DE LA SALLE LIPA

COLLEGE OF NURSING
Nursing Care Management 107
Maternal and Child Nursing 1 (Well Clients)

Procedural Checklist in
Administering Medications and Injections

Name: ___ Date: _____Year/Sec: ____ Rating:

General Objective:
• Given actual or simulated situations, the student will be able to systematically
demonstrate administering medications and injections aseptically

Specific Objectives:
• Discuss the different methods and medication administration
• Perform medication administration through the different routes following the ten (10)
R’s and aseptic technique
• Document the procedure and note patient responses

Item
Descriptors Verbal Interpretation
Weight
2 Excellent Performed the procedure with great ease and confidence,
observing work ethics (prudent, accepts criticisms and
suggestions), able to rationalize scientifically and shows
diligence in documenting observations at all times .
1.75 Very Performed the procedure with less confidence, observing work
Satisfactory ethics (prudent, accepts criticisms and suggestions), able to
rationalize scientifically and shows minimal diligence in
documenting observations.
1.5 Satisfactory Performed the procedure but requires close supervision and
shows potential for improvement.
1.25 Needs Failed to perform the procedure, unable to function well and
Improvement needs repeated specific/ detailed guidance or direction.

Skills (10) 2.0 1.75 1.50 1.25 Remarks

1. Check the doctor’s order regarding the medication to be
given and the medication administration record of the
patient.
2. Prepare the necessary materials needed in performing
medication administration:
medication card, medication glass, medication tray,
distilled water for injection, hypodermic needles,
disposable gloves, sharps collector, and alcohol prep
pads. Perform hand hygiene.
3. Explain the procedure to the patient and obtain consent.
Verify the patient’s identity. Done gloves.

Observe the 10 R’s of medication administration.

4. Administer oral medication by using a medication glass
placed neatly on a medication tray. Follow aseptic
technique and observe hospital protocol. Discard the
medication foil accordingly. Perform hand hygiene and
document the procedure.
5. Administer medication using the intramuscular route.
Aspirate the medication in a 3cc syringe and place it
neatly on a medication tray. Follow aseptic technique
and observe hospital protocol. Discard the used syringe
in the sharps collector. Perform hand hygiene and
document the procedure.
6. Administer medication using the subcutaneous route.
Aspirate the medication in a 3cc syringe and place it
neatly on a medication tray. Follow aseptic technique
and observe hospital protocol. Discard the used syringe
in the sharps collector. Perform hand hygiene and
document the procedure.
7. Administer medication using the intradermal route.
Aspirate the medication in a 1cc syringe and place it
neatly on a medication tray. Follow aseptic technique
and observe hospital protocol. Discard the used syringe
in the sharps collector. Perform hand hygiene and
document the procedure.
8. Briefly discuss process of medication administration
using the heparin lock intravenous access.
9. Inform the client on the completion of the procedure.
Place the patient comfortably on bed. Thank the client
for his/her cooperation. Document the procedure
performed. Discard the disposable materials used
according to the hospital protocol.
10. Evaluate the patient’s response to the medication
administered. Report untoward responses to the
patient’s attending physician. Perform additional nursing
interventions as required.
11. The student reports in proper uniform and maintains
proper grooming at all times.
12. Observes good work ethics and proper decorum, and
exhibits resourcefulness in his/her work.

Comments: (Strengths & Weaknesses)

Conforme: Evaluated by:

___________________________ _____________________________

Student’s Signature CI’s Signature over Printed Name

Date: Date: