School of Nursing and Allied Medical Sciences

Department of Radiologic Technology

Venipuncture Rubric

Student’s Name:____________________________
Section:_____________

Poor Fair Good Excellent

1 pts 2 pts 3 pts 4 pts
Confidence  Trembles while Communicates with Communicates well
Refuses to draw  drawing; patient Performs procedures
or will only draw Does not Draws following with full confidence;
certain people. communicate with procedures without Well-prepared for the
patient trembling practical
Number of No successful
3rd try 2nd try 1st try
draws  venipuncture at all
Disinfection 
Followed the proper
Didn't follow the Followed some of the Followed the proper
procedure with
right procedure procedure aseptic procedure
minimal errors
Tourniquet Too tight; almost near
Too loose; Near the Proper tourniquet Proper, smooth and
application (x2)  the venipuncture site
venipuncture site(1") application but slow fast application
(2")
Preparation of
Materials  Well-prepared before
Prepared but some Prepared before
Did not prepare extraction; still sterile
were not extraction
before extraction
Venipuncture
proper (x3)
Poor Fair Good Excellent

Disposal of Area not clean plus

Disposed; area not Disposed properly,
materials  didn't disposed Disposed properly
clean after the clean area after the
materials right after some of his materials
procedure procedure
procedure
Recapping
needle  Didn't perform Performed with a risk Performed properly, Performed properly,
properly of needle stick injury slow smooth and fast

Time (8mins)  Successful procedure Successful procedure

Unfinished within the
Poor within the time limit done within the time
time limit
but with 2nd/3rd try limit

Total
/48
Comments:

Evaluator’s Name:______________________________ Date:_______________