PAMANTASAN NG LUNSGOD NG MAYNILA

COLLEGE OF NURSING

Medical-Surgical Nursing 1
SKILLS LABORATORY CHECKLIST

Name: Davillo, Khrisha Anne A. Date: February 15, 2021

Year Level and Block: BSN 3-5 Clinical Instructor:

Rating Scale:

3 Performed correctly, systematically according to standard with correct rationale.

2 Performed correctly, with correct rationale but not systematic.
1 Performed correctly, but not systematic and with inadequate rationale.
0 Performed incorrectly.

Procedure: Intravenous (IV) Therapy Skill Checklist

PREPARATION
1. Checked physician’s order and
gathered equipment and
supplies. Introduced self,
explained what procedure was
to be done and why.
2. Performed hand hygiene,
following infection control
measures, and verified client’s
identity. Assessed for any
allergies.
3. Provided comfort and safety
for client and self, including
raising bed to appropriate
height for procedure
RATIONALE PERFORMANC REMARKS
E
3 2 1 0
 An order requesting
initiation of peripheral IV
access must be made by
a physician before the
initiation of this therapy
 Preparing equipment
allows for smooth,
organized performance.
 Knowing the procedure
and it importance relieve
is often reassuring,
lessens anxiety and most
likely to gain client’s
cooperation
 Reduces microorganism
transfer
 Verifying client’s identity
prevents potential errors.
 Reduce possibility of
allergic reactions
 Facilitates comfort;
promotes safety
 Prevents injury due to
fall.
4. Prepared client: Assisted the  Promotes comfort and
client to a comfortable position, relaxation to the client.
either sitting or lying Provide Provides proper body
patient privacy. mechanics. Aids in
successful vein location
5. Selected venipuncture site:  Ensures adequate vein
A. Used client’s non that is easier to puncture
dominant arm. with needle and less
Identified possible likely to rupture.
venipuncture sites by  Prevents skin micro
looking for veins that abrasions; helps
are relatively straight. protective dressing
B. Checked agency adhere to skin
protocol about shaving  Prevents staining bed
if site is very hairy. linens
C. Placed towel or bed
protector under
extremity to protect
linens.
6. Dilated the vein  Permits venous dilation
A. Placed extremity in a and visibility.
dependent position.  The pressure of the
B. Applied tourniquet tourniquet should cause
firmly 15 to 20 cm (6 to the vein to dilate
8 in.) above  To ease client’s anxiety.
venipuncture site.  Applying tourniquet
C. Explained that increases venous
tourniquet may feel pressure the vein is
tight. overstretched may
D. For elders, placed arm in rupture the wall of the
comfortable position vein
(do not use tourniquet.)  Promotes blood flow to
E. If vein did not the extremity and aids in
sufficiently dilate, dilating veins.
massaged or stroked  Tapping the vein causes
vein distal to site and in reflex mechanism
direction of venous flow producing venous
toward heart. dilation in response to
Encouraged client to venous congestion
clench and unclench fist.
F. Lightly tapped vein with
fingertips.
G. If preceding steps failed
to distend vein,
removed tourniquet and
 wrapped the extremity
in a warm, moist towel
for 10 to 15 minutes.
7. Put on gloves and cleaned  Prevents contamination
venipuncture site. of hands; reduces risk of
A. Cleaned skin at site of infection transmission
entry with a topical  Maintains asepsis
antiseptic swab.  Mechanical friction in this
B. Used a back -and -forth pattern allows
motion for a minimum penetration of the anti -
of 30 seconds to scrub septic solution into the
the insertion site by cracks and fissures of the
using solution and dry epidermal layer of the
the skin. skin
C. Prepare equipment  Preparing equipment
aseptic technique (set allows for smooth,
aside catheter, organized performance
tegaderm, flush the
extension set tubing)
8. Inserted the catheter, and  Stabilizes vein and
initiated the infusion. prevents skin from
A. Removed catheter moving during insertion
assembly from sterile  Anchors the skin and vein
packaging. to prevent rolling;
B. Used non dominant ensures simultaneous
hand to pull skin taut entry of skin and tissue
below entry site.  Decreases risk of
C. Held the over -the - penetrating opposite wall
needle catheter at a 15 - of vein
to 30 -degree angle with  Ensures proper location
needle bevel up, for needle insertion
inserted catheter  Reduces backflow of
through skin and into blood and exposure to
vein. blood
D. Once blood appeared in  Permits venous flow,
the lumen of the needle, reduces back flow of
lowered the angle of the blood and allows
catheter until almost connection with
parallel with the skin, administration set with
and advanced the minimal blood loss.
needle and catheter  Prevents transmission of
approximately 0.5 to infection, maintains
1cm (about 1/4 in) sterility.
further. Held needle  Prompt connection of
assembly steady, infusion set maintains
 advanced the catheter patency of vein and
until the hub was at the prevents exposure to
venipuncture site. blood
E. Released the
tourniquet.
F. Put pressure on vein
proximal to catheter to
eliminate or reduce
blood oozing out of
catheter. Stabilized hub
with thumb and index
finger of non-dominant
hand.
G. Carefully removed
stylet, engaged needle -
safety device, and
connect distal end of
extension set tubing to
the hub. Flushed
catheter with sterile
normal saline. Maintain
sterility. Placed stylet
directly into sharps
container.
H. While maintaining
sterility connect distal
end of the extension set
to the IV tubing.
Initiated infusion as
prescribed.