UNIVERSITY OF COLORADO HOSPITAL

RECORD OF EDUCATION
DATE: _____________
EMPLOYEE NAME: ____________________
EDUCATOR NAME: ___Brandi Schimpf, RN BSN CEN Clinical Nurse Educator ___
FACTS LEADING UP TO THE CONFERENCE:
PSN/SI # __________ MR ____________ Date _________
PSN reports no p!e"oto#$st or %er$&'$n( $n$t$a!s o& "!oo) "an* spe+$#en as
Re,-$re) per osp$ta! po!$+' an) pro+e)-re.
EMPLOYEE COMMENTS:
ACTION TA/EN:
Must re-take the healthstream moule re!ar"#! s$e%"me#
ha#l"#! &see "#stru%t"o#s 'elo() a# tur# "# the %ert"*"%ate o* %om$let"o# to +ra#"
S%h"m$* ("th"# , (eeks-
Go to Healthstream/Ulearn
1. Click on the catalog tab
2. Search for Laboratory Sample Handling title
!. Click on the Lab Sample Handling title
". #nroll in the co$rse% there is no cost associate &ith the co$rse
E#p!o'ee0s S$(nat-re S-per%$sor0s S$(nat-re
(This signature simply acknowledges the employee has seen this document)
FOLLO1 2 UP: (Recognize Improvement or Descries ne!t step if ehavior is not
corrected"# $ailure to ta%e designated corrective action or repetition of ehavior
ma& lead to further disciplinar& action up to and including termination of
emplo&ment#
DATE ACTION SIGNATURE