HOLY ANGEL UNIVERSITY

School of Nursing and Allied Medical Sciences

First Semester, 2019-2020
Rubric: Hemoglucotest

Name: _____________________________________ Final Rating: ____________________________

Section: ___________________ Date: __________________________________

5 4 3 2 1
Score
Content (Exemplary) (Accomplished) (Developing) (Beginning) (Launching)
1. Identified self and patient.
2. Performed proper hand hygiene and prepare the
materials needed.
3. Insert the test strip into test strip slot of the
glucometer. The meter should turn on
SPECIMEN О 5/5 О 4/5 О 3/5 О 2/5 О 1/5
COLLECTION
automatically.
4. Disinfect the puncture site and puncture the
appropriate site (3rd or 4th finger).
5. Wiped the first blood that came out. The finger
may bleed without assistance, but may need
‘milking’ gently.
1. Apply a drop of blood to the strip by holding the
patient’s finger to the edge of the strip until it is
completely filled with blood.
ANALYTICAL 2. Wipe the puncture site and apply pressure with a
PHASE & clean dry tissue until bleeding stops. О 5/5 О 4/5 О 3/5 О 2/5 О 1/5
RESULTS 3. Dispose the used lancet into a sharps container.
4. Remove test strip from meter and switch meter
off.
5. Reads and document the result.
TOTAL

Signature above printed name of evaluator:

Signature above printed name of evaluator: