Phlebotomist Skills Checklist

Please rate your experience / frequency within the last year
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)

Please rate your experience / frequency within the last year

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)

Please rate your experience / frequency within the last year
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)

MM slash DD slash YYYY

Age Of Patients Cared For

Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler/Preschool (13 months to 5 years)
School Age Child/adolescent (6 years to 18 years)
Young AdultsMiddle Adult (19 years to 64 years)
Older Adults/Elderly (65+ years)

General Skills

Standard Precautions
Isolation Precautions
Do you have charge/supervisor experience?
Knowledge of "Do Not Use Abbreviations"
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores
IV Pumps

Experience

Hospital Laboratory
Clinic Experience
Blood Bank

Patient Identification

Inpatient Identification
Infants and Young Children Identification
Emergency Department Identification
Ambulatory patient Identification

Equipment

Alcohol Swabs
Arterial Blood Gas Kits
Cotton Swabs
Occult Blood Packets
Heel Warmers
Infant Restraints
Laboratory Requisitions
Serum Separators
Vacutainer holder
Vacutainer Tubes
Order of Tubes
Blood Culture Bottles
Blood Culture Preparation Kits
Centrifuge
24 Hour Urine Containers
Capillary Blood Kits
Bacteria Media
Drug Screen Kits
Ova parasite Containers
Legal Blood Draw Kits
Paternity Blood Draw Kits
RSV Kits
Glucola

Complications/troubleshooting

Fainting
Hematoma
Failure to Draw Blood
Petechiae
Excessive Bleeding
Mastectomy
Edema
Collapsed Veins
Hemolysis
Burned or Scarred Areas