Quality Control Clinical Site

PERFORMANCE EVALUATION: MDL *** - PHL

Student: Sara Allen ald

Semester: Fall / Grind Summer 2024

joes not Meets)

EBOTOMY

piss rate the student’s profession competency and skill,

UIRED: professianal competencies student must meet to pass

meet

Arrives on time, begins promptly, completes shift, attends regularly

» beg! ptly, J hi

i pr p!, atten i

a onstrates prope: ygicne, dresses appropriately and professionally

ae ee ae

Exhibits patient confidentiality within HIPAA parameters

Safety

Demon.

si = Tae

trates consistent safe practice within industry standards

Maintains a safe, clean & orderly work station

f Adhere PEE and demonstrates proper hand washing

S to site specific safety and/or isolation procedures

0

2

Y Efficiency

Unsatisfactory

Needs

Improvement Standards

Accu

Pee performs verbal and written directions

rms tasks with minimal error and supervision

iG -

Ompletes assigned tasks thoroughly and in an orderly manner

Organize wi

b ganize workflow for maximal efficiency.

Y Integrity

Recognizes limitati

nae nizes limitations and asks for help when unsure

eres to site specific protocols

Y_ Professionalism

Demons: i

onstrates readiness and preparation for work in advance

S$ = 5

States facts and responds to basic questions

eacts in a calm & logical manner under stress

Red issi ifies i

Re juests permission, notifies instructor of absence and or tardiness

fA 5 es F

municates with staff, co-workers and patients in a professional manner

High error Moderate exror

Unacceptable

(10-15%). (5-10%)

Displays self-confidence and professional poise

¥ Technical Skill

error (>15%)

Records patient data within industry accuracy standards

Distinguishes acceptable/non-acceptable samples using established criteria

Troubleshoots non-acceptable samples

Discusses phlebotomy theory, technique, quality control

Recognizes and promptly corrects errors using sound decision making skills

Efficiently collects specimens and retums them to lab for testing

Applies knowledge to perform tasks with sound judgment

Meets

Standards

90-95% success

Needs

Improvement

85-90%

Proficient

tisfact

Unease > 95% success

¥ Procedures

< 85%

SUCCESS,

wv

success.

Perform routine collection of adult, infant, and geriatric

Total:

Mee

v

7

N/A

patients Vacutainer (minimum 100)

[__ Total:

[}4.

20

26

inge

Syringe, [ Total:

N/A

fl

Butterfly _ [__Total:

Capillary

COLUMN TOTALS

Expected outcomes Will

Please place comments 0

SanhTe Mott

Site Evaluator OA JON

be evidenced by minimum scores of

n the back of this page.

dl

Clinical Site: Labcorp- [OHO.M

/ /

(an om ;

3 in all categories.

ate: 4/24 24 i

ve Richmond VA_ 23235

Date:

his evaluation with my preceptor.

i iew tl

ve had the opportunity to review

a

Student: adicates ! h

jenature indlc : ; revise

My sign jpor2: Advisory committee review/apProval

1/34 i

-2018

(Phieb)

EVAL-190!

“egy GOOD 1")

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