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JP Drain Hemovac CHECKLIST
JP Drain Hemovac CHECKLIST
PROCEDURE CHECKLIST
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 Practice - 70-75
ASSESSMENT
Check doctor’s order on the notes
Assess for the need to drain fluids.
PLANNING
Wash hands and put on gloves if necessary.
Plan for any assistance you may need.
Gather equipments needed (Collection container, alcohol pads, gauze)
IMPLEMENTATION
REMARKS:
______________________________________________________________________
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PROCEDURE CHECKLIST
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 Practice - 70-75
ASSESSMENT
Check doctor’s order on the notes
Assess for the need to drain fluids.
PLANNING
Wash hands and put on gloves if necessary.
Plan for any assistance you may need.
Gather equipments needed (Collection container, alcohol pads, gauze, normal
saline)
IMPLEMENTATION
REMARKS:
_________________________________________________________________
PROCEDURE CHECKLIST
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 Practice - 70-75
ASSESSMENT
1. Verify type of procedure scheduled, purpose, and procedure site with patient and
medical record.
2. Verify that informed consent was obtained before administering any analgesia or
antianxiety agents.
3. Review medical record for contraindications.
PLANNING
1. Expected outcomes following completion of procedure:
2. Explain steps of skin preparation, anesthetic injection, needle insertion, position
required.
3. If ordered, premedicate for pain 30 minutes before procedure.
IMPLEMENTATION
REMARKS:
______________________________________________________________________
______________________________________________________________________