Anesthesia Technologist Skills Checklist One program to handle all talent management needs from acquisition to development Personal Information This field is hidden when viewing the formOverall ScoreName(Required) First Middle Last Last 4 Digits of Social Security NumberEmail(Required) This field is hidden when viewing the formDate MM slash DD slash YYYY Proficiency Scale1 – No Experience 2 – Need Training 3 – Able to perform with supervision 4 – Able to perform independentlyGENERAL SKILLS EXPERIENCEProper identification of patient using at least 2 identifiers(Required) 1 2 3 4 Proper identification/labeling of all lab or specimen results(Required) 1 2 3 4 Pre-procedural time-out process(Required) 1 2 3 4 Demonstrate application of all monitoring devices(Required) 1 2 3 4 Understanding of scope of practice and limitations as a certified anesthesia technician(Required) 1 2 3 4 Prioritize tasks related to role and function(Required) 1 2 3 4 Delegating responsibilities to other team members of anesthesia team(Required) 1 2 3 4 Knowledge of professional standards to uphold patient rights and confidentiality(Required) 1 2 3 4 Knowledge of "Do Not Use Abbreviations"(Required) 1 2 3 4 Charge/supervisor experience(Required) 1 2 3 4 Knowledge of current Joint Commission National Patient Safety Goals(Required) 1 2 3 4 Knowledge/familiarity with HCAHPS scores(Required) 1 2 3 4 Basic life support(Required) 1 2 3 4 Purpose, use and care of physiological monitors relating to the administration of anesthesia(Required) 1 2 3 4 Biologic hazards, infection control, and standard precautions(Required) 1 2 3 4 Fire, electrical, laser and explosion hazards in the operating room and other anesthesia related areas(Required) 1 2 3 4 Storage, use and safe handling of bulk and cylinder gases(Required) 1 2 3 4 Structure, function and care of all components of anesthesia delivery systems(Required) 1 2 3 4 Sterile technique and the principals of aseptic practice(Required) 1 2 3 4 Usage of common anesthetic gases(Required) 1 2 3 4 Type and indications for local, monitored anesthesia care (MAC), regional and general anesthesia(Required) 1 2 3 4 Assists the licensed anesthesia providers in various settings(Required) 1 2 3 4 Performs duties under the direct supervision of a licensed anesthesia provider and/or Registered Nurse (RN)(Required) 1 2 3 4 Provides support for routine surgical cases by assisting in the preparation and maintenance of patient equipment and anesthesia delivery systems before, during and after anesthesia(Required) 1 2 3 4 Performs first level maintenance on anesthesia equipment(Required) 1 2 3 4 Cleans, sterilizes, disinfects, stocks, orders and maintains the routine anesthesia equipment and supplies(Required) 1 2 3 4 Principles of purchasing and supply levels(Required) 1 2 3 4 Communication skills(Required) 1 2 3 4 Ability to troubleshoot delivery systems, monitors, and ancillary devices(Required) 1 2 3 4 Participate in Quality Assurance(Required) 1 2 3 4 Maintain quality control records for anesthesia department(Required) 1 2 3 4 Use of electronic medical record charting(Required) 1 2 3 4 Participate in continuing education development for the certified anesthesia technician(Required) 1 2 3 4 Implement safety procedures and guidelines for fire safety and infection control(Required) 1 2 3 4 IV Pumps: Alaris(Required) 1 2 3 4 IV Pumps: Alibaba(Required) 1 2 3 4 IV Pumps: Bard(Required) 1 2 3 4 IV Pumps: Baxter(Required) 1 2 3 4 IV Pumps: Braun(Required) 1 2 3 4 IV Pumps: Other(Required) 1 2 3 4 Other IV Pumps(Required) 1 2 3 4 AGE-SPECIFIC EXPERIENCE:Newborn/Neonate (birth to 30 days)(Required) 1 2 3 4 Infant (31 days to 12 months)(Required) 1 2 3 4 Toddler/Preschool (13 months to 5 years)(Required) 1 2 3 4 School Age Child/adolescent (6 years to 18 years)(Required) 1 2 3 4 Young Adults/Middle Adult (19 years to 64 years)(Required) 1 2 3 4 Older Adults/Elderly (65+ years)(Required) 1 2 3 4 AuthorizationsLegal Consent(Required) I agree to the terms and conditions.Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. 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