Biomedical Technician Competency Validation Checklist

This form is to be jointly completed to assess the technical competency of our employees and identify opportunities for improvement. This form is not an employee evaluation, but will be used as input during the evaluation process.

NAME:
New / or Semi Annual Date: Annual / Date: LE ND:
A. B. C. D. E. F. G. Review Policy Direct Observation Video Review/Testing Skills Lab/Proficiency Testing Written Exam Service School Other (Specify) Initials Date How Met Emp Facility Customer Evaluator

JOB TITLE:
CBET Certified / Expiration Date: CRES Certified / Expiration Date: CLES Certified / Expiration Date: STANDARDS: LEVELS OF PERFORMANCE:
Demonstrates Proficiency in Performing Technical Procedures Safely in Accordance with Department Standards as Evidenced by Unit-Specific Criteria. 0 1 2 3 N/A Not Applicable Needs Assistance - Little or no experience Minimal Assistance - Some experience Perform Independent -Competent/Experienced Resource/Instructor - CompetentAble to teach

STANDARD
This section is to be completed with the customers input. Environment of Care - Demonstrates knowledge of: 1. Safety Department specific and hospitalwide safety risks 2. Security Processes for minimizing security risks 3. Haz Mat/Waste Emergency procedures for spill/MSDS 4. Emergency Preparedness Role during emergency drills 5. Life Safety Role in fire drills/response to fire 6. Med Equipment Safe operation of equipment (see specific list) 7. Utility systems Emergency procedures for utility failures Infection Control 1. Hospital wide approach to Performance Improvement 2. Location/use of personal protective equipment Performance Improvement - Demonstrates Knowledge of: 1. Hospitalwide approach to Performance Improvement 2. How Biomed assists/participates in hospitalwide PI program Patient Rights - Demonstrates Knowledge of: 1. Patient rights and responsibilities 2. Confidentiality Policy 3. Ethical Issue Resolution Policy 4. Organizational Ethics Policy

Level of Performance Self Customer Eval Evaluator

Date

How Met

Emp

BIOME D Evaluator

BIOMED CORE COMPETENCIES

Use of Biomedical Test Equipment 1. Safety Analyzer 2. Patient Simulator 3. Defibrillator Analyzer 4. Electrosurgical Unit Analyzer 5. Blood Pressure Analyzer 6. Infusion Pump Analyzer 7. Anesthetic Gas Analyzer 8. Respiratory/Ventilator Function Analyzer 9. MultiMeter 10. Digital Pressure Meter 11. Digital Thermometer 12. Analog/Storage Oscilloscope 13. Power Supply 14. Frequency Counter/generator 15. Function generator 16. RF Meter 17. Maintain annual test equipment calibration and records 18. Spectrum analyzer

Self Eval

BIOME D Evaluator

Date

How Met

Emp

BIOME D Evaluator

BIOMED CORE COMPETENCIES

Environmental Health & Safety Program 1. Bloodborne Pathogens 2. Hazard Communications 3. Energy Control 4. Injury/Illness Reporting 5. Emergency Contingency Plan 6. Ergonomics/Back Safety Use of Computer Based Equipment Maintenance Program 1. Inventory Addition, Deletion, Modification 2. Schedule Planned Maintenance 3. Review of Equipment History 4. Search Functions 5. Open/Close Demand Work order 6. Close PM work order 7. Knowledge of Activity and Failure codes for tracking/trending 8. Producing reports Equipment Management Report to Safety Committee 1. Standard Safety Committee Report 2. Liaison Report 3. Department Could Not Locate equipment report

Self Eval

BIOME D Evaluator

Date

How Met

Emp

BIOME D Evaluator

OPERATION AND PREVENTATIVE MAINTENANCE

Alternating Pressure Pads Anesthesia Units (Specify Model), Vaporizers Apnea Monitor Intra aortic Balloon Pump (Specify Model) Bilirubinometer/Bili Lights NIBP Units/Modules Invasive Blood Pressure Units/Modules (arterial, left ventricle, CVP) Blood Pump (Specify Model) Cardiac Output Computer (CO module) Centrifuge Carbon Dioxide Module (CO2) Defibrillator Dialysis Equipment ECG Equipment EEG Equipment Electrosurgical Unit Fetal Monitors Fiberoptic Light Sources Holter Monitor System (Long Term ECG Recorders) Hypo/Hyperthermia units Infant Incubators/Isolette Infant Warmers Infusion Pumps Laboratory Equipment (Specify Model) Lasers, Optical Lasers, Surgical PCA Pumps Pulse Oximeters (SpO2) Physiologic Monitoring Systems (hardwired with central, War Rooms) Physical Therapy Ultrasound Physical Therapy Muscle Stimulators IT networks, SANs Cloud computing, Distributed Antenna systems

Self Eval

BIOME D Evaluator

Integration to EMRs/DataCaptor or other middleware Diagnostic Imaging equipment: (expand for DI service BMETs) 1. 2. 3. 4. 5. 6. 7. 8. 9. Sterilizers Surgical Microscope Surgical Operating Tables Surgical Video Camera Traction Unit Telemetry Systems Ventilators (Specify Model) Other (Please Specify) X-ray, R&F, portables, digital imaging CT Ultrasound MR Mammography Nuclear Medicine, PET, Molecular PACs CVIS Cath Lab

10. Radiation Oncology

Date:

List educational achievements since last revision:

Date:

Evaluators comments:

Date:

Employee comments:

Date: Date:

Employee signature: Evaluators signature: