Instructions:

Please rate your experience / frequency (within the last year) using the following scale (check the appropriate boxes below):

  • 0 = No Experience / Observed Only
  • 1 = Limited Experience / Rarely Done (<6 times/year)
  • 2 = May Need Some Review / Occasionally Done (1 - 2 times/month)
  • 3 = Experienced / Frequently Done (daily or weekly)
  • PROCESSING
    Single Instruments
    Instrument Containers
    Endoscopes
    Repairs
    Wrapped Sets/Trays
    Care of Instruments
    SAFETY PROCEDURES
    Protective Attire
    Standard Precautions
    Sharps Handling
    Managing Biohazard Waste
    DECONTAMINATION
    Manual Cleaning
    Use of Washer
    Washer/ Disinfectors
    Washer/ Sterilizers
    Sharps
    Cleaning Equipment
    Detergents
    Chemical Agents for Decontamination
    Ultrasonic Cleaner
    STERILIZATION
    Steam Autoclave
    Gravity Displacement
    Prevacuum
    Flash
    Sterility Assurance Test
    Bowie Dick
    Biological
    Chemical
    Steam Sterilization
    Cart Loading/Load Documentation
    Testing Validation Procedures
    Trouble Shooting
    Gas (ETOH)
    Loading Procedures/Documentation
    Testing Validation Procedures
    Trouble Shooting
    Sterrad
    Loading Procedures/Documentation
    Testing Validation Procedures
    Trouble Shooting
    Steris
    Tray Loading/Documentation
    Testing Validation Procedures
    Trouble Shooting
    ASSEMBLY AND PREPARATION
    Instrument Set Assembly
    Wrapping Procedure
    Assembly of Peel Pack Items
    Preparation of Hard Instrument Containers
    Autoclave Tape
    Dust Covers
    Proper Towel/ Linen Folding
    Proper Labeling
    Expiration Dates
    Packing for Steam
    Peel Pack/Heat Sealing
    Instrument Count Sheets
    Physicians Preference Cards
    Sterile Storage Standards
    Case Picking
    SPECIALTY EQUIPMENT PROCESSING
    General
    Cardiac
    Endoscopy
    Laparoscopic
    Neurology
    OB/GYN
    Ophthalmology
    Orthopedics
    Plastics
    Robotics
    Urology