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  • Procedure Checklist With Rating Form Administering Intradermal Injections

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    Charlhyn Bisnar
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    This document contains a procedure checklist and rating form for administering intradermal injections. The checklist contains 34 criteria divided into assessment, planning, implementation, and evaluation sections. A student's performance of each criterion is rated on a scale of 5 to 0. The total score is calculated and converted to an equivalent numeric grade with a passing cutoff of 65. The form is used to evaluate a nursing student's skills and documentation when administering an intradermal injection to a patient.

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    This document contains a procedure checklist and rating form for administering intradermal injections. The checklist contains 34 criteria divided into assessment, planning, implementation, and evaluation sections. A student's performance of each criterion is rated on a scale of 5 to 0. The total score is calculated and converted to an equivalent numeric grade with a passing cutoff of 65. The form is used to evaluate a nursing student's skills and documentation when administering an intradermal injection to a patient.

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    211 views4 pages

    Procedure Checklist With Rating Form Administering Intradermal Injections

    Uploaded by

    Charlhyn Bisnar
    This document contains a procedure checklist and rating form for administering intradermal injections. The checklist contains 34 criteria divided into assessment, planning, implementation, and evaluation sections. A student's performance of each criterion is rated on a scale of 5 to 0. The total score is calculated and converted to an equivalent numeric grade with a passing cutoff of 65. The form is used to evaluate a nursing student's skills and documentation when administering an intradermal injection to a patient.

    Copyright:

    © All Rights Reserved
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    of 4

    CENTRO ESCOLAR UNIVERSITY

    Manila * Makati * Malolos

    SCHOOL OF NURSING

    PROCEDURE CHECKLIST WITH RATING FORM


    Administering Intradermal Injections
    Name of Student Score

    Year/Section/Group/Number

    Rate the student's performance by checking the appropriate box using the following criteria:
    5 - Excellent (Carries out procedures efficiently, systematically and independently/Personality trait is observed at all times)
    4 - Very Satisfactory (Carries out procedures efficiently and systematically but requires minimal guidance and supervision/Personality trait is
    observed at all times)
    3 - Satisfactory (Carries out the procedures efficiently and systematically but requires moderate guidance and supervision/Personality trait is
    observed at all times)
    2 - Fair (Carries out the procedures efficiently and systematically but requires close guidance and supervision/Personality trait is observed at all
    times)
    1 - Poor (Carries out the procedures inefficiently, unsystematically even under close guidance and supervision/Personality trait is observed at all
    times)
    0 - Not done

    Criteria 5 4 3 2 1 0
    ASSESSMENT
    1. Check accuracy and completeness of each medication administration record
    (MAR) with prescriber’s medication order.
    2. Review pertinent information related to medication: action, purpose, normal
    dose, route, side effects, adverse reactions, time of onset, peak of action and
    nursing implications.
    3. Assess patient’s medical and medication history and history of allergies.
    Know his or her normal response to an allergy.
    4. Check date of expiration for medication.
    5. Assess patient symptoms or condition for which medication has been
    prescribed.
    PLANNING
    6. Prepare the materials needed.
    7. Obtain the appropriate medication. Read the MAR and prepare medications
    for one client at a time. Select the proper medication from the unit stock/
    patient’s medication drawer
    8. Compare the label of the medication against the order on the patient’s MAR/
    CMAR. Check the expiration date and perform calculations. Return expired
    medications to the pharmacy
    9. Bring medications to patient’s bedside and keep in sight at all times.
    IMPLEMENTATION
    10. Wash hands.
    11. Identify the patient using two identifiers (1.e name and birth date or name
    and account number.) Compare identifiers with information on the patient’s
    medical record.
    12. Explain the procedure and purpose to the patient and family.
    13. Provide privacy.
    14. Re-check again the medication against the MAR at the patient’s bedside.
    15. Explain to the client that the medication will produce a small wheal/ bleb. The
    client will feel a slight sting as the medicine enters dermis.
    16. Select the injection site:
    16.1 Site can be: forearm about a hand’s width above the wrist and three or
    four finger widths below the antecubital space.

    Administering Intradermal Injections


    Rev. September , 2018
    Page 1 of 3
    Criteria 5 4 3 2 1 0
    16.2 Refrain from using sites that are hairy, tender, inflamed or swollen
    and with lesions
    17. Assist patient to appropriate positon. Have the patient extend elbow and
    support it with forearm on flat surface.
    18. Cleanse the skin using a firm circular motion starting at the center and
    widening the circle outward. Allow the area to dry thoroughly.
    19. Uncap the needle with non-dominant hand by pulling it straight off.
    20. Using non-dominant hand, spread the skin and taut over the injection site.
    21. Using the dominant hand, hold the syringe between thumb and forefinger
    with bevel up. (Refer to Figure 2)
    22. Insert needle with bevel up at 5- 15 degree angle. Place the needle flat almost
    against patient’s skin. (Refer to Fig.3)
    22.1 Advance needle through epidermis to approximately 3 mm (1/8 inch)
    below skin surface. Once needle is in place steady the lower end of the
    syringe and slide hand to plunger.
    22.2 Stabilize the hub of needle with thumb of non-dominant hand.
    23. Inject medication slowly. Normally you feel resistance. If there is no
    resistance, this indicates that needle is too deep; remove and begin again.
    24. While injecting medication, notice that small bleb approximately 6 mm (1/4
    inch) in diameter (resembling mosquito bite) appears on surface of skin.
    Instruct patient that this is a normal finding. (Refer to Fig.4)
    25. Withdraw needle quickly at the same angle that it was inserted. Do not recap
    and engage safety shield.
    26. Blot the site with dry gauze if necessary. Do not massage site. Remind patient
    not to rub or scratch the site.
    27. Assist patient to comfortable position.
    28. Discard uncapped needle or needle enclosed in safety shield and attached
    syringe into puncture-proof and leak-proof receptacle.
    29. Draw a perimeter circle around the wheal/ bleb using black ink pen carefully.
    30. Remove gloves and perform hand hygiene. Care for equipment.
    EVALUATION
    31. Document the administration of medication. (medication, time injected,
    route, site and nursing assessments)
    32. Evaluate the patient’s response to the medication/ testing substance within an
    appropriate time frame.
    33. Evaluate the condition of the site depending on the test done. Measure the
    area of redness and induration in millimeters at the largest diameter and
    document findings.
    34. Read site within appropriate amount of time, designated by type of
    medication or skin test administered together with physician.

    Total Score:

    Comments/Suggestions:

    Administering Intradermal Injections


    Rev. September , 2018
    Page 2 of 3
    Computation: Total Score divided by 36 (number of items) x 20 (factor) = _________________

    *Total points shall be transmuted using the table for 100 pts. Passing cut-off point is 65.

    Equivalent Numeric Grade: _______________

    Interpretation: __________________________

    Evaluator: Conforme:

    Clinical Instructor's Student’s Signature Date:


    Printed Name & Signature

    Administering Intradermal Injections


    Rev. September , 2018
    Page 3 of 3

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