Clinical Competency III Skills Test Form

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PLEASE FAX FORMS TO: 866.241.7526 (Toll Free) ATTN: Health Sciences Clinical Placement Department Please do not mail or email. Clinical Competency III Skills Check Off Name of Student:____________________________ Student ID (last 4 digits SS#):___________________ Directions: Please initial each skill as it is completed. Once all appropriate skills have been initialed, the approved staff member must sign the document. Documents that are not signed by the approved staff member cannot be accepted. Required Skills (Must be performed during clinical experience) Staff member initials Recommended Skills Student should complete as many skills as possible, minimum of at least four recommended skills is required. Staff member initials…show more content…
blood glucose testing) Properly dispose of sharps Administer injections (unless prohibited by law) Prepare medications Screen test results Clinical Instructor: Prepare items for autoclaving/use autoclave Perform sterilization (of instruments or surfaces) Perform EKG Perform First Aid (basic bandaging and care of acute injuries) Demonstrate use of fire extinguisher Use proper body mechanics Simple maintenance of office equipment (i.e. loading paper/toner, keeping maintenance log) Demonstrate use of OSHA required eyewash equipment Pulmonary function testing/spirometry Administer oral medication Perform quality control testing Hematology testing Urinalysis Immunology testing Obtain specimens for microbiological testing Perform CLIA waived microbiological testing I certify that this student was able to complete the skills listed above at a satisfactory level of performance for an entry level medical
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