MT/MLT Skills Checklist

Experience with Different Ages

Newborn (birth - 30 days)*

1
2
3
4

Infant (30 days - 1 year)*

1
2
3
4

Toddler (1 - 3 years)*

1
2
3
4

Preschooler (3 - 5 years)*

1
2
3
4

School Age (5 - 12 years)*

1
2
3
4

Adolescents (12 - 18 years)*

1
2
3
4

Young Adults (18 - 39 years)*

1
2
3
4

Middle Adults (39 - 64 years)*

1
2
3
4

Older Adults (64+ years)*

1
2
3
4

Certifications

ASCP MT/MLS*

Yes
No

ASCP MLT*

Yes
No

HEW*

Yes
No

AMT*

Yes
No

Blood Bank

Patient Identification Process*

1
2
3
4

ABO/Rh/Antibody Screen & ID*

1
2
3
4

Crossmatch- Immediate Spin/ IgG*

1
2
3
4

Antigen Typing*

1
2
3
4

Antibody Typing: Gel Method*

1
2
3
4

Antibody Typing: Tube Method*

1
2
3
4

Cold Agglutinins*

1
2
3
4

Rhogam Screening*

1
2
3
4

Coombs Test Direct*

1
2
3
4

Coombs Test Indirect*

1
2
3
4

Cord Blood Evaluation*

1
2
3
4

Thawing/ Cooling of Blood Products*

1
2
3
4

Donor Collection Procedures*

1
2
3
4

Issue Blood Product to Pt. Care Area*

1
2
3
4

Emergency Release*

1
2
3
4

Elutions*

1
2
3
4

Transfusion Reaction Workshop*

1
2
3
4

Irradiating Packed Cells*

1
2
3
4

Splitting a Baby Unit*

1
2
3
4

Chemistry

Specimen Preparation*

1
2
3
4

Acetone Analysis*

1
2
3
4

Arterial Blood Gas*

1
2
3
4

B-12 Folates*

1
2
3
4

Cardiac Enzymes*

1
2
3
4

Chromatography- Gas*

1
2
3
4

Chromatography- Thin Layer*

1
2
3
4

Electropheresis*

1
2
3
4

Hormone/ Thyroid*

1
2
3
4

Immunoassay*

1
2
3
4

Osmolality*

1
2
3
4

Therapeutic Drug Monitoring*

1
2
3
4

Tumor Markers*

1
2
3
4

Analyzer Use/ Troubleshooting*

1
2
3
4

Review & Interpretation of QC*

1
2
3
4

HEMATOLOGY / COAGULATION

Automated Instrument Use*

1
2
3
4

Differential Manual*

1
2
3
4

Sed Rate Manual*

1
2
3
4

Reticulocyte Count*

1
2
3
4

Fetal Hemoglobin*

1
2
3
4

RBC Morphology*

1
2
3
4

Platelet Count*

1
2
3
4

Sickle Cell Prep*

1
2
3
4

Platelet Morphology*

1
2
3
4

Body Fluid Manual Cell Count*

1
2
3
4

Body Fluid Manual diff.*

1
2
3
4

Special Stains- e.g. PAS, LAP, Peroxidase*

1
2
3
4

WBC Stool*

1
2
3
4

Semen Analysis*

1
2
3
4

PT/PTT/INR*

1
2
3
4

D-Dimer*

1
2
3
4

Fibrinogen*

1
2
3
4

Factor Assays*

1
2
3
4

Fibrin Degradation Products*

1
2
3
4

Thrombin Time*

1
2
3
4

Platelet Function Analysis*

1
2
3
4

IMMUNOLOGY / SEROLOGY

RPR/ RPR Titer*

1
2
3
4

Rheumatoid Titer*

1
2
3
4

ANA*

1
2
3
4

LE Prep*

1
2
3
4

HIV Rapid*

1
2
3
4

HIV Antibody Detection*

1
2
3
4

Rubella*

1
2
3
4

CMV*

1
2
3
4

MICROBIOLOGY

Plating Micro Specimens*

1
2
3
4

Reading Plates*

1
2
3
4

Gram Stains*

1
2
3
4

Kit Testing- Monospot/ ASO Titer*

1
2
3
4

Kit Testing- Flu/Rapid Strep/ RSV*

1
2
3
4

Wet Prep/ KOH Prep*

1
2
3
4

AFB Stain/ Culture*

1
2
3
4

O&P*

1
2
3
4

CDiff*

1
2
3
4

Occult Blood*

1
2
3
4

Chlamydia*

1
2
3
4

Processing Specimens for Viral/ Fungal Cultures*

1
2
3
4

URINALYSIS

Crystal Identification*

1
2
3
4

Macroscopic Analysis*

1
2
3
4

Microscopic Analysis*

1
2
3
4

Pregnancy Testing*

1
2
3
4

PHLEBOTOMY

Newborn/Neonate (birth to 30 days)*

1
2
3
4

Infant (1 month to 1 year)*

1
2
3
4

Toddler (1 year to 3 years)*

1
2
3
4

Preschooler (3 years to 5 years)*

1
2
3
4

School Age Child (5 years to 12 years)*

1
2
3
4

Adolescents (12 years to 18 years)*

1
2
3
4

Young Adults (18 years to 39 years)*

1
2
3
4

Middle Adults (39 years to 64 years)*

1
2
3
4

Older Adults (64 years to 79 years)*

1
2
3
4

Elderly Adults (over 79+ years)*

1
2
3
4

Patient Identification*

1
2
3
4

PPE Equipment (Gloves, Mask, Etc.)*

1
2
3
4

Adult Venipuncture*

1
2
3
4

Pediatric Venipuncture*

1
2
3
4

Dermal Stick (Finger/Heel)*

1
2
3
4

Butterfly Draw*

1
2
3
4

Arterial Draw*

1
2
3
4

Tube Types and Usage*

1
2
3
4

Centrifuge Operations*

1
2
3
4

Bleeding Time*

1
2
3
4

Blood Culture Collections*

1
2
3
4

Blood Alcohol Collections*

1
2
3
4

Drug Screening Collections*

1
2
3
4

Please list the LIS Systems You Have Used*

Please list the Chemistry systems you have used*

Please list the Hematology systems you have used*

Please list the Urinalysis systems you have used*

Please list the Coagulation systems you have used*

Please list the blood bank systems you have used*

Please list the microbiology systems you have used*

Please list any miscellaneous systems you have used*

Please list the EMR systems you have used*

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 consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*

Your Recruiter*

Name*

First Last

Email*

Phone*

TODAY'S DATE*

MT/MLT Skills Checklist