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
(PROFICIENCY)
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
(FREQUENCY)
1 = Never performed observed only
2 = Less than 6 times per year
3 = 1-2 times per month
4 = Daily or Weekly
PROFICIENCY / FREQUENCY
PROFICIENCY
FREQUENCY
Proper identification of patient using at least 2 identifiers
Proper identification/labeling of all lab or specimen results
Pre-procedural time-out process
Demonstrate application of all monitoring devices
Understanding of scope of practice and limitations as a certified anesthesia technician
Prioritize tasks related to role and function
Delegating responsibilities to other team members of anesthesia team
Knowledge of professional standards to uphold patient rights and confidentiality
Knowledge of 'Do Not Use Abbreviations'
Do you have charge/supervisor experience?
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores
Purpose, use and care of physiological monitors relating to the administration of anesthesia
Biologic hazards, infection control, and standard precautions
Fire, electrical, laser and explosion hazards in the operating room and other anesthesia related areas
Storage, use and safe handling of bulk and cylinder gases
Structure, function and care of all components of anesthesia delivery systems
Sterile technique and the principles of aseptic practice
Usage of common anesthetic gases
Performs duties under the direct supervision of a licensed anesthesia provider and/or RN
Provides support for routine surgical cases by assisting in the preparation and maintenance of patient equipment and anesthesia delivery systems before, during and after anesthesia
Performs first level maintenance on anesthesia equipment
Cleans, sterilizes, disinfects, stocks, orders and maintains the routine anesthesia equipment and supplies
Principles of purchasing and supply levels
Ability to troubleshoot delivery systems, monitors, and ancillary devices
Participate in Quality Assurance
Maintain quality control records for anesthesia department
Use of electronic medical record charting
Participate in continuing education development for the certified anesthesia technician
Implement safety procedures and guidelines for fire safety and infection control
Section 4: IV Pump Experience - Select IV pump brands you have experience with (Checkboxes):