Skill Checklists
Sterile Processing Tech
Name
Email
LAST 4 OF SSN
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
Single instruments
Endoscopes
Repair
Sets/ Trays
Care of instruments
Other (list):
Manual cleaning
Washer sterilizer
Soiled linen
Disinfectants
Sharps
Disposable items
Cleaning equipment
Detergents
Dress code
Chart recording
Biological monitoring
Time
Testing/ Monitoring
Test control
Recording
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
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.
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