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Skills Checklists

Congratulations on your decision to apply for an allied position with ClubStaffing! Before we can offer you an allied employment opportunity, an electronic skills assessment must be completed. From the skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!

ClubStaffing
5901 Broken Sound Pkwy.
Suite 450
Boca Raton, Florida 33487
Fax: (561) 367-0884


Polysomnographic Technologist Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
1. No experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others
 
WORK SETTINGS
1 2 3 4
 
Freestanding Sleep Clinic
 
Hospital
 
STUDY TYPES
1 2 3 4
 
Adult MSLT/MWT
 
Pediatric MSLT/MWT
 
Seizure Study
 
Research Study
 
Portable Sleep Study
 
ELECTRODE PLACEMENT - EEG
1 2 3 4
 
Standard 10-20 Hook-Up
 
Seizure Hook-Up
 
Full head Hook-Up
 
ELECTRODE PLACEMENT - BODY
1 2 3 4
 
ECG
 
Face
 
Intercostal Leads
 
Limb Leads
 
MONITORING
1 2 3 4
 
ECG
 
EEG
 
End-Tidal CO2
 
O2 Saturation
 
PLM
 
STAGING & SCORING
1 2 3 4
 
Arousal
 
Cheyne-Stokes
 
Complex Sleep Apnea
 
Hypopnea
 
Obstructive Sleep Apnea
 
Periodic Breathing
 
Respiratory Events
 
Sleep Stages
 
MASK FITTING
1 2 3 4
 
Full Face
 
Nasal Mask
 
Nasal Pillow
 
TITRATION
1 2 3 4
 
ASV
 
BiPAP
 
CPAP
 
VPAP
 
MEDICATION EFFECT ON SLEEP STUDY
1 2 3 4
 
Alcohol
 
Benzodiazepines
 
Caffeine/Stimulants
 
Opioids
 
SSRI
 
Tricyclic Antidepressants
 
EQUIPMENT
1 2 3 4
 
Nihon Kohden
 
ResMed
 
Respironics
 
Other (Specify):
 
Other (Specify):
 
Other (Specify):
 
TECHNOLOGY
1 2 3 4
 
Software (Specify):
 
Software (Specify):
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Patient Education
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computer Physician Order Entry
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
Other: Specify
 
Other: Specify
 
EMR Conversion
 
CERTIFICATIONS/LICENSURES/REGISTRATIONS(Current at the time of completing this form)
 
BLS
 
RPSGT
 
CPSGT
 
RST
 
RRT
 
CRTT
 
Other: Specify
Polysomnographic Technologist Skills Checklist, version 7

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

© 2018 AMN Healthcare, Inc. All rights reserved. Reproduction and distribution of these materials is prohibited without the expressed written authorization of AMN Healthcare, Inc.