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.
AGE OF PATIENTS CARED FOR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Newborn/Neonate (birth to 30 days) |
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Infant (1 month to 1 year) |
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Toddler (1 year to 3 years) |
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Preschooler (3 years to 5 years) |
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School Age Child (5 years to 12 years) |
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Adolescents (12 years to 18 years) |
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Young Adults (18 years to 39 years) |
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Middle Adults (39 years to 64 years) |
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Older Adults (64 years to 79 years) |
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Elderly Adults (over 79+ years) |
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GENERAL LABORATORY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Centrifuge Operation and Maintenance |
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Refractometer Operation and Maintenance |
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Cytospin Operation and Maintenance |
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Hood Operation and Maintenance |
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Proper Storage of Specimens for Later Testing |
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Departmental Record Completion |
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Departmental Sample Preparation |
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Referral Testing – Sample Requirements, Packaging, Reporting |
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Patient and Sample Identification |
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Collection of Samples |
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Specimen Labeling |
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General Venipuncture |
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Heel Stick |
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Finger Stick |
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Whole Blood Bedside Glucose Testing |
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Preparation of Peripheral Blood Smears |
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Collection of Specimens for Microbiology |
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Emergency Identification Procedure |
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Specimen Collection for Drug Testing |
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Handling of Biohazardous Materials/Waste |
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Guidelines for Specimen Rejection/Acceptance |
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Standard Precautions |
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Isolation Precautions |
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Electronic Documentation |
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TESTING | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Daily Startup Procedure |
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Run and Review Q.C. |
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Follow Policy/Procedure Corrective Action for Out-of-Range Q.C. |
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Perform CBC Testing |
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Perform PT and APTT Testing |
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Perform Urinalysis Dipstick Procedures |
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Perform Urinalysis Microscopic Procedures |
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Perform Confirmation Testing for Positive Results |
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Kit Testing (RPR, H. Influenza, Monotest UPT, RSV, Strep A Screen, Rotavirus, etc.) |
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Culture Routine, Collection, and Setup |
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Culture Collection Procedure |
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Set Up Culture According to Protocols |
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Proper Planting Techniques |
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Seek Assistance for Critical or Absurd Results |
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Report Acceptable Results |
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Save/Archive/File Patient Results Per Policy |
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Perform Preventative Maintenance |
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Ability to Troubleshoot Instruments per Policy |
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CYTOLOGY SPECIFIC | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
Assist with Collection of Bronchoscopy |
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Assist with Fine Needle Aspiration |
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Assist with Cyst Aspiration |
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Assist with Buccal Smears |
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Assist with Renal Biopsies |
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Assist with Effusions |
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Assist with Pleural Biopsies |
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Assist with Cytogenetics Prep |
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Logging and Accessioning of Specimens |
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Fixation of Specimens |
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Staining and Coverslipping |
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Processing of Specimens by Centrifuge Method |
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Processing by Cytocentrifuge Method |
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Filing Slides, Requisitions, and Reports |
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Carbowax Preparation |
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Cresyl Violet Preparation |
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3% Amphyl Preparation |
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10% Bleach Preparation |
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Scott’s Tap Water Preparation |
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Saponin Preparation |
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Centrifuge Operation and Maintenance |
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Fume/Biological Hood Operation and Maintenance |
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