This checklist was electronically signed on (Today’s date)
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
Blood bank
Chem
Hemo
Micro
Serol
Procedure
Patient positioning
Fingerstick
Venipuncture
Warming the puncture site
Tourniquet application & removal
Decontamination of the puncture site
Tuberculosis exposure control plan
Post venipuncture site care
Order of tube collection
Arterial blood gas kits
Occult blood packets
Heel warmers
Pin worm kits
Serum separators
Blood culture preparation kits
Centrifuge
Capillary blood kits
Bacteria media
Drug screen kits
Ova parasite containers
Legal blood draw kits
Paternity blood draw kits
RSV kits
Acetone analysis
Atomic absorption
B12/fiolates
CSF protein
Drug monitoring
Electrolytes
Electrophoresis
Gas chromatography
Hepatitis
Hormone testing
Immunoelectrophoresis
Include blood gas
Main chemistry unit
Osmolality
Stool analysis (fecal fats)
Thin layer chromatography
Thyroid testing
Tumor markers
Background counts
Counters
Curves/regressions
Data reduction
Instrumentation/gamma
Radiation safety techniques
Scintillation counter
Antibody identification
Antibody titer
Blood irradiation
Component preparation
Direct
Indirect
Cross match
Donor unit collections
Emergency release
Freezing blood
Immediate spin cross match
Patient identification
Plasmapheresis
Plateletpheresis
Procedures
Rhogam
Antigen typing
Type, RH
Concentration techniques
Identification
Acid fast stain (fluorescent)
Acid fast stain (kinyoun)
Anaerobic culture
Anaerobic identification
Blood culture
C. difficile assay
Cell culture technique (viral)
Chlamydia culture
Chlamydia smear
Culture plating
Darkfield
Gram stain
India ink
KOH prep
Malarial examination
Myobacteria culture
Occult blood
Organism identification
Ova & parasite concentration
Trichcone
Wet mount
K.B.
M.I.C.
Virus isolation
Wet mount-motility
Automated instrumentation:
Large volume automation equipment
Small volume automation equipment
Crystal identification
Macroscopic U.A
Microscopic U.A
Semen analysis
Bleeding time
Body fluid count
CBC
D-dimer
Differential
Eosinophil count
Factor assays
Fetal hemoglobin
Fibrin split products/FDP
Fibrinogen
Lee-White clotting time
Platelet aggregation
Platelet count
PT & PTT
Reticulocyte count
Sedimentation rate
Special stains (PAS, peroxidase, leukocyte alkaline phosphatase)
Sickle cell prep
Thrombin time
ANA
ASO titer
C3, C4, total complement
Cold agglutinins
C-reactive protein
ELISA testing
Febrile agglutinations
Fluorescent testing
FTA-ABS
Hemagglutination inhibition
LE cell prep
Monospot
Pregnancy testing
Radial immuno diffusion
Rheumatoid factor
RPR
Rubella serology
TORCH studies
Accurate patient identification
Labeling
Effective communication
Infection control
Quality control/quality assurance
Assist with On-site procedure
Newborn / neonate (Birth-30 days)
Infant (31 days-1 year)
Toddler (2-3 years)
Preschool (ages 4-5 years)
School Age (ages 6-12 years)
Adolescents (ages 13-21 years)
Young Adult (ages 22-39 years)
Adults (ages 40-64 years)
Older Adult (ages 65-79 years)
Elderly (80+ years)
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