Skill Checklists
MLT/MT/CLS/MLS
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
Component Preparation
Special Blood Typing
Procedures
Patient Identification
Freezing Blood
Antibody Identification
Antibody Titer
Blood Irradiation
Cold Agglutinins
Direct Coombs Test
Indirect Coombs Test
Cross Match
Donor Unit Collections
Immediate Spin Cross Match
Plasmapheresis
Rhogam
Kell, Kidd, Duffy, RH HR, MNS, Lewis, P
Type RH
Automated Instrumentation
Crystal Identification
Semen Analysis
Macroscropic UA
Microscopic UA
Body Fluid Count
Bleeding Time
Lee-White Clotting Time
Differential
Eosinophil Count
Factor Assays
Fibrinogen
Fibrin Split Products/FDP
Platelet Aggregation
Platelet Count
PT and PTT
Reticulocyte
Sedimentation Rate
Sickle Cell Prep
PAS, Peroxidase, Leukocyte, Aldaline, Phosphatase
Thrombin Time
Fetal Hemoglobin
Acetone Analysis
Atomic Absorption
Thin Layer Chromatography
Gas Chromatography
CSF/Body Fluid Drug Monitoring
CSF/Body Fluid Electrolytes
Electrophoresis
Immunoelectrophoresis
Osmolality
Stool Analysis
Instrumentation Used - Blood Gas
Instrumentation Used - Main Chemistry Unit
Hemagglutination Inhibition
Pregnancy Testing
Meningitis Screen
Body Fluids
Rubella Serology
ANA
ASO Titer
C3, C4, Total Complement
Febrile Agglutinations
FTA-ABS
LE Cell Prep
Monostat
RAdial Immuno Diffusion
Rheumatoid Factor
RPR
Basic Safety Guidelines: gloves and goggles
Communication Skills
Ability to Write Procedures
Masks
Use of Balance (weighing)
Anticoagulants - Knowledge of Tube Types and Uses
Calculation for Solution Prep: Molarity and Molality
Finger Stick
Heel Stick
M.L.A.
Operation of Centrifuge
Pediatric
Pipetting
To Contain
To Deliver
Venipuncture
Volumetric
Blood Culture
Cell Culture
Aerobic Culture
Anaerobic Culture
Anaerobic Identification
Mycobacteria: Culture
Sensitivities
Virus Identification
Virus Isolation
Acid Fast Stain (Fluorescent)
Acid Fast Stain (Kinyoun)
C Difficili Assay
Concentration Techniques
Culture Plating
Darkfield
Gram Stain
Identification
India Ink
KOH Prep
M.I.C
Chlamydia Culture
Chlamydia Smear
Malarial Examination
Occult Blood
Organism Identification (Aerobic)
Ova and Parasite Concentration
Ova and Parasite Identification: Trichone
West Mount – Mobility
Wet Mount
Data Reduction
Curves/Regression
Counters
Background Counts
Scintillation Counter
Hormone Testing
Radiation Safety Techniques
Instrumentation/Gamma Counters
B12/Folates
Hepatitis
Thyroid Testing
Tumor Markers
Allscripts
Cerner
Epic
HomeCare Home Base
McKesson
Meditech
Other Computerized Documentation System
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.
