/THROAT
1 2 3 4
 
Cochlear Implant
 
Laryngotracheoplasty
 
Myringotomy with Tubes
 
Septoplasty
 
Suspension Microlaryngoscopy
 
Tonsillectomy & Adenoidectomy
 
Tracheostomy
 
Tympanoplasty/Tympanomastoidectomy
 
Frenulectomy
 
Tympanoplasty
 
Scrub Peds ENT
 
PEDIATRICS CRANIOFACIAL/ORAL/PLASTICS
1 2 3 4
 
Pediatric Dentistry
 
Craniofacial Reconstruction
 
Dental Surgery
 
Lefort Maxillary Procedure
 
Mandibular Osteotomy
 
Open Cranial Vault Remodeling
 
Repair of Cleft Lip, Nose, Palate
 
Rhinoplasty
 
Otoplasty
 
Pharyngoplasty/Pharyngeal Flap Procedure
 
Skin Grafts
 
Scrub Peds C-Fl/Oral/Plastics
 
PEDIATRICS ORTHOPEDICS
1 2 3 4
 
Acetabuloplasty/Triple Innominate
 
External Fixators
 
Femoral Varus Derotational Osteotomy
 
ORIF Fractures
 
Tendoachilles Lengthening
 
Anterior Cruciate Ligament Reconstruction
 
Arthroscopy of Knee, Shoulder, Wrist
 
Arthrotomy
 
Closed Reduction of Fractures
 
Percutaneous Pin
 
Spinal Fusion/Spinal with Instrumentation
 
Scrub Peds Ortho
 
OR EQUIPMENT
1 2 3 4
 
Lasers:
 
CO2
 
Holmium
 
YAG
 
Other Laser Types
 
OR Fracture Tables:
 
Amsco
 
Mizuho
 
Skytron
 
Steris
 
Stryker
 
Other Fracture Tables
 
Robotics Systems:
 
DaVinci
 
Other Robotics Systems
 
Spinal Fusion Instrumentation:
 
MedTronic
 
Depuy
 
Synthes
 
NuVasive
 
Other Spinal Fusion Instrumentation
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Isolation Precautions
 
Patient/Family Teaching
 
Administer and Monitor Moderate Sedation
 
Fall Risk Assessment/Prevention
 
Malignant Hyperthermia Protocol
 
National Patient Safety Goals/Core Measures
 
Pressure Ulcer Risk Assessment/Prevention
 
Restraints/Use of Least Restrictive Device
 
Universal Protocol for Wrong Site Surgery
 
National Patient Safety Goals/Core Measures
 
Interpretation and communication of lab values
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
PISCES
 
Cerner
 
Epic
 
McKesson
 
Meditech
 
Other Computerized System (List Types)
 
CERTIFICATIONS (Current at time of completing this form)
 
ACLS
 
CNOR
 
RNFA
 
BLS
 
PALS
 
Other: Specify
 
Other: Specify
Operating Room Nursing Skills Checklist, version 12

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided will result in being ineligible to work with AMN Healthcare. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.
O'Grady Peyton International staffs nursing jobs for individuals wanting to work in the United States. We staff travel nurses domestically and fill long-term nursing and allied health assignments for international providers.
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