You are on page 1of 1

Community Prescription

Subcutaneous Injection (IM)

Candidate Name: ___________________________________


Please read this briefing carefully before proceeding with your skills assessment. You need to refer to this sheet during the station.
Please administer the injection according to the Royal Marsden Manual of Clinical Nursing Procedures. You must sign, date, and
record the time of medication administered.

Read out the chart and explain to the examiner what you are checking/ giving/ not giving and why.
Complete all the required drug administration checks.

Scenario
Scenario will be written here.

All the equipment you need is provided.


Please administer the injection using the prescription below. It is TODAY, and it is XX:XX

Patient Details: Medication: Dose: Date and Time


Name Drug Dose TODAY at XX:XX Signature: ………………………...
Address
Postcode Date: ……………………………….
Date of birth
Allergies: Allergies Signature of Doctor and Date: Time: ………………………………

Prescriber: Prescriber DOCTOR SIGNATURE - TODAY

Page 1 of 1

You might also like