PROCEDURE CHECKLIST

Chapter 28, Skill 28-09: Maintaining Chest Tubes

Check () Yes or No

PROCEDURE STEPS YES NO COMMENTS

1. Gathers needed equipment: chest tube with
insertion tray, drainage system, sterile water,
connectors, petroleum jelly gauze dressings, split
drain sponges, abdominal dressing pad, padded
Kelly clamps, sterile gloves, masks, gowns,
goggles as needed.
2. Sets up the suction and water seal per order.
3. Follows the “Initial Implementation Steps.”
4. Once the tube is in place, attaches it to the
drainage system and removes the padded Kelly
clamp.
5. Applies petroleum jelly gauze dressing around
the chest tube site, sealing any area where an air
leak could occur. Covers the petroleum jelly
gauze with drain sponges and an ABD. Tapes the
dressing area completely.
6. Tapes all connections thoroughly, taping away
from the patient first, then back toward the
patient. Attaches the chest tube to the patient
with a loop of tape.
7. Turns on suction as ordered until gentle
bubbling is noted, if it is a wet suction system.
Places drainage system securely on the floor and
arranges the tubing so that there are no kinks or
downward loops.
8. Maintains the drainage system in an upright
position below the level of the chest at all times.
Frequently assesses the tubes for kinks or loops,
and the drainage in the tubing for clots.
9. Ensures that petroleum jelly gauze and 4 × 4s
are at the bedside in case of air leakage or other
emergency.
10. Assesses output in the collection chamber.
Assesses the color and amount draining each
hour. Assesses for air leaks in the drainage
system.
11. Assists the patient to a comfortable position
and reassures him or her regarding the chest
tubes. Encourages the patient to change position,

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cough, and deep breathe every 2 hours.
12. Marks output for shift correctly on chest
drainage unit and calculates output correctly.
13. Follows the “Ending Steps.”
14. Documents chest tube assessments and care
appropriately.

Recommendation: Pass _____ Needs more practice _____

Student: Date:

Instructor: Date:

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