UNIVERSITY OF BOHOL

0186 Dr. Cecilio Putong Street

Tagbilaran City,Bohol,Philippines
TeleFax No.(038)411-3101
www.universityofbohol.com
COLLEGE OF NURSING
CHECKLIST FOR POST OPERATIVE WOUND CARE
NURSING SKILLS LABORATORY

Name: ___________________________________ Year/Section: _________________ Date: __________

Instruction: Please check (√) on the space provided to assure whether the participant is able to perform
the procedure correctly or whether it is incorrectly done.

WEIGHT VALUE DESCRIPTION MEANING

2 Competent Student performs correctly the procedure
1 Needs Improvement Performance is too slow to judge satisfactorily
0 Not Performed Procedure/steps not done

RATING
PROCEDURE 2 1 0
Preparation
1 Prepare the client and assemble the equipment.
Performance
2 Introduce self and verify the client’s identity using agency protocol.
3 Explain the procedure, why it is necessary and how the client can participate.
4 Perform hand hygiene and observe other appropriate prevention control
procedures.
5 Provide client privacy.
6 Remove the adhesive tape by holding down the skin and pulling the tape gently
but firmly toward the wound.
7 Remove and dispose of soiled dressing appropriately.
8 Apply clean gloves and remove the outer dressing or surgipad.
9 Remove underdressing and discard in a moisture proof bag.
10 Remove and discard glove as before.
11 Perform hand hygiene.
12 Set-up sterile supplies.
a Open the sterile dressing set using surgical aseptic technique.
b Place the sterile drape beside the incision.
c Open the sterile cleaning solution and pour it over the gauze sponges in the
plastic container.
d. Apply sterile gloves.
13 Clean the wound using gloved hands or forceps and gauze swabs moistened with
cleaning solution.
14 Use separate sterile swab for each stroke. Depending on the type of wound or
 incision, start from top to bottom, starting from the center going outward, or
cleaning the wound from inner to outer in circular motion.
15 Apply dressing to the incision.
a Place a 4x4 gauze snugly over the wound and apply the final surgical pad.
b Remove and discard gloves.
c Secure the dressing with tape.
d Perform hand hygiene.
15 Document procedure and all nursing assessments.
TOTAL
PERCENTAGE
EQUIVALENT

Evaluated by:

_________________________ __________________________

Signature Over Printed Name Signature Over Printed Name

CLINICAL INSTRUCTOR LEARNER

RLE PERFORMANCE RATING SCALE

EQUIVALENT GRADE 75% PASSING MEANING

1.0 95-100
1.1 94
1.2 93 Very Competent
1.3 92
1.4 91
1.5 90
1.6 89
1.7 88 Competent
1.8 87
1.9 86
2.0 85
2.1 84
2.2 83 Progress Acceptable
2.3 82
2.4 81
2.5 80
2.6 79
2.7 78
2.8 77 Needs Improvement
2.9 76
3.0 75