Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur

COLLEGE OF HEALTH SCIENCES

Name: ________________________________________ Rating: ________________________

Year and Section: _______________________________ Group: ________ Date: __________

PROCEDURE CHECKLIST FOR

COMFORT AND RESTRAINT TECHNIQUES FOR IMMUNIZATION

Definition:
IMMUNIZATION is a simple, safe, and effective way of protecting you against
harmful diseases. It is the process where a person is made immune or resistant to an infectious
disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune
system to protect the person against subsequent infection or disease.

Instruction: Below is the grading scale which will be used in rating your performance.
5 - Excellent - 95-100
4 - Very Satisfactory - 88-94
3 - Satisfactory - 82-87
2 - Fair - 76-81
1 - Needs Improvement - 70-75

STEP/TASK 5 4 3 2 1 REMARKS
Purpose:
 To provide safe and effective vaccine
administration to children.
PROCEDURE 5 4 3 2 1 REMARKS
I. PATIENT/PARENT EDUCATION
1. Welcome the patient/family and establish
rapport.
2. Explain what vaccines will be given, the
type of injection, and site of injection.
3. Ask for contraindications or adverse
reactions from previous vaccination.
II. VACCINE PREPARATION
1. Perform proper handwashing prior to
preparing vaccine.
2. When removing the vaccine from the
refrigerator, freezer, or vaccine carrier,
look at the storage unit’s temperature to
make sure it is in proper range.
 3. Check the vial expiration date. Double-
check the label and contents prior to
drawing up.
4. Select the correct needle size for IM,
SC, or ID.
5. Maintain aseptic technique throughout
the vaccine preparation.
III. VACCINE ADMINISTRATION
1. Verify patient’s identity. Recheck the
vaccination card and the prepared
vaccine syringe.
2. Perform the POSITION AND
RESTRAINT TECHNIQUE

POSITION AND RESTRAINT TECHNIQUE

PROCEDURE 5 4 3 2 1 REMARKS
A. CUDDLE POSITION
The infant is lying sideways, caregiver hugs
infant’s upper body close to her body,
caregiver’s other arm holds the infant’s leg.

B. BED POSITION
The infant lies on a flat surface, with legs bare,
caregiver stands on the side of the bed and
holds the infant’s hands and arms.
The vaccinator stands at the infant’s feet,
gently holding one knee.

C. UPRIGHT POSITION
Infant is sitting upright on the caregiver’s lap,
facing out. The caregiver rest the infant’s back
against her chest, she hugs the infant’s upper
body with one arm and uses the other arm or
her knees to hold the Infant’s leg.

D. STRADDLE POSITION
Used in children older than 12 months, the
child sits upright on the caregiver’s lap facing
her with legs straddling her body. The
caregiver hugs the child’s upper body.

E. CUDDLE POSITION (OLDER CHILD)

The child is seated sideways on the caregiver’s
lap with the child’s legs held
between the parent’s legs. The arm to be
injected is held close to the child’s body; the
 other arm is tucked under the parent’s arm and
behind the back of the parent/caregiver.

F. INDEPENDENT POSITION
Used in older and calm children, adolescents,
and adults. Injection is done while sitting
upright without the help of caregiver.

3. Inject vaccine using steady pressure,

withdraw needle at angle of insertion.
IV. POST-VACCINATION
4. Apply gentle pressure on the site of
injection.
5. Properly dispose needles, syringes and
vials used.
6. Acknowledge the caregiver’s help and
praise the child’s cooperation.
7. Do handwashing after vaccination.
8. Fully document each vaccination in
patient’s record and vaccination card.
9. Instruct on the next immunization schedule.

Signed

LEIZEL B. BORROMEO, RM, RN

Clinical Instructor