Competency Performance Checklist

Skill 15-6: Administering a Subcutaneous Injection Student: _______________________________________

Essential/ critical element?

Date: _______________
Competency Demonstrated? Yes No

Element
1. Introduced self and verified clients identity 2. Explained procedure to client and discussed how results will be used. 3. Gathered appropriate equipment. 4. Performed hand hygiene and observed other appropriate infection control procedures. 5. Prepared medication from ampule or vial for drug withdrawal. 6. Provided for client privacy. 7. Prepared client. a. Assisted client to a position in which arm, leg, or abdomen could be relaxed. b. Obtained assistance in holding an uncooperative client. 8. Selected and cleaned the site: a. Selected site free of tenderness, hardness, swelling, scarring, itching, burning, or localized inflammation. Selected site that had not been used frequently. b. Applied clean gloves. c. Cleaned site with antiseptic swab. Started at center of site and cleaned in a widening circle to about 5 cm. Allowed area to dry thoroughly. d. Placed and held swab between third and fourth fingers of nondominant hand or positioned swab on clients skin above intended site. 9. Prepared the syringe for injection. a. Removed needle cap while waiting for antiseptic to dry. Pulled cap straight off to avoid contaminating needle by outside edge of cap. b. Disposed of needle cap. 10. Injected the medication: a. Grasped the syringe in the dominant hand and held between thumb and fingers. b. Used the nondominant hand, pinched or spread the skin at the site, and inserted the needle. c. After needle inserted, moved nondominant hand to end of plunger. d. Injected medication by holding syringe steady and depressing plunger with a slow, even pressure. 11. Removed the needle. a. Removed needle smoothly, pulling along the line of insertion while depressing skin with nondominant hand. b. Applied pressure to sit with dry sterile gauze if bleeding occurred.

12. Disposed of supplies appropriately. a. Activated needle safety device or discarded uncapped needle and attached syringe into designated receptacles. b. Removed and discarded gloves. Performed hand hygiene. 13. Assessed effectiveness of medication at time it was expected to act. Variation: Administering a Heparin Injection a. Selected a site on abdomen at least 2 inches away from umbilicus and above level of iliac crests. Avoided injecting into bruises, scars, masses, or areas of tenderness. b. Used a 3/8-inch, #25-, or #26-gauge needle or smaller, and inserted it at a 90 degree angle. c. Did not aspirate when giving injection. d. Did not massage site after injection. e. Alternated sites of subsequent injections. Variation: Administering enoxaparin (Lovenox) a. Selected a site on abdomen at least 2 inches away from umbilicus and above level of iliac crests. Avoided injecting into bruises, scars, masses, or areas of tenderness. b. Checked that the prefilled Lovenox syringe is for the correct dosage. Did not expel the air bubble. c. Pinched an inch of cleansed area on the abdomen to make a fold in the skin. Inserted the full length of the needle at a 90 0 angle into the fold of the skin. d. Pressed the plunger with thumb until the syringe was empty. e. Pulled the needle straight out at the same angle that it was inserted and released the skin fold. f. Pointed the needle down and away from self and others and pushed down on the plunger to activate the safety shield. ___ ___ ___ Used effective body mechanics throughout procedure. Communicated appropriately with the client. Documented all relevant information.

Comments: ______________________________________________________________________________ ______________________________________________________________________________

Overall Performance:

Satisfactory

Unsatisfactory

Evaluator: _______________________________