KDM 001

SEKOLAH TINGGI ILMU KESEHATAN (STIKES)

RS. BAPTIS KEDIRI

Type of skills : collecting sputum for examination

No. Revision :0
Student Name : _________________________________
Study Program / NIM : ________________/_________________
Rate / Semester : ________________/_________________
Date / Time : ________________/_________________
Place of Practice : _________________________________

*Scale
NO COMPONENT
(0, 1, 2, 3)
I Tools Preparation :
1 Sterile place to hold the sputum specimen with a lid
2 Clean gloves
3 Crooked
4 Tissue
5 Tooth brush (client’s)
6 Label
7 File for requesting laboratory examination
8 Plastic specimen
9 Disinfectant liquid
II Pre-interaction stage:
1 Order verification
2 Nurse’s self preparation
3 Prepare a tool
4 Prepare the environment Keep the client’s privacy closed
III The orientation phase :
1 Carry tools and identifi patients (call name, ask names, read cars TT,
reading patient bracelets)
2 Give a therapeutic greeting
3 Clarification of contracts when awarding positions
4 Explain the purpose and procedure of positioning
5 Give clients the opportunity to ask questions
6 Prepare tools near the client
IV Work Stage :
1 Wash you hands with the right steps
2 Wear clean gloves
3 Bring the crooked near the patient
4 Ask the client not to touch the inside of the sputum container
5 Do deep breathing techniques and effective cough
6 Ask the clien to remove sputum in the specimen reservoir. Do it
repeatedly until the amount of sputum is met or around 2-10 cc
7 Close the specimen reservoir
8 Clean with disinfectant liquid if there is sputum on the outside of the
specimen reservoir
9 Give the client a tissue to clean if around the dirty mouth
10 Perform oral care (toothbrush) if needed
11 Label specimens (client name, date, type of inspection, room name)
12 Store dpecimen reservoirs in specimen plastic
13 Tidy up the tools and client, take of the gloves and wash your hands
properly
14 Document and deliver the specimen place to the laboratory with the
request form laboratory examination
V Termination stage :
1 Evaluate client responses
2 Summarize the results of the activity
 *Scale
NO COMPONENT
(0, 1, 2, 3)
3 Message delivery
4 Contract time, place, topic / next activity
VI Document :
1 Client’s new position
2 Time of transfer position
3 Client response
VII Attitude :
1 Therapeutic communication
2 Maintain working principies
3 Work carefully and carefully
4 Work systematically
VIII Cognitive
1 The purpose of taking sputum
2 Indications for taking sputum
3 Vigilance of nurses

1. Rating Table
Step Step Sub value Final score
Weigh
Scale (Weight x Total value x 100
t
Scale) Maximum Score (. . .)
I Preparation of tool
1
and environments
II Pre-interaction stage 1
III The orientation phase 1
IV Work Stage 3
V Termination stage 1
VI Document 1
VII Attitude 1
VIII Cognitive 1
Total value

2. convert values
A : > 80
AB : 75-79,9
B : 70-74,9 Results : Pass / Not pass
BC : 65-69,9 * cross the unnecesssary ones
C : 55-64,9 Guidance note :
Kediri, …………………………
Supervising / Examiner

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