Skills Checklist – Sterile Processing Technologies

Skills Checklist – Sterile Processing Technologist

• Name
  
  First
  
  Last
• Phone
• Email
  
• PROCESSING*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Single Instruments
  Endoscopes
  Repair
  Sets/ Trays
  Care of Instruments

• DECONTAMINATION*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Steam Sterilization
  Low Temperature Sterilization
  Manual cleaning
  Washer Sterilizer
  Soiled Linen
  Disinfectants
  Sharps
  Disposable Items
  Cleaning Equipment
  Detergents
  Dress code
  Proper labeling

• OTHER (LIST):*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Test Control
  Recording

• ASSEMBLY AND PREPARATION*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Sterile Storage Standards
  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

• Age Group Experience*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Newborn (birth – 30 days)
  Infant (30 days – 1 year)
  Toddler (1 – 3 years)
  Preschooler (3 – 5 years)
  School Age (5 – 12 years)
  Adolescents (12 – 18 years)
  Young Adults (18 – 39 years)
  Middle Adults (39-64 years)
  Older Adults (64+ years)

• Do you speak any languages other than English?*
  • No

  If yes, enter languages above, separated by commas.

• Confirmation*
  • 
    I attest that the information I have given is both true and, to the best of my knowledge, represents an accurate self assessment of my professional skills and/or education.
• Signature
• Date
  
  Date Format: MM slash DD slash YYYY