Louisiana State Board of Medical Examiners Clinical Laboratory Personnel Committee PO Box 2270, New Orleans, LA 70176-2270 Phone (504) 568-6820 Fax (504) 568-6823 Laboratory Assistant Competency Checklist (Rev. 10/2015 ) This form is to be completed by the Medical Director/Laboratory Director upon initial application and annually thereafter. only the procedures that the Lab Assistant demonstrates proficiency with CLIA standards as evidenced by unit specified criteria. Trainer must be a licensed practitioner at the CLS level or a specialist qualified in that specialty area. Procedures listed are representative samples of the technical competencies necessary for safe clinical practice. This checklist is intended for licensure purposes only. Name of Lab Assistant: ________________________________________________ To be completed by Medical Director/Laboratory Director, CLS-Generalist or Specialist (if in specialty). General Laboratory Initial Initial √Competency Lab Assistant Trainer Miscellaneous Duties Centrifuge operation and maintenance Refractometer operation and maintenance Cytospin operation and maintenance Hood operation and maintenance Proper storage of specimens for testing Departmental record completion Departmental sample preparation Referral testing sample requirements, packaging, reporting – Specimen procurement Patient and sample identification Collection of samples Specimen labeling General venipuncture Heel stick Finger stick Whole blood bedside glucose testing Whole blood bedside testing other _______________________ Preparation of peripheral blood smears Collection of specimens for microbiology Emergency identification procedure Specimen collection for drug testing Handling of bio-hazardous materials/waste Guidelines for specimen rejection/acceptance Participation in proficiency testing program duties Hematology Specific Instrument ________________________ Review Policy/Procedure Manual Daily startup procedure Run and review Q.C.
Louisiana State Board of Medical Examiners Clinical Laboratory Personnel Committee PO Box 2270, New Orleans, LA 70176-2270 Phone (504) 568-6820 Fax (504) 568-6823 Laboratory Assistant Competency Checklist (Rev. 10/2015 ) This form is to be completed by the Medical Director/Laboratory Director upon initial application and annually thereafter. only the procedures that the Lab Assistant demonstrates proficiency with CLIA standards as evidenced by unit specified criteria. Trainer must be a licensed practitioner at the CLS level or a specialist qualified in that specialty area. Procedures listed are representative samples of the technical competencies necessary for safe clinical practice. This checklist is intended for licensure purposes only. Name of Lab Assistant: ________________________________________________ To be completed by Medical Director/Laboratory Director, CLS-Generalist or Specialist (if in specialty). General Laboratory √Competency Initial Lab Assistant Initial Trainer Miscellaneous Duties Centrifuge operation and maintenance Refractometer operation and maintenance Cytospin operation and maintenance Hood operation and maintenance Proper storage of specimens for testing Departmental record completion Departmental sample preparation Referral testing – sample requirements, packaging, reporting Specimen procurement Patient and sample identification Collection of samples Specimen labeling General venipuncture Heel stick Finger stick Whole blood bedside glucose testing Whole blood bedside testing other _______________________ Preparation of peripheral blood smears Collection of specimens for microbiology Emergency identification procedure Specimen collection for drug testing Handling of bio-hazardous materials/waste Guidelines for specimen rejection/acceptance Participation in proficiency testing program duties Hematology Specific Instrument ________________________ Review Policy/Procedure Manual Daily startup procedure Run and review Q.C.
CLP%20Competency%20Checklist%20Lab%20Assistants%2010%202015.docx