SKILLS CHECKLIST OXYGEN THERPAY

4= Competent 3= Very Good 2=Good 1= Needs Improvement

PROCEDURE 4 3 2 1

ASSESSMENT: Skin and mucous membrane color: Note whether cyanosis is

present, presence of mucus, sputum production, Breathing patterns: Note
depth of respirations and presence of tachypnea, bradypnea, or orthopnea.
Chest movements: Note whether there are any intercostal, substernal,
suprasternal, supraclavicular, or tracheal retractions during inspiration or
expiration
PLANNING: Initiating the administration of oxygen is considered similar to
administering a medication and is not assigned to assistive personnel (AP).
IMPLEMENTATION:
Preparation:
1. Determine the need for oxygen therapy, and verify the order for the therapy.
Perform a respiratory assessment to develop baseline data if not already
available.
2. Prepare the client and assist the client to a semi-Fowler’s position if possible.
Rationale: This position permits easier chest expansion and hence easier
breathing. Explain to patient and family about the safety precautions
connected with oxygen use.
PERFORMANCE
1. Introduce self and verify the client’s identity using agency protocol.
Explain to the client what you are going to do, why it is necessary, and
how to participate. Discuss how the effects of the oxygen therapy will
be used in planning further care or treatments
2. Perform hand hygiene and observe other appropriate infection
prevention procedures
3. Provide for client privacy, if appropriate.
4. Set up the oxygen equipment and the humidifier. Attach the flow meter
to the wall outlet or tank it should be on off position.
5. Fill the humidifier bottle. Attach the humidifier bottle to the base of the
flow meter
6. Attach the prescribed oxygen tubing and delivery device to the
humidifier
7. Turn on the oxygen at the prescribed rate and ensure proper
functioning.
8. Check that the oxygen is flowing freely through the tubing. There
should be no kinks in the tubing, and the connections should be
airtight. There should be bubbles in the humidifier as the oxygen flows
through, oxygen is felt at the outlets of the cannula, mask
9. Apply the appropriate oxygen delivery device.
Using Nasal Cannula
10. Put the cannula over the client’s face with the outlet prongs fitting into
 the nares and tubing hooked around the ears
11. If the cannula will not stay in place, tape it at the sides of the face.
12. Pad the tubing and band over the ears and cheekbones as needed
13. Assess the client’s nares for encrustations and irritation. Apply a water-
soluble lubricant as required to soothe the mucous membranes.
Using a Face Mask:
14. Guide the mask toward the client’s face, and apply it from the nose
downward.
15. Fit the mask to the contours of the client’s face. Rationale: The mask
should mold to the face so that very little oxygen escapes into the eyes
or around the cheeks and chin.
16. Secure the elastic band around the client’s head so that the mask is
comfortable but snug.
17. Pad the band behind the ears and over bony prominences. Rationale:
Padding will prevent irritation from the mask
18. Inspect the facial skin frequently for dampness or chafing, and dry and
treat it as needed
19. Inspect the equipment on a regular basis. • Check the liter flow and the
level of water in the humidifier in 30 minutes and whenever providing
care to the client. • Be sure that water is not collecting in dependent
loops of the tubing. • Make sure that safety precautions are being
followed
20. Document findings in the client record using forms or checklists
supplemented by narrative notes when appropriate
Total = 80

Name _____________________________________Score ____________________________

Year and section ____________________________CI Signature________________________

Reference: Berman, Audrey; Snyder Shirliee; Frandse Grealyn: Fundamentals of Nursing, Concept, Processes and Practice 11 th
Edition