Obstetrics Technician Skills Checklist

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Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

Email Address: *

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GENERAL SKILLS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Advanced directives	123
National Patient Safety Goals/Core Measures	123
Awareness of HCAHPS scores	123
Accurate patient identification	123
Use of proper body mechanics	123
Use of transfer/lifting devices	123
Infection control/ handwashing	123
Universal Precautions	123
Isolation Precautions	123
Minimize Fall Risks	123
Computerized Charting	123
Crash Cart	123
Defibrillator	123
Electronic Medical Record	123
Labeling of lab specimens	123
Care of Patient in restraints	123
Obtain Vital Signs	123
Patient/Family Education	123
Ensures HIPAA Compliance	123

VITAL SIGNS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Obtain manual Blood Pressure	123
Obtain temperature	123
Obtain Height and Weight	123
Oxygen therapy and delivery	123
Pulse oximetry/pulse check	123
Monitor and record Intake and Output	123

OB/GYNECOLOGY:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Prepare delivery room	123
Assist with Dilation & Curettage	123
Assists with C-Section recovery under the guidance of the RN	123
Assists with Vaginal delivery recovery under the guidance of the RN	123
Suction Curettage	123
Tubal Ligation	123
Hysterectomy Laparoscopic	123
Hysterectomy -Vaginal	123
Vulvectomy	123
Marshall Marchetti	123
Vaginal Reconstruction	123
Radium Insertion	123
Laser Surgery	123
Tubal Ligation	123
Shirodkar Procedure	123
Termination of Pregnancy	123
Anterior repair	123
Documents patient data accurately	123
Urine specimen/culture	123
Vaginal specimen/ culture	123
Posterior Repair	123
Diagnostic Laparoscope	123

EQUIPMENT:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Robotics	123
Electrocautery	123
Specimen count	123

STERILIZATION OF EQUIPMENT:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Log	123
Biological Indicators	123
Autoclave Operations	123
STERIS	123
Steam	123
GAS	123
FLASH	123

WORK SETTING EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Acute care hospital	123
Long term care	123
Rehabilitation center	123
Home health/private duty	123
Hospice	123

AGE-SPECIFIC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Newborn / neonate (birth-30 days)	123
Infant (31 days-1 year)	123
Toddler (ages 2-3 years)	123
Preschool (ages 4-5 years)	123
School age (ages 6-12 years)	123
Adolescent (ages 13-21 years)	123
Young adult (ages 22-39 years)	123
Adult (ages 40-64 years)	123
Older adult (ages 65-79 years)	123
Elderly (ages 80+ years)	123

Attestation

ATTESTATION: *

I certify that the information provide 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. *