Write the score on the corresponding box on the following grading criteria: 5-Activity performed accurately with evident ease without supervision 4-Activity performed but needs minimal supervision 3-Activity performed with slight difficulty, needs supervision most of the time 2-Activity performed inaccurately 1-Activity not performed PROCEDURE Setting Up an IV Line EXPECTED OUTCOME: The student should be able to set up an IV line correctly ASSESSMENT TASK: Return Demonstration ‘Assessment Dimension @® Toa Tea Tato 1, Verify the doctors order and make an IV label: 2. Observe 10 R’s when preparing and administering IV flu. '3 Explain the procedure to reassure pationt and or significant others, secure consent if necessary. 4, Do hand hygiene before and after the procedure, 5. Prepare the necessary materials for the procedure. 6. Check for the sterility and integrity of the solution, IV set and other materials needed 7. Place the IV label on the IV bolle duly signed by the nurse who prepared it '8, Open the seal of the IV infusion aseptically and disinfect rubber port with cotton balls with alcohol. ‘3. Open the IV administration set aseptically and close the roller clamp and spike to infusate container aseptically 10. Fillin the drip chamber half full 11. Expel the air bubbles if any and put back the cover to the distal end of the IV set 12, Get ready for |V insertion SCORE: 160)*100 Target Raw Score: 45 out of 100 _f raw score is less than 45, repeat the demonstration. CI SIGNATURE OVER PRINTED NAME Prepared by: EVANGELINE F. ORATA RN, RM, MAN Noted by: FRANCIS S, VASQUEZ RN, MAN, ROSANA P. SUVA RN. MAN. Coordinator MELANIE S. CAMBEL RN. MAN. ‘Approved by: LURCEL! L. SANTOS RN. MAN Dean, College of NursingWrite the score on the corresponding box on the following grading criteria: 5-Activity performed accurately with evident ease without supervision 4-Activity performed but needs minimal supervision 3-Activity performed with slight difficulty, needs supervision most of the time 2-Activity performed inaccurately 1-Activity not performed PROCEDURE Setting Up an IV Line EXPECTED OUTCOME: The student should be able to set up an IV line correctly ASSESSMENT TASK: Return Demonstration ‘Assessment Dimension @® Toa Tea Tato 1, Verify the doctors order and make an IV label: 2. Observe 10 R’s when preparing and administering IV flu. '3 Explain the procedure to reassure pationt and or significant others, secure consent if necessary. 4, Do hand hygiene before and after the procedure, 5. Prepare the necessary materials for the procedure. 6. Check for the sterility and integrity of the solution, IV set and other materials needed 7. Place the IV label on the IV bolle duly signed by the nurse who prepared it '8, Open the seal of the IV infusion aseptically and disinfect rubber port with cotton balls with alcohol. ‘3. Open the IV administration set aseptically and close the roller clamp and spike to infusate container aseptically 10. Fillin the drip chamber half full 11. Expel the air bubbles if any and put back the cover to the distal end of the IV set 12, Get ready for |V insertion SCORE: 160)*100 Target Raw Score: 45 out of 100 _f raw score is less than 45, repeat the demonstration. CI SIGNATURE OVER PRINTED NAME Prepared by: EVANGELINE F. ORATA RN, RM, MAN Noted by: FRANCIS S, VASQUEZ RN, MAN, ROSANA P. SUVA RN. MAN. Coordinator MELANIE S. CAMBEL RN. MAN. ‘Approved by: LURCEL! L. SANTOS RN. MAN Dean, College of NursingWrite the score on the corresponding box on the following grading criteria: 5-Activity performed accurately with evident ease without supervision 4-Activity performed but needs minimal supervision 3-Activity performed with slight difficulty, needs supervision most of the time 2-Activity performed inaccurately 1-Activity not performed PROCEDURE Setting Up an IV Line EXPECTED OUTCOME: The student should be able to set up an IV line correctly ASSESSMENT TASK: Return Demonstration ‘Assessment Dimension @® Toa Tea Tato 1, Verify the doctors order and make an IV label: 2. Observe 10 R’s when preparing and administering IV flu. '3 Explain the procedure to reassure pationt and or significant others, secure consent if necessary. 4, Do hand hygiene before and after the procedure, 5. Prepare the necessary materials for the procedure. 6. Check for the sterility and integrity of the solution, IV set and other materials needed 7. Place the IV label on the IV bolle duly signed by the nurse who prepared it '8, Open the seal of the IV infusion aseptically and disinfect rubber port with cotton balls with alcohol. ‘3. Open the IV administration set aseptically and close the roller clamp and spike to infusate container aseptically 10. Fillin the drip chamber half full 11. Expel the air bubbles if any and put back the cover to the distal end of the IV set 12, Get ready for |V insertion SCORE: 160)*100 Target Raw Score: 45 out of 100 _f raw score is less than 45, repeat the demonstration. CI SIGNATURE OVER PRINTED NAME Prepared by: EVANGELINE F. ORATA RN, RM, MAN Noted by: FRANCIS S, VASQUEZ RN, MAN, ROSANA P. SUVA RN. MAN. Coordinator MELANIE S. CAMBEL RN. MAN. ‘Approved by: LURCEL! L. SANTOS RN. MAN Dean, College of NursingWrite the score on the corresponding box on the following grading criteria: 5-Activity performed accurately with evident ease without supervision 4-Activity performed but needs minimal supervision 3-Activity performed with slight difficulty, needs supervision most of the time 2-Activity performed inaccurately 1-Activity not performed PROCEDURE Setting Up an IV Line EXPECTED OUTCOME: The student should be able to set up an IV line correctly ASSESSMENT TASK: Return Demonstration ‘Assessment Dimension @® Toa Tea Tato 1, Verify the doctors order and make an IV label: 2. Observe 10 R’s when preparing and administering IV flu. '3 Explain the procedure to reassure pationt and or significant others, secure consent if necessary. 4, Do hand hygiene before and after the procedure, 5. Prepare the necessary materials for the procedure. 6. Check for the sterility and integrity of the solution, IV set and other materials needed 7. Place the IV label on the IV bolle duly signed by the nurse who prepared it '8, Open the seal of the IV infusion aseptically and disinfect rubber port with cotton balls with alcohol. ‘3. Open the IV administration set aseptically and close the roller clamp and spike to infusate container aseptically 10. Fillin the drip chamber half full 11. Expel the air bubbles if any and put back the cover to the distal end of the IV set 12, Get ready for |V insertion SCORE: 160)*100 Target Raw Score: 45 out of 100 _f raw score is less than 45, repeat the demonstration. CI SIGNATURE OVER PRINTED NAME Prepared by: EVANGELINE F. ORATA RN, RM, MAN Noted by: FRANCIS S, VASQUEZ RN, MAN, ROSANA P. SUVA RN. MAN. Coordinator MELANIE S. CAMBEL RN. MAN. ‘Approved by: LURCEL! L. SANTOS RN. MAN Dean, College of NursingWrite the score on the corresponding box on the following grading criteria: 5-Activity performed accurately with evident ease without supervision 4-Activity performed but needs minimal supervision 3-Activity performed with slight difficulty, needs supervision most of the time 2-Activity performed inaccurately 1-Activity not performed PROCEDURE Setting Up an IV Line EXPECTED OUTCOME: The student should be able to set up an IV line correctly ASSESSMENT TASK: Return Demonstration ‘Assessment Dimension @® Toa Tea Tato 1, Verify the doctors order and make an IV label: 2. Observe 10 R’s when preparing and administering IV flu. '3 Explain the procedure to reassure pationt and or significant others, secure consent if necessary. 4, Do hand hygiene before and after the procedure, 5. Prepare the necessary materials for the procedure. 6. Check for the sterility and integrity of the solution, IV set and other materials needed 7. Place the IV label on the IV bolle duly signed by the nurse who prepared it '8, Open the seal of the IV infusion aseptically and disinfect rubber port with cotton balls with alcohol. ‘3. Open the IV administration set aseptically and close the roller clamp and spike to infusate container aseptically 10. Fillin the drip chamber half full 11. Expel the air bubbles if any and put back the cover to the distal end of the IV set 12, Get ready for |V insertion SCORE: 160)*100 Target Raw Score: 45 out of 100 _f raw score is less than 45, repeat the demonstration. CI SIGNATURE OVER PRINTED NAME Prepared by: EVANGELINE F. ORATA RN, RM, MAN Noted by: FRANCIS S, VASQUEZ RN, MAN, ROSANA P. SUVA RN. MAN. Coordinator MELANIE S. CAMBEL RN. MAN. ‘Approved by: LURCEL! L. SANTOS RN. MAN Dean, College of NursingWrite the score on the corresponding box on the following grading criteria: 5-Activity performed accurately with evident ease without supervision 4-Activity performed but needs minimal supervision 3-Activity performed with slight difficulty, needs supervision most of the time 2-Activity performed inaccurately 1-Activity not performed PROCEDURE Setting Up an IV Line EXPECTED OUTCOME: The student should be able to set up an IV line correctly ASSESSMENT TASK: Return Demonstration ‘Assessment Dimension @® Toa Tea Tato 1, Verify the doctors order and make an IV label: 2. Observe 10 R’s when preparing and administering IV flu. '3 Explain the procedure to reassure pationt and or significant others, secure consent if necessary. 4, Do hand hygiene before and after the procedure, 5. Prepare the necessary materials for the procedure. 6. Check for the sterility and integrity of the solution, IV set and other materials needed 7. Place the IV label on the IV bolle duly signed by the nurse who prepared it '8, Open the seal of the IV infusion aseptically and disinfect rubber port with cotton balls with alcohol. ‘3. Open the IV administration set aseptically and close the roller clamp and spike to infusate container aseptically 10. Fillin the drip chamber half full 11. Expel the air bubbles if any and put back the cover to the distal end of the IV set 12, Get ready for |V insertion SCORE: 160)*100 Target Raw Score: 45 out of 100 _f raw score is less than 45, repeat the demonstration. CI SIGNATURE OVER PRINTED NAME Prepared by: EVANGELINE F. ORATA RN, RM, MAN Noted by: FRANCIS S, VASQUEZ RN, MAN, ROSANA P. SUVA RN. MAN. Coordinator MELANIE S. CAMBEL RN. MAN. ‘Approved by: LURCEL! L. SANTOS RN. MAN Dean, College of NursingWrite the score on the corresponding box on the following grading criteria: 5-Activity performed accurately with evident ease without supervision 4-Activity performed but needs minimal supervision 3-Activity performed with slight difficulty, needs supervision most of the time 2-Activity performed inaccurately 1-Activity not performed PROCEDURE Setting Up an IV Line EXPECTED OUTCOME: The student should be able to set up an IV line correctly ASSESSMENT TASK: Return Demonstration ‘Assessment Dimension @® Toa Tea Tato 1, Verify the doctors order and make an IV label: 2. Observe 10 R’s when preparing and administering IV flu. '3 Explain the procedure to reassure pationt and or significant others, secure consent if necessary. 4, Do hand hygiene before and after the procedure, 5. Prepare the necessary materials for the procedure. 6. Check for the sterility and integrity of the solution, IV set and other materials needed 7. Place the IV label on the IV bolle duly signed by the nurse who prepared it '8, Open the seal of the IV infusion aseptically and disinfect rubber port with cotton balls with alcohol. ‘3. Open the IV administration set aseptically and close the roller clamp and spike to infusate container aseptically 10. Fillin the drip chamber half full 11. Expel the air bubbles if any and put back the cover to the distal end of the IV set 12, Get ready for |V insertion SCORE: 160)*100 Target Raw Score: 45 out of 100 _f raw score is less than 45, repeat the demonstration. CI SIGNATURE OVER PRINTED NAME Prepared by: EVANGELINE F. ORATA RN, RM, MAN Noted by: FRANCIS S, VASQUEZ RN, MAN, ROSANA P. SUVA RN. MAN. Coordinator MELANIE S. CAMBEL RN. MAN. ‘Approved by: LURCEL! L. SANTOS RN. MAN Dean, College of Nursing