OUR LADY OF FATIMA UNIVERSITY

College of Nursing - Valenzuela City

PROGRAM Bachelor of Science in Nursing STUDENT NAME

NCMA113 YEAR & SECTION
COURSE Fundamentals of Nursing Practice INSTRUCTOR
SKILLS LABORATORY DATE
PROCEDURE: Oropharyngeal and Nasopharyngeal Suctioning
EXPECTED OUTCOME: The student should be able to perform Oropharyngeal and Nasopharyngeal suctioning.
ASSESSMENT TASK: Return demonstration
Assessment Exceptional Good Average Poor SCORE
Dimension (3) (2) (1) (0)
1. Determine the Determined the Determined the Determined the Failed to perform the
patient’s need for patient’s need patient’s needs patient’s needs assessment.
suctioning for suctioning. for suctioning for suctioning
with minimal with maximal
errors. errors.
2. Explain the Explained Explained the Explained the Failed to explain
procedure. procedure and procedure but procedure but in procedure and its
its purpose to lack some an unclear purpose.
the client details. manner.
clearly and
completely
with client’s
consent
3. Prepare the Gathered Gathered Gathered Failed to gather the
materials needed. materials materials materials but materials for the
(suction tube with needed completely but some of the procedure.
appropriate size, completely. disorganized. needed materials
gloves, towel, are lacking.
gauze, sterile water)
4. Sets the pressure The procedure Performed the The procedure Failed to perform the
on the suction performed procedure with performed with procedure
gauge. accurately with minimal slight difficulty,
evident ease supervision needs
without supervision most
supervision of the time.
5. Open the sterile The procedure Performed the The procedure Failed to perform the
package with performed procedure with performed with procedure.
appropriate size of accurately with minimal slight difficulty,
the suction tube, evident ease supervision. needs
sterile water, and without supervision most
gauze pack. supervision of the time
6. Dons sterile Performed the Performed the Performed the Failed to perform the
gloves. procedure with procedure with procedure with procedure.
ease minimal maximal
supervision supervision
7. With the sterile Performed the Performed the Performed the Failed to perform the
gloved hand, pick up procedure with procedure with procedure with procedure.
the catheter and ease. minimal maximal
connect it to the supervision supervision.
suction machine
8. Measure the Measured the Measured the Measured the Failed to perform the
catheter to be catheter to be catheter to be catheter to be procedure.
inserted. inserted inserted inserted correctly
correctly correctly with with maximal
minimal supervision.
supervision
9. Lubricate the end Performed the Performed the Performed the Failed to perform the
of the suction tube procedure with procedure with procedure with procedure.
and introduce the ease. minimal maximal
suction tube supervision supervision.
correctly without
applying pressure
10. Performs Performed the Performed the Performed the Failed to perform the
 suctioning by procedure with procedure with procedure with procedure
applying pressure ease. minimal maximal
on the suction supervision supervision
control past and
gently rotates the
catheter.
11. Apply Performed the Performed the Performed the Failed to perform the
intermittent procedure with procedure with procedure with procedure
suctioning for 5 – 10 ease. minimal maximal
seconds, rotate the supervision supervision.
catheter, then
removes finger from
the suction control
and removes the
catheter.
12. Cleans the Performed the Performed the Performed the Failed to perform the
catheter by wiping procedure with procedure with procedure with procedure
off thick secretions ease. minimal maximal
or by flushing it with supervision supervision.
sterile water.
13. Encourage the Performed the Performed the Performed the Failed to perform the
client to perform procedure with procedure with procedure with procedure
deep breathing and ease. minimal maximal
coughing between supervision supervision.
suctions.
14. Promote client’s Performed the Performed the Performed the Failed to perform the
comfort and procedure with procedure with procedure with procedure
hygiene. ease. minimal maximal
supervision supervision.
15. Disposes soiled Performed the Performed the Performed the Failed to perform the
materials and procedure with procedure with procedure with procedure.
ensure availability ease. minimal maximal
of materials for the supervision supervision.
next suction
16. Assess the Performed the Performed the Performed the Failed to perform the
effectiveness of procedure with procedure with procedure with procedure.
suctioning. ease. minimal maximal
supervision supervision.
17. Wash hands and Washed hands Washed hands Washed hands Washed hands but
document the and and some of the but most of the documentation was
procedure done and documented details of details of the not done
relevant data the information procedure were procedure were
observed about the not documented. not documented.
procedure
properly and
completely.

OVERALL SCORE: ___________________

Target raw score is 38 out of 51. If raw score is less than 38, repeat the return demonstration.

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FACULTY SIGNATURE OVER PRINTED NAME: