• RESPIRATORY THERAPIST SKILLS CHECKLIST

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  • Instructions

    Please check the appropriate column that best describes your experience level for each knowledge competency and skill. Please use the rating scale below to evaluate yourself based on experiences within the last two years.

  • Self-Assessed Experience Rating Scale

    1 = No Experience  2 = Minimal Experience

    3 = Performs well/competent  4 = Supervise & Teach

  • Skills

    Treatment/ Procedures

  • 1. Assessment

  • 2. Interpretation of Lab Results

  • 3. Equipment and Procedures

    Airway Management Devices/ Suctioning

  • Care of the Patient With a Chest Tube:

  • Drawing Arterial Blood Gasses:

  • Medication Delivery Systems:

  • 02 Therapy:

  • Nebulizer:

  • Ventilator Set Up and Care:

  • 4. Care of the Patient With:

  • 5. Medications

    Administration of:

  • Familiar with the Effects Of:

  • 6. Phlebotomy

    Equipment & Procedures:

  • 7. Neonatal/ Pediatrics

    Equipment & Procedures:

  • Care of the Infant or Child With:

  • 1. Age Specific Practice Criteria

  • 2. Care of Patient with:

  • Experience With the Following Ventilators:

  • Ventilator:

  • Certification

    Please check the boxes below and indicate the expiration date for each certificate that you hold. If you do not know the exact date, please use the last date of the specific month (Example: 1/31/2012).
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  • I hereby certify all statements and claims as true and that any misrepresentation of the facts on this checklist is sufficient cause for dismissal at any time without prior notice even if I have been already employed.

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  • Should be Empty: