Laboratory Competency Assessment Form
Please fill out this form to evaluate and confirm the competency of laboratory personnel in performing essential tasks and procedures.
Part A: Pre-analytic
| Meets Standard | Does Not Meet Standard | N/A | Notes |
|---|
Sample Handling | | | | |
Sample Storage | | | | |
Laboratory Information Management System | | | | |
Part B: Analytic
| Meets Standard | Does Not Meet Standard | N/A | Notes |
|---|
Sample Preparation | | | | |
Preventative maintenance logbook | | | | |
Instrument maintenance | | | | |
Function checks | | | | |
Intermediate test results | | | | |
Review and record test results | | | | |
Part C: Post-analytic
| Meets Standard | Does Not Meet Standard | N/A | Notes |
|---|
Peer Review | | | | |
Final reporting of test results | | | | |
Sample management | | | | |
Test results documentation retention | | | | |
Validation or exercise data | | | | |
Quality improvement reports, case studies and/or scenarios | | | | |
Problem solving demonstration or quiz | | | | |
Assessor Signature
Name:
Date:
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