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    IVPiggyback

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    lilchibaby3161
    Skills Check-Off IV Piggyback Candidate:________________________ Date:________________________ Signature:_____________________ Points Possible Points Awarded Time Started:_______ Takes, or verbalizes, body substance isolation precautions Confirms correct patient Confirms patency of primary IV site Checks selected IV fluid for: Proper fluid (1) Clarity (1) Expiration Date (1) Checks selected medication: Proper medication (1) Concentration (1) Expiration Date (1) Injects correct amount of

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    IVPiggyback

    Uploaded by

    lilchibaby3161
    63 views1 page
    Skills Check-Off IV Piggyback Candidate:________________________ Date:________________________ Signature:_____________________ Points Possible Points Awarded Time Started:_______ Takes, or verbalizes, body substance isolation precautions Confirms correct patient Confirms patency of primary IV site Checks selected IV fluid for: Proper fluid (1) Clarity (1) Expiration Date (1) Checks selected medication: Proper medication (1) Concentration (1) Expiration Date (1) Injects correct amount of

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    Skills Check-Off IV Piggyback Candidate:________________________ Date:________________________ Signature:_____________________ Points Possible Points Awarded Time Started:_______ Takes, or verbalizes, body substance isolation precautions Confirms correct patient Confirms patency of primary IV site Checks selected IV fluid for: Proper fluid (1) Clarity (1) Expiration Date (1) Checks selected medication: Proper medication (1) Concentration (1) Expiration Date (1) Injects correct amount of

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    63 views1 page

    IVPiggyback

    Uploaded by

    lilchibaby3161
    Skills Check-Off IV Piggyback Candidate:________________________ Date:________________________ Signature:_____________________ Points Possible Points Awarded Time Started:_______ Takes, or verbalizes, body substance isolation precautions Confirms correct patient Confirms patency of primary IV site Checks selected IV fluid for: Proper fluid (1) Clarity (1) Expiration Date (1) Checks selected medication: Proper medication (1) Concentration (1) Expiration Date (1) Injects correct amount of

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Skills Check-Off

    IV Piggyback

    Candidate:_______________________ Examiner:________________________

    Date:___________________________ Signature:________________________

    Points Points
    Time Started:_______ Possible Awarded
    Takes, or verbalizes, body substance isolation precautions 1
    Confirms Allergies 1
    Confirms correct patient 1
    Confirms patency of primary IV site 1
    Checks selected IV fluid for: Proper fluid (1) Clarity (1) Expiration Date (1) 3
    Checks selected medication: Proper medication (1) Concentration (1) Expiration
    3
    Date (1)
    Injects correct amount of medication into IV bag 1
    Labels mixed medication appropriately 1
    Connects appropriate administration set 1
    Prepares administration set 1
    Attaches appropriate device (needle, blunt needle, or needless device) to
    1
    administration set
    Cleanses port of primary line 1
    Inserts device (needle, blunt needle, or needless device) into most proximal port on
    1
    primary line
    Hangs secondary bag above primary bag 1
    Adjusts flow rate of secondary line 1
    Secures device (needle, blunt needle, or needless device) to port which it was inserted 1
    Verbalizes need to watch patient for desired/adverse effects of the medication 1
    Time End:_______ Total 21

    CRITICAL CRITERIA
    Does not immediately don or verbalize BSI
    Contaminates site of injection and does not take appropriate action
    Administers improper medication (wrong drug, incorrect amount, or infuses at a
    inappropriate rate
    Failure to flush tubing on secondary set
    Failure to hang secondary bag above primary bag

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