<p>PATRAN Competency Checklist: ORIENTATION (TEMPLATE) Position Title: ______Employee Name & #: ______Unit: ______Area: </p><p>Method of Instruction Key: Method of Evaluation Key: Self-Assessment by Employee Validation of Competency P = Protocol/Procedure Review O = Observation (in clinical setting) Method of Evaluation E = Education Session RD = Return Demonstration Needs Instruction Method Never S = Self Learning Package T = Written Test Review/ Competent (Use Date Initials (Use Done C = Clinical Practice V = Verbal Review Practice Instruction Evaluation D = Demonstration Key on Left) Key on Left) A. INSERTION AND REMOVAL Log-roll Insertion Tucking Insertion Unfolding Insertion Burrito Roll Insertion Pre-surgery/transport insertion (raised upper body but preventing patient from sliding down) Removal B. SAFETY PRECAUTIONS PATRAN is for single-patient, multiple use. Not multiple patient use. Do NOT leave around children or depressed patients (suffocation hazard). Do NOT leave under patients long term (overnight) or under unattended patients. Do NOT use to lift patients. Do NOT allow PATRAN to touch open wounds. PATRAN is not sterile. Do NOT send PATRAN home with untrained patients or caregivers. Caregiver understands and demonstrates proper ergonomics in moving patients. C. MOVING TASKS Lateral transfer between flat surfaces. Lateral transfer from an upper body raised surface such as EMS stretcher. Boosting Turning on side to prevent pressure sores Turning to get into or out of bed Moving a fallen patient</p><p>Initials Signature Initials Signature Initials Signature</p><p>Revised 12/2008 Page 1 of 3 PATRAN Competency Checklist: ORIENTATION (TEMPLATE) Position Title: ______Employee Name & #: ______Unit: ______Area: </p><p>Method of Instruction Key: Method of Evaluation Key: Self-Assessment by Employee Validation of Competency P = Protocol/Procedure Review O = Observation (in clinical setting) Method of Evaluation E = Education Session RD = Return Demonstration Needs Instruction Method Never S = Self Learning Package T = Written Test Review/ Competent (Use Date Initials (Use Done C = Clinical Practice V = Verbal Review Practice Instruction Evaluation D = Demonstration Key on Left) Key on Left) ERCP proning Changing sheets while laterally transferring patient (often surgery/obgyn) Chair boosting Putting on slings (patient sitting) Putting on slings (patient lying down) Sliding linen or air transfer mattresses under patients Moving patient out of or into wheelchair Dressing patients/putting on and removing compression stockings Centering patient on a commode Straightening slumped patient Getting patients in and out of vehicles D. REHAB/MOBILITY TASKS Heel and toe exercises Hamstrings and quad exercises Core exercises Stroke rehabilitation Spine alignment</p><p>E. RADIOLOGY SPECIALTIES Sliding x-ray cassette holder under patient Transferring into/out of CT SCAN or MRI with or without slideboard. Boosting on imaging bed/table</p><p>Initials Signature Initials Signature Initials Signature</p><p>Revised 12/2008 Page 2 of 3 PATRAN Competency Checklist: ORIENTATION (TEMPLATE) Position Title: ______Employee Name & #: ______Unit: ______Area: </p><p>Method of Instruction Key: Method of Evaluation Key: Self-Assessment by Employee Validation of Competency P = Protocol/Procedure Review O = Observation (in clinical setting) Method of Evaluation E = Education Session RD = Return Demonstration Needs Instruction Method Never S = Self Learning Package T = Written Test Review/ Competent (Use Date Initials (Use Done C = Clinical Practice V = Verbal Review Practice Instruction Evaluation D = Demonstration Key on Left) Key on Left)</p><p>Initials Signature Initials Signature Initials Signature</p><p>Revised 12/2008 Page 3 of 3</p>