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Cebu Institute of Technology

University
N. Bacalso Ave., Cebu City Philippines

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCE

NAME OF STUDENT: _____________________________ DATE: ____________

INTRADERMAL INJECTION
Performance Checklist

Equipment:
 Medication administration record (MAR)
 Medication
 Sterile tuberculin syringe and short bevel, 25-27 gauge, 3/8- to 1/2-inch needle.
 Disposable gloves
 Alcohol swab
 sterile 2 × 2 gauze pad

PROCEDURE:
STEPS 1 2 3 4 5 Rationale
1. Check with the client and the chart
for any known allergies.

2. Wash hands.

3. Follow the five rights.

4. Prepare the medication from an


ampule or vial;

5. Take the medication to the client’s


room and place on a clean surface.

6. Check the client’s identification


armband.

7. Explain the procedure to the client.

8. Place the client in a comfortable


position; Provide Privacy

9. Wash hands and don non-sterile


gloves.

10. Select and clean the site.

1
11. Assess the client’s skin for
bruises, redness, or broken tissue.

12. Select an appropriate site using


appropriate anatomic landmarks.

13. Cleanse the site with an alcohol


wipe using a firm circular motion;
cleanse from inside to outside; allow
alcohol to dry.

Prepare the syringe for injection.


14. Remove the needle guard.

15. Check the amount of solution in


the syringe.

16. Inject the medication.

17. Hold the syringe in dominant


hand.

18. With non-dominant hand, grasp


the client’s dorsal forearm and gently
pull the skin taut on ventral forearm.

19. Administer the medication slowly;


observe the development of a bleb
(large flaccid vesicle that resembles a
mosquito bite). If none appears, with-
draw the needle slightly.

20. Withdraw the needle.

21. Pat area gently with a dry 2 × 2


sterile gauze pad.

22. Remove gloves, dispose of in ap-


propriate receptacle, and wash hands.

23. Observe for signs of an allergic


reaction.

24. Draw a circle around the perime-


ter of the bleb with a ballpoint pen.

25. Document medication and site of


injection on the MAR.

Evaluated by: ____________________________

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