UCHC Competency Checklist: ORIENTATION
Position Title: Phlebotomist Employee Name: Unit: Laboratory Medicine
Method of Instruction Key: Method of Evaluation Key: Self-Assessment by Employee Validation of Competency
P = Protocol/Procedure Review O = Observation (in clinical setting)
Method of Evaluation
E = Education Session RD = Return Demonstration
Needs Instruction Method
S = Self Learning Package T = Written Test Never
Review/ Competent (Use Date Initials (Use
Done
C = Clinical Practice V = Verbal Review Practice Instruction Evaluation
D = Demonstration Key on Left) Key on Left)
A. PRACTICUMS & SKILL VALIDATIONS
PREPARATION:
Review contents of the Specimen Collection Manual online
Identify Central Processing, (phone ext. 2498) as a resource
Treat patients courteously and professionally
Verify patient identity according to policy
PERFORMANCE
Demonstrates use of universal precautions in a phlebotomy procedure
Demonstrates ability to collect blood with evacuated tube system (single tube)
according to protocol
Demonstrates ability to collect blood with evacuated tube system (multi-tube)
according to protocol
Observes patient for adverse response to phlebotomy:
Disposes of sharps according to policy
Labels specimens according to policy
Perform fingerstick/heel stick
Demonstrates ability to collect blood with a syringe
Demonstrates ability to collect blood with a “butterfly”
Perform blood cultures according to protocol
Collect Blood Bank specimens according to protocol
Initials Signature Initials Signature Initials Signature
Revised 12/2008 Page 1 of 1