This checklist was electronically signed on
September 12, 2026
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
PATIENT RIGHTS
COMMUNICATION
GENERAL INFECTION CONTROL MEASURES
TRANSMISSION-BASED PROTOCOL
GENERAL LABORATORY TESTING
GENERAL LAB TESTING - PREPARE APPROPRIATE
GENERAL LAB TESTING - CORRELATE LAB DATA WITH
EVALUATE LABORATORY DATA
BLOOD BANK
HEMATOLOGY
MICROBIOLOGY/VIROLOGY
URINALYSIS AND BODY FLUIDS
SEROLOGY/IMMUNOLOGY
PHLEBOTOMY
CHEMISTRY
PROTEINS/ NITROGEN-CONTAINING COMPOUNDS
RIA
AGE-SPECIFIC COMPETENCIES