INFECTION CONTROL COMPETENCY
Employee Name:
Date
-
Month
-
Day
Year
Date
Step 1
Rows
Score
Comments
Trainer Initials
Hand washing
Technique
Step 2
Rows
Score
Comments
Trainer Initials
Quality Control for
Glucometer Device
Use of Disposable
lancets
Step 3
Rows
Score
Comments
Trainer Initials
Cleaning of the
Glucometer Device
Step 4
Rows
Score
Comments
Trainer Initials
Bag Technique
legend:
Score:
P = Pass
R = Retake
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