Sterile Processing Technologist CheckList

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Processing Rating Stars (Click) 1 2 3 4  
Single instruments 
Sets/ Trays 
Care of instruments 
Other (list): 
Decontamination Rating Stars (Click) 1 2 3 4  
Manual cleaning 
Washer sterilizer 
Soiled linen 
Disposable items 
Cleaning equipment 
Dress code 
Other (list): 
Steam Sterilization Rating Stars (Click) 1 2 3 4  
Chart recording 
Biological monitoring 
Testing/ Monitoring 
Other (list): 
Tests Rating Stars (Click) 1 2 3 4  
Test control 
Other (list): 
Assembly andPreparation Rating Stars (Click) 1 2 3 4  
Wrapping materials 
Autoclave tape 
Dust covers 
Proper towel/ linen folding 
Proper labeling 
Expiration dates 
Packing for steam 
Heat sealing 
Instrument count sheets 
Placing instruments on trays 
Other (list): 
Age Specific Competencies Rating Stars (Click) 1 2 3 4  
Infant (Birth - 1 year) 
Preschooler (ages 2-5 years) 
Childhood (ages 6-12 years) 
Adolescents (ages 13-21 years) 
Young Adults (ages 22-39 years) 
Adults (ages 40-64 years) 
Older Adults (ages 65-79 years) 
Elderly (ages 80+ years)