Sleep Technologist Skills Checklist

Requested by:

Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

Email Address: *

Confirm email: *

PATIENT CARE SETTINGS

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Acute care/hospitals	1234
Independent sleep labs	1234
Skilled nursing facility	1234
Private home setting	1234
Tele-health sleep studies	1234

PATIENT PREPARATION

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Hook up - full head	1234
Patient CPAP Trials	1234
Patient IPAP Trials	1234
Patient pre-study calibration	1234
Hook up - seizure	1234
Hook up - Standard 10-20	1234

SLEEP STUDIES & CLINICAL SKILLS

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Full mask fitting	1234
Nasal mask fitting	1234
Nasal ventilation	1234
Esophageal pressure tube insertion	1234
Oxygen set up - nasal cannula	1234
Oxygen set up - mask	1234
Oxygen set up - trach	1234
Oxygen titration	1234
Placement of body electrodes	1234
Scoring	1234
ECGs	1234
ECG rhythms	1234
Oxygen saturation monitoring	1234
Staging sleep, respirations, PLMs	1234
Audio video monitoring	1234
EEGs	1234
EEG rhythms	1234
Endotracheal suctioning	1234
Nasotracheal suctioning	1234
Multiple sleep latency test	1234
Night terror study	1234
Portable sleep study at home	1234
Portable sleep study in hospital	1234
REM behavioral disorder precautions	1234
Research studies	1234
Seizure study	1234
Sleep logs	1234
Study of sleep walking	1234
Wake study	1234

EQUIPMENT & REPORTING

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Troubleshooting all equipment (e.g. leak levels pressure release, humidification, etc.)	1234
Alice 3	1234
Alice 4	1234
Biological	1234
Digitrace	1234
Grass Digital Systems	1234
Medgraphics Lab	1234
Medgraphics P series	1234
Nicolet	1234
Nihon Koden Digital	1234
Sandman	1234
Sensormedics	1234
Sullivan CPAP	1234
Sullivan VPAP	1234
Teca	1234
Calculations - AHI	1234
Calculations - RDI	1234
Calculations - TST	1234
Technologist observation and summary	1234
Histograms, hypnogram	1234

SYSTEMS

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

100% digital	1234
Paper (Graph)	1234
Windows-based software	1234
DOS-based software	1234

PHARMACOLOGY

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Steroids (inhaled)	1234
Bronchodilators (inhaled)	1234
D-Nase (pulmozine)	1234
Dopamine	1234
Morphine sulfate	1234
Pavulon	1234
Pentamidine (NebuPent)	1234
Ribaviran (Virazole)	1234
Tobramycin	1234

SAFETY & INFECTION CONTROL

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Verifying patient identity prior to treatment	1234
National patient safety goals	1234
Effective communication with patients	1234
Effective interdisciplinary communication with peers, providers, etc.	1234
Universal precautions	1234
Contact precautions	1234
Droplet precautions	1234
COVID-19 precautions	1234
High risk for falls	1234
Bleeding precautions	1234
Aspiration precautions	1234
Suicide precautions	1234
Rapid response system	1234
Emergency codes	1234

AGE SPECIFIC CARE

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Infant (birth to 1 year)	1234
Toddler (ages 1-3 years)	1234
Preschooler (ages 4-5 years)	1234
Childhood (ages 6-12 years)	1234
Adolescent (ages 13-21 years)	1234
Young adults (ages 22-39 years)	1234
Adults (ages 40-64)	1234
Older adults (ages 65-79 years)	1234
Elderly (ages 80+ years)	1234

Attestation

ATTESTATION: *

I certify that the information provided above accurately reflects my experience in each of the clinical areas identified within the past three years.

If you agree with the Attestation above, please electronically sign your name. *