EP Lab Orientation Checklist Our Lady of the

EP Lab Orientation Checklist Our Lady of the Lake Regional Medical Center Rating Scale: Orientee: 1 = Competent 2 = Able to perform with supervision 3 = Needs more practice N/A = Not applicable General Orientation: 2 Days Objective Orientee Preceptor Tour of EP Lab Brief overview of lab equipment Understands expectations Study materials assigned Review of cardiac anatomy Review of conduction system Preceptor Orientee Date Circulator Orientation: 20 Cases Objective Orientee Preceptor Exhibits competency with all circulator duties from the Cath Lab Prepares patient for various procedures, including patch placement, flush lines, etc. Administers medications properly Recognizes rhythms Defibrillates/Cardioverts appropriately Able to trouble shoot equipment Able to insert NG tube Able to insert Foley catheter Able to safely apply and use Bovie pad Preceptor Orientee Date Source: Our Lady of the Lake Regional Medical Center, Baton Rouge, LA; Cardiovascular Roundtable interviews and analysis. © 2015 The Advisory Board Company 1 advisory. com

EP Lab Orientation Checklist (Cont. ) Our Lady of the Lake Regional Medical Center Scrub Orientation: 30 Cases Objective Orientee Preceptor Exhibits competency with all scrub duties from the Cath Lab Prepares patient for various procedures Sets up appropriate equipment for various cases Identifies appropriate catheters and cabling Operates Prucka Operates pacing generator Pulls sheaths Recognizes rhythms Understands different ablation systems Understands different pacing systems Introduced to different mapping systems Introduced to Hansen system Preceptor Orientee Date Monitor Orientation: 10 Cases Objective Orientee Preceptor Exhibits competency with all monitor duties from the Cath Lab Recognizes rhythms Properly identifies and charts catheters used Recognizes case flow Charges appropriately for all procedures Assists with the case as needed Preceptor Orientee Date Source: Our Lady of the Lake Regional Medical Center, Baton Rouge, LA; Cardiovascular Roundtable interviews and analysis. © 2015 The Advisory Board Company 2 advisory. com

EP Lab Orientation Checklist (Cont. ) Our Lady of the Lake Regional Medical Center Review: 1 Day Objective Orientee Preceptor Review of study material Discussion of cases Questions Preceptor Orientee Date Circulator Orientation 2: 10 Cases Objective Orientee Preceptor Demonstrates proficiency with all competencies learned during the first phase of circulator training with minimal guidance from preceptor Further discussion of cases Questions Able to perform circulator duties without supervision Preceptor Orientee Date Scrub Orientation 2: 20 Cases Objective Orientee Preceptor Demonstrates proficiency with all competencies learned during the first phase of scrub training with minimal guidance from preceptor Demonstrates advanced understanding of EP equipment Able to perform scrub duties without supervision Preceptor Orientee Date Source: Our Lady of the Lake Regional Medical Center, Baton Rouge, LA; Cardiovascular Roundtable interviews and analysis. © 2015 The Advisory Board Company 3 advisory. com

EP Lab Orientation Checklist (Cont. ) Our Lady of the Lake Regional Medical Center Monitor Orientation 2: 5 Cases Objective Orientee Preceptor Demonstrates proficiency with all competencies learned during the first phase of monitor training with minimal guidance from preceptor Recognizes and appropriately reacts to rhythm changes Able to perform monitor duties without supervision Preceptor Orientee Date Final Review Objective Orientee Preceptor Orientee has learned all skills necessary to perform independently in the EP Lab Preceptor Orientee Date Preceptor Source: Our Lady of the Lake Regional Medical Center, Baton Rouge, LA; Cardiovascular Roundtable interviews and analysis. © 2015 The Advisory Board Company 4 advisory. com