Anesthesia Technician Skills Checklist

Fill Out and Submit your Skills Checklist

(Cath Lab Tech)

Your name

Your Email

Last 4 Of SSN

Date

E-Signature

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

AGE-SPECIFIC EXPERIENCE

Newborn/Neonate (birth to 30 days):

★★★★

Infant (31 days to 12 months):

★★★★

Toddler/Preschool (13 months to 5 years):

★★★★

School Age Child/adolescent (6 years to 18 years):

★★★★

Young Adults/Middle Adult (19 years to 64 years):

★★★★

Older Adults/Elderly (65+ years):

★★★★

GENERAL KNOWLEDGE

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:

★★★★

Basic life support:

★★★★

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:

★★★★

Type and indications for local, monitored anesthesia care (MAC), regional and general anesthesia:

★★★★

Assists the licensed anesthesia providers in various settings:

★★★★

Performs duties under the direct supervision of a licensed anesthesia provider and/or Registered Nurse (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:

★★★★

Communication skills:

★★★★

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:

★★★★

IV PUMPS

Alaris:

★★★★

Alibaba:

★★★★

Bard:

★★★★

Baxter:

★★★★

Braun:

★★★★

CADD:

★★★★

IVAC:

★★★★

Zynomed:

★★★★

N/A: YesNo