SKILLS ENHANCEMENT N103 CHECKLIST Name: ________________________________ __________ Yr. & Sec.

PROCEDURE: Medication Administration Checklist on Parenteral Route (IM, SC, ID) Performed COMMENTS YES NO PREPARATION I. Preparing Injections 1. Checks expiration date 2. Compares medication with order 3. Chooses appropriate supplies and equipment 4. Triple checks - When taking from shelf - Before withdrawing/ pouring - After withdrawing the medication 5. Chooses appropriate route 6. Calculates correct dose 7. Prepares medication correctly from the ampule or vial 8. Places medication and MAR together in the cart II. Intramuscular Injections 9. Identifies patient 10.Explains procedure & gets consent 11.Asks about medication allergies 12.Asks if patient faints with injections 13.Positions the client 14.Observes the 5 basic rights in medication administration 15.Selects appropriate site 16.Washes hands and observes other appropriate infection control procedures, ex. Put on clean gloves 17.Cleanses site appropriately 18.Prepares to inject, places or holds swab in between 3rd and 4th fingers or on clients skin above intended site 19.Stretches skin taut for Z-track method and pinches skin for emaciated clients or infants 20.Injects at 90 degree angle 21.Aspirates 22.Follows appropriate protocol if blood is aspirated
SKILLS ENHANCEMENT N103 CHECKLIST ID) Medication Administration Checklist Parenteral Route (IM, SC, 1

23.Withdraws appropriately 24.Does not massage site 25.Removes needle properly 26.Disposes syringe and properly 27.Documents appropriately

materials

III. Subcutaneous Injections 28.Identifies patient 29.Explains procedure & gets consent 30.Asks about medication allergies 31.Asks if patient faints with injections 32.Positions the client 33.Observes the 5 basic rights in medication administration 34.Selects appropriate site 35.Washes hands and observes other appropriate infection control procedures, ex. Put on clean gloves 36.Cleanses site appropriately 37.Prepares to inject, places or holds swab in between 3rd and 4th fingers or on clients skin above intended site 38.Pinches clients skin if thin and spreads if fat 39.Injects at 45 degree angle 40.Aspirates by appropriate situations 41.Follows appropriate protocol if blood is aspirated 42.Injects appropriately 43.Removes needle properly 44.Does not massage site 45.Disposes of supplies appropriately 46.Documents appropriately IV. Intradermal Injections 47.Identifies patient 48.Explains procedure & gets consent 49.Asks about medication allergies 50.Asks if patient faints with injections 51.Positions the client 52.Observes the 5 basic rights in medication administration 53.Selects appropriate site 54.Wash hands and observes other appropriate infection control procedures, ex. Put on clean gloves 55.Cleanses site appropriately 56.Stretches skin taut
SKILLS ENHANCEMENT N103 CHECKLIST ID) Medication Administration Checklist Parenteral Route (IM, SC, 2

57.Injects at 10- 15 degree angle 58.Bevel up 59.Injects appropriately 60.Forms wheal 61.Withdraws needle quickly at the same angle it was inserted. 62.Does not massage the area 63.Does not apply anything like alcohol or creams 64.Disposes materials properly 65.Circles injection site with ink per agency policy 66.Evaluates site after 30 minutes for skin test, after 24 to 72 hours for tuberculin test 67.Documents procedure and findings appropriately

TOTAL SCORE: 67

Prepared by: N103

Noted by: Prof. GEMELIN B. CELIZ Over-all Coordinator

SKILLS ENHANCEMENT N103 CHECKLIST ID)

Medication Administration Checklist Parenteral Route (IM, SC, 3