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STERILE PROCESSING TECHNOLOGIST SKILLS | ||||||
| NAME | |||||||
| LAST 4 OF SSN | |||||||
| DATE | |||||||
| I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination. | |||||||
| 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 |
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| Rating Stars (Click) | Processing | 1 | 2 | 3 | 4 | ||
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Single instruments | ||||||
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Endoscopes | ||||||
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Repair | ||||||
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Sets/ Trays | ||||||
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Care of instruments | ||||||
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Other (list): | ||||||
| Rating Stars (Click) | Decontamination | 1 | 2 | 3 | 4 | ||
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Manual cleaning | ||||||
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Washer sterilizer | ||||||
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Soiled linen | ||||||
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Disinfectants | ||||||
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Sharps | ||||||
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Disposable items | ||||||
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Cleaning equipment | ||||||
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Detergents | ||||||
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Dress code | ||||||
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Other (list): | ||||||
| Rating Stars (Click) | Steam Sterilization | 1 | 2 | 3 | 4 | ||
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Chart recording | ||||||
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Biological monitoring | ||||||
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Time | ||||||
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Testing/ Monitoring | ||||||
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Other (list): | ||||||
| Rating Stars (Click) | Tests | 1 | 2 | 3 | 4 | ||
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Test control | ||||||
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Recording | ||||||
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Other (list): | ||||||
| Rating Stars (Click) | Assembly andPreparation | 1 | 2 | 3 | 4 | ||
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Wrapping materials | ||||||
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Autoclave tape | ||||||
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Dust covers | ||||||
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Proper towel/ linen folding | ||||||
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Proper labeling | ||||||
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Expiration dates | ||||||
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Packing for steam | ||||||
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Heat sealing | ||||||
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Instrument count sheets | ||||||
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Placing instruments on trays | ||||||
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Other (list): | ||||||
| Rating Stars (Click) | Age Specific Competencies | 1 | 2 | 3 | 4 | ||
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Infant (Birth - 1 year) | ||||||
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Preschooler (ages 2-5 years) | ||||||
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Childhood (ages 6-12 years) | ||||||
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Adolescents (ages 13-21 years) | ||||||
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Young Adults (ages 22-39 years) | ||||||
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Adults (ages 40-64 years) | ||||||
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Older Adults (ages 65-79 years) | ||||||
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Elderly (ages 80+ years) | ||||||