Welch Allyn OAE Hearing Screener Directions for Use 705353 Rev E
20
Welch Allyn OAE Hearing Screener Clinical Competency Evaluation
Purpose:
This evaluation certifies that _________________ has met Welch
Allyn’s requirements for utilizing the OAE Hearing Screener. The training
involved hands-on exercises. Although further training may be needed, this
individual has demonstrated competency in the following areas at this time.
TASK
Performed Task Needed Training Did Not
Observe
1) Properly plugs in equipment
_______
_______
_______
2) Properly turns on equipment
_______
_______
_______
3) Powers on label printer
_______
_______
_______
4) Demonstrates how to clean probe
_______ _______
_______
5) Follows facility infection control
_______
_______
_______
6) Launches Screener program
_______
_______
_______
7) Records patient Log Number
_______
_______
_______
8) Swaddles baby and/or prepares _______
_______
_______
patient for test
9) Selects patient's ear in software
_______
_______
_______
10) Selects proper sized probe tip
_______
_______
_______
11) Places probe into patient’s ear
_______
_______
_______
12) Troubleshoots probe fit if needed
_______
_______
_______
13) Knows how to View Details
_______
_______
_______
14) Prints results from label printer
_______
_______
_______
15) Restarts for next patient
_______
_______
_______
16) Provides appropriate counseling to _______
_______
_______
patient or caregiver regarding results
17) Documents results according to
_______
_______
_______
facility’s protoco
l
The above evaluation was successfully completed on ___________________.
_______________________________
_______________________________
Name and Title of Person Supervising the Competency Evaluation
Summary of Contents for REF 29400
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