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Skills Checklists

Before you can begin applying for NurseChoice assignments, you need to complete a skills checklist. Required by hospitals, this mandatory form highlights your skills, proficiencies and experience in your specialty. The quickest and easiest way to complete your skills checklist is online. Just select your specialty from the list below, enter the necessary information on the form and click to submit. Once we receive your completed skills checklist you will be one step closer to finding a rewarding travel assignment that meets your needs.

Sterile Processing Technologist Skills Checklist

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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*
Last 4 of Social Security Number*
- -
E-Mail Address* Phone Number*
Please mark your level of experience
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
1 2 3 4
Single Instruments
Wrapped Sets
Instrument Containers
Endoscopes (indicate types)
Safety Procedures
1 2 3 4
Protective Attire
Standard Precautions
Sharps Handling
Managing Biohazardous Waste
1 2 3 4
Use of Washers
Detergent Use and Refills
Chemical Agents for Decontamination
Ultrasonic Cleaner
Equipment (e.g. crash carts, IV pumps)
1 2 3 4
Steam Autoclave
• Gravity Displacement
• Prevacuum
• Flash
Sterility Assurance Tests
• Bowie Dick
• Biological
• Chemical
Steam Sterilization
• Load Documentation
• Cart Loading
• Testing Validation Procedures
• Trouble Shooting
Gas (ETOH)
• Load Documentation
• Loading Procedures
• Testing Validation Procedures
• Trouble Shooting
• Load Documentation
• Loading Procedures
• Testing Validation Procedures
• Trouble Shooting
• Load Documentation
• Tray Loading
• Testing Validation Procedures
• Trouble Shooting
Assembly and Preparation
1 2 3 4
Instrument Set Assembly
Selection of Appropriate Wrapping Material
Assembly of Peel Pack Items
Preparation of Hard Instrument Containers
Wrapping Procedure
Selection of Sterilization Tapes
Towel/Linen Folding
Labeling Standards
Peel Pack/Heat Sealing
Instrument Count Sheets
Physician Preference Cards
Case Picking
Sterile Storage Standards
Specialty Equipment Processing
1 2 3 4
Other Specialty Service
Other Specialty Service
Age specific practice criteria
A. Newborn/Neonate (birth - 30 days) F. Adolescents (12 - 18 years)
B. Infant (30 days - 1 year) G. Young adults (18 - 39 years)
C. Toddler (1 - 3 years) H. Middle adults (39 - 64 years)
D. Preschooler (3 - 5 years) I. Older Adults (64+)
E. School age children (5 - 12 years)
Please check the boxes below for each age group for which you have expertise in providing age-appropiate care
Experience with age groups
Able to adapt care to incorporate normal growth and development
Able to adapt method and terminology of patient instructions to their age, comprehension, and maturity level.
Can ensure a safe environment reflecting specific needs of various age groups
Yrs. SPT: In-Patient OR
SPT: In-Patient OR - # of Suites
Yrs. SPT: Ambulatory Surg. Center
SPT: Ambulatory Surg. Center - # of Suites
Yrs. Surgical Tech: In-Patient OR
Surgical Tech: In-Patient OR - # of Suites
Yrs. Surgical Tech: Ambulatory Surg. Center
Surgical Tech: Ambulatory Surg. Center - # Suites
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Certified Sterile Processing & Distribution Technician (CSPDT)
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Certified Surgical Instrument Processor (CSIP)
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Certified Flexible Endoscope Reprocessor (CFER)
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Certified Surgical Technologist (CST)
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Other Certification 
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Other Certification 
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Sterile Processing Technologist Skills Checklist, version 1

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. 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.

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