medical assistants improving medication safety · vital signs and measurements to injections,...
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Medical Assistants: Improving Medication Safety and Competency Assessment Franklin Square Hospital Center Program/Project Description. Medical Assistants (MAs) play a vital role in ambulatory settings, providing clinical and clerical support to physicians. Clinical skills range from basic vital signs and measurements to injections, phlebotomy, administering inhalants, and performing 12-lead EKGs. Competence is essential to patient safety and quality care. However, educational background, level of experience, and competency can vary significantly, and oversight is inconsistent. There is no governing board which oversees performance, and physicians are legally responsible for delegation and assessment of competency. Educational background can be a matter of a few months, none, or on-the-job training only. Certification is optional, and registration can be obtained with no schooling at all. Our organization has 26 ambulatory sites, with a variety of services and treatments. Observations revealed concerns about level of skill for MAs, especially related to administering injections and medications. After speaking with schools that teach MAs, we discovered only a small emphasis on medication administration, and a task-oriented rather than teaching the significance behind why a task should be performed a certain way. Discussion with other organizations revealed similar concerns and yet no consistent solution. Further evaluation was done by surveying MAs and physicians, and administering a medication safety pre-test to our existing MAs. 67% were unable to pass the exam, and many expressed a lack of comfort related to safe medication practices, resources, and drug dose calculation. In order to focus on the area of greatest risk, we first worked on medication safety. MAs within our organization were observed for skills when administering injections, and tested for knowledge about safe medication practices. 67% of our MAs were unable to pass the medication safety exam, and 86% received failing scores on drug dose calculation. None of our MAs verified dosage calculations prior to administering a medication, and many were unfamiliar with the "6 rights" of medication administration. Essential safety steps such as handwashing, using landmarks, and identifying the patient were inconsistent. W e began to work on a formal process to better train and assess competency for MAs. Process. Processes were in place for RNs related to medication safety and competency assessment, but were not practical for our MAs. A survey revealed that many physicians did not fully understand their role and legal obligation in overseeing medical assistants. A survey of our MAs revealed that they were not comfortable with many elements of medication safety, and needed additional education and training. A review of our orientation curriculum revealed that although RNs take and pass a medication safety exam prior to administering medications, this process was not in place for MAs, and our orientation had little to no content that was ambulatory specific. Literature searches revealed little to no guidance on how to best ensure competency in this group, and nursing's role in training and support for MAs is often misunderstood. Colleagues at neighboring facilities had some orientation programs in place, but some elements of the solutions were impractical, given our limited resources. We were on our own for a solution. Solution. Our initial solution was to develop a curriculum for hospital orientation for MAs. Four hours of content included Medication Administration, Injection Safety, Drug Dose Calculation, and Medication and Vaccine Storage. Newly hired MAs are required to complete this course, and achieve a passing score on a medication safety exam, prior to administering medications. We then implemented the same requirements for our existing MAs, and provided education to providers as to their role in training and assessing competency. A formalized tool and process was developed for orienting new MAs to clinical skills, including use of evidence-based checklists for even basic skills such as vital signs measurement. This was designed to ensure preceptors and providers who orient new MAs are evaluating competency based on current, evidence-based guidelines. Physicians are required to sign off on the orientation process once the MA has been oriented and assessed by a competent preceptor. Now, we are in the process of developing a program designed to reduce the burden on small physician practices who are limited in resources for training and competency assessment. A course, specific for MAs, is being developed using the MedStar Health Simulation and Training Environment and Lab (SimLab). Skills were identified which are vital to the role and to patient safety, and critical action items were defined. Newly hired MAs, or those needing refresher or practice, can rotate through the course, practicing basic skills (vital signs, height, weight) and more complex skills (administering a nebulizer, 12-lead EKG, injections). Manikens simulate specific pulse, blood pressure, respirations, blood flow, and urine return. Live actors simulate conversation for evaluating communication skills and techniques, such as assessing allergy status and identifying the patient. MAs are evaluated for every step in the process including handwashing, maintaining clean and sterile fields, and interpersonal interactions.
Proctors/mentors, comprised of RNs or lead MAs, provide feedback as well as documented competency assessment. The course will: 1. Provide a safe, creative learning environment for MAs 2. Allow for thorough competency assessment without impacting patient care 3. Encourage MAs to grow professionally by developing new skills 4. Reduce the burden of orientation and competency assessment for physician-based offices which may have limited resources 5. Improve patient safety and quality of care 6. Ensure compliance with organizational policies, procedures, regulatory standards, and evidence-based guidelines for clinical skills 7. Offer a stimulating, versatile environment for skills refresher and annual competency assessment Collaboration throughout MedStar Health, among other leaders, educators and physicians who have oversight of medical assistants, ensures the course is developed so that it can be modified to meet the needs of each individual practice, depending on services provided and skills required. The Baltimore SimLab will share the MA course with the Washington, D.C. SimLab so that regardless of geographical location, all MedStar ambulatory facilities have acess to this program. It is hoped that this will enhance consistency in quality, safety, and competency throughout our organization. Measurable Outcomes. After taking the Medication Safety Course, 100% of our existing plus newly hired MAs received a passing score. Post-program survey of MAs revealed an increased comfort level with medication safety practices, and a change in behavior related to utilizing resources and performing the 6 rights of medication administration. Physician survey post-program showed that physicians observed improved behavior in their MAs related to medication safety, but still requested additional education. Medication administration errors declined at one family practice site, and errors that did occur did not reach the patient. However, two years post-program, an evaluation was done to determine if improvements were sustained. Observation and survey revealed that although improvement was sustained in most MAs, some had a decrease in comfort level with drug dose calculation, and some reverted to old "bad habits" related to rushing. Our conclusion is that we cannot assume competency simply because of schooling, past experience, or successful completion of the Medication Safety Course, and that refresher education is essential to maintaining competency and quality of care. Our plan is to utilize the SimLab project to accomplish this periodic refresher and assessment.
Sustainability. Medication Safety education and competency assessment are now hard-wired into our orientation curriculum and culture, and are mandatory for all incoming MAs. Education for physicians related to scope of practice and delegation to MAs is being added to an "on-boarding tool kit" for new physicians, so they fully understand their role in supervising MAs. The SimLab project allows for educational opportunities as well as ongoing competency assessment, and once implementation is complete, this too will become mandatory for all MAs. This will reduce the inconsistency that was observed when each practice was responsible for their own orientation process and competency assessment. Role of Collaboration and Leadership. Teamwork and collaboration have been essential in this solution. We have sought support from other educators, as well as our Professional Development department, to create the orientation curriculum. Ambulatory leaders have collaborated to achieve consistency and buy-in from each of our physician-based practices. The SimLab program requires managers and physicians to think "outside the box" about how to best ensure competency while minimizing impact on patient care. Our Ambulatory Operations Group supported development and implementation of this project, which enables us to pilot the program and demonstrate its effectiveness. Input was obtained from RNs and MAs throughout MedStar Health so that the program has value not only for patients but also has professional value for our MAs. Partnership with MedStar Physician Partners has been essential in identifying resources and best practices. The SimLab staff shared their creative approach to blended learning techniques and expertise, which enables us to create an environment which allows for non-threatening development of clinical skills. In addition, our leadership supported these efforts by empowering myself and others to take an idea and work to make it a reality. This project, which is very much in the early stages, will hopefully result in organization-wide improvements to quality and patient safety, and our leadership's willingness to embrace this vision is the reason it has developed thus far. Contact Person Debbie Biewer, RN, BSN Title Ambulatory Quality Educator Email [email protected] Phone 443-777-8460
1
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tati
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Pro
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m D
esig
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Tit
le:
Am
bu
lato
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CM
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an
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Ns
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com
ple
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alu
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mb
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lin
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re H
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ter
an
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ealt
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vie
w—
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ctu
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aff
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rep
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pes
of
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va
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role
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rev
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bo
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ex
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Community Medicine and Wellness
Certified Medical Assistant Medication Safety and Pharmacology Exam
1. TRUE FALSE All medication errors, “near misses”, and severe adverse reactions to a medication or vaccine
while still in the office are reported using the on-line Occurrence Reporting Database under the “Medication Error Report” link.
2. TRUE FALSE Reporting unsafe acts, whether actual occurrences or “near-misses”, will enable MedStar Health to identify areas for process and performance improvement.
3. TRUE FALSE When unsafe acts are identified, the focus is placed punishing the individual who made the mistake.
4. TRUE FALSE A CMA may take a verbal order from an RN who is working under a physician. 5. TRUE FALSE Per FSHC policy, only a physician may dispense a sample medication. 6. TRUE FALSE Aerosol medications such as Albuterol, administered via nebulizers or inhalers, should be
documented in the same manner as oral or injectable medications. 7. TRUE FALSE It is necessary to aspirate for blood prior to injecting an IntraMuscular injection. 8. TRUE FALSE After administering an EpiPen, it is necessary to monitor the patient and document efficacy,
vital signs, and adverse reactions for a minimum of 30 minutes. 9. TRUE FALSE Any abbreviation is acceptable as long as it makes sense to the person who is doing the
documentation. Questions 10 – 25 are multiple choice. Select the best answer from the choices listed. Record your responses on the answer sheet. 10. An adverse drug reaction is defined as
A. Any “ negative side effect resulting from the use of a drug” or “an untoward (unfavorable) event or reaction caused by a vaccine that is not in keeping with the vaccine’s primary purpose of production of immunity”
B. A preventable event that is caused by giving the wrong medication C. A mistake made by a staff member that results in harm to a patient
11. Which of the following responsibilities may be assigned to CMAs? A. Administer appropriate medications only after confirming patient identification B. Independently refill a prescription for routine medications for a regular patient in the practice C. Administer continuous IV medicated and filtered infusions to patients requiring fluids or IV drips
12. How frequently is the patient’s pain score documented in the outpatient medical record?
A. As needed if pain exists B. With every visit C. After injuries or surgical procedures
13. A verbal order can be taken by a CMA only if:
A. The doctor promises he will write the order down within the next hour B. Patient flow is heavy and the physician is too busy to do charting at the time of the order C. The situation is urgent and/or emergent and the physician is unable to write the order at the time of need D. The CMA is familiar with the patient and the medication being given
14. A nurse draws up several vaccines for her patient and then is called away for an emergency and will be unable to return. She
asks the CMA to give the vaccines to the patient for her. The CMA should: A. Accept the delegated task from the RN, and administer the pre-filled syringes to the patient B. Discard the pre-drawn syringes, re-draw and administer the vaccines herself, practicing the 5 rights of safe
medication administration C. Tell the patient the nurse will be gone indefinitely and they will have to wait for her return D. Tell her supervisor
15. The most common causes of medication errors are: distractions and interruptions during medication administration,
inadequate staffing and high nurse - patient ratios, illegible medication orders, incorrect dosage calculations, sound alike drug names and look alike packaging. To minimize the potential for an error to occur the nurse must do which of the following: A. Check the five rights before administering the drug B. Ensure the patient’s identity, and check allergy status prior to administration of the medication. C. Have the patient state his/her full name and date of birth. Compare to the medical record and physician order. D. All of the above are correct
16. In creating a “non-punitive” environment, current medication error-reduction efforts focus
on: A. Individual practitioners and dangerous nurses and CMAs B. The process that leads to errors C. The unit where most errors occur
17. All of the following are acceptable abbreviations except
A. BID B. Q HS C. QD D. TID
18. After reviewing the physician’s orders, you calculate the patient should receive 8 tablets of a medication, which seems like an
unusually high dosage to you. What actions should you take? A. Administer all 8 tablets as ordered B. Administer 2 tablets at a time over 30 minutes until all 8 have been administered C. Verify the calculations and dose using a drug reference and another nurse and/or pharmacist. If safe, give the
medication. If unsafe, do not give and notify the physician. 19. Which of the following must be entered into the on-line Occurrence Reporting Database?
A. The CMA becomes confused by two different oral medications preparations that have labels indicating the same name, but different doses. She realizes the problem and administers the correct medication.
B. A patient develops hives and difficulty breathing following a first time dose of Rocephin while in the waiting room C. A CMA administers a DTaP to Johnny Smith in room 1. The order was written for Td. D. All of the above should be entered into the Database.
20. Medication Reconciliation is a process which includes:
A. Recording a comprehensive list of a patient’s current medications, time of last dose, history of adverse reactions to meds, and the source of information
B. Giving the patient a complete list of their medications and allergies at the end of their visit C. Documenting and addressing medication changes, allergies, or adverse reactions that may have arisen since the patients’
last visit D. All of the above
21. A comprehensive medication list should include which of the following: A. Prescription medications B. Over-the-counter and herbal medications C. Illicit drugs C. All of the above
22. Which of the following must be included in the documentation in the patient’s medical record after administering Tetanus, Influenza, and Pneumococcal vaccinations? A. Lot number and expiration date B. Dosage administered, Route of administration and Administration site C. Educational literature given to the patient and the date it was updated (VIS) D. All of the above
23. An order is written for an adult patient to receive a Hepatitis B vaccine IM. This injection may be given in the following
places: A. Anterolateral upper thigh (vastus lateralis) or outer upper arm (Deltoid) B. Abdomen
C. Back of the upper outer arm D. Antecubital vein
24. A subcutaneous injection may be given in the:
A. Back of the upper outer arm B. Outer aspect of the upper thigh C. Abdomen D. All of the above
25. An EpiPen is ordered STAT for a patient experiencing an anaphylactic reaction. The injection is to be administered via:
A. IM B. SQ C. Venous injection D. IntraDermal
Questions 26 – 36 are calculations. Select the best answer from the choices listed. Record your responses on the answer sheet. Use the work sheet at the back of this packet for your calculations. Be sure to number each problem/calculation and return the work sheet, your answer sheet and test booklet when you have completed the exam. You may use your study guide as a reference. 26. Mr. KL weighs 158.4 pounds. His weight must be recorded in kg. What is his weight in kilograms?
A. 72 kg B. 316.8 kg C. 79.2 kg D. None of the above
27. A patient is to receive Benadryl (Diphenhydramine) 50 mg PO x 1 for an allergic rash. The tablets you have on hand are 25 mg per 1 tablet. How much Benadryl do you give the patient?
A. 1 tablet B. 100 mg C. 2 tablets D. 4 tablets
28. The physician orders a baby to receive Tylenol (Acetaminophen) liquid, 120 mg PO x 1, prior to receiving her vaccinations. The liquid you have on hand is Tylenol Infant Drops, 80 mg/0.8 ml. How much Tylenol do you give?
A. 1 ml B. 0.8 ml C. 1.6 ml D. 1.2 ml
29. A small boy weighs 35 lbs. What is his weight in kilograms?
A. 15.9 kg B. 77 kg C. 35 kg D. 10 kg
30. One tsp (teaspoon) is equal to:
A. 15 ml B. 5 ml C. 1 ounce D. 10 ml
31. The physician orders a teenager to receive Motrin 100 mg PO x 1 for an earache. You administer the following:
A. 10 ml Ibuprofen oral suspension (100 mg/5ml) B. Three Ibuprofen tablets (100 mg/chewable tablet) C. One Ibuprofen tablet (100 mg/chewable tablet) D. Either A or C are both correct
32. 200 mg is equal to how many grams? A. 20 grams B. 0.2 grams C. 2 grams D. 200 grams 33. An initial dose of 1 gram Ampicillin is to be given orally to your patient prior to leaving the center. The Ampicillin is available in 250 mg capsules. How many capsules will you give your patient? A. 4 capsules B. 2 capsules C. 1 capsule D. 2.5 capsules 34. You are to give 125 mg of Medication X to your patient. The elixir comes in 25 mg/5cc. How many cc’s should you give? A. 100 cc B. 25 cc C. 12.5 cc D. 250 cc 35. Medication XYZ comes in 200 mg/3cc. Your doctor orders your patient to receive 100 mg of Medication XYZ. How much will you give the patient? A. 1.5 cc B. 3 cc C. 6 cc D. 15 cc 36. A baby weighs 8.2 pounds at her newborn visit. How many kilograms does she weigh? A. 18 kg B. 16.4 kg C. 2.8 kg D. 3.7 kg MATCHING: You may use a FSHC approved resource to assist you in answering the following questions Match the brand names in Column A with the correct generic names from Column B. There is only one answer for each blank and a letter may only be used once COLUMN A COLUMN B 37. ______C_______Benadryl a. Ibuprofen 38. ______D_______Tylenol b. Ceftriaxone 39. _______A______Motrin c. Diphenhydramine Hydrochloride 40. ______B_______Rocephin d. Acetaminophen Match the drug or vaccine in Column A with its major use in Column B. There is only one answer for each blank and a letter may only be used once COLUMN A COLUMN B 41. _____E________Benadryl a. Vaccinate against Diptheria, Tetanus, and Pertussis 42. _____D________Insulin or Novolin b. Antibiotic (to fight infection) 43. ______F_______Motrin/Ibuprofen c. Vaccinate against pneumococcal bacteria (which can cause illness)
44. ______B_______Rocephin d. To reduce blood sugar levels 45. ______C______Pneumovax e. Antihistimine (to reduce body’s response to allergens) 46. _____A_______DtaP f. To reduce fever, inflammation, and/or pain Match the injection technique in Column A with the correct information from Column B. There is only one answer for each blank and a letter may be used only once 47. _______C_______ IM (Intramuscular) a. Creates a “wheal” just under the skin surface 48. _______D_______SC (Subcutaneous) b. Special technique used to reduce damage to subcutaneous tissue 49. ______A________ID (Intradermal) c. Promotes rapid absorption by placing medication in muscular tissue 50. _______B_______Z-tracking IM d. Places medication in fatty tissue just under the skin for slower absorption
1
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spit
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ase
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on
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bes
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he
skil
l.
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the
Com
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Res
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rce
to a
ssis
t in
com
ple
ting y
our
self
-ass
essm
ent.
The
Guid
elin
es w
ill
pro
vid
e th
e ori
ente
e/pre
cepto
r
w
ith m
ore
det
aile
d i
nfo
rmat
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once
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g t
he
com
pet
ency
.
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Pre
cepto
r w
ill
sign o
ff e
ach c
om
pet
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in t
he
Met
colu
mn a
s th
e O
rien
tee
com
ple
tes
the
com
pet
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.
If N
ot
Ap
pli
cab
le i
s se
lect
ed,
the
reas
on w
hy t
he
com
pet
ency
is
not
appli
cable
mu
st b
e docu
men
ted i
n t
he
com
men
t se
ctio
n.
0
Nev
er p
erfo
rmed
2
Occ
asio
nal
ly p
erfo
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1
Nee
d r
evie
w o
n h
ow
to p
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rm
3
Can
Per
form
wit
h a
ssis
tance
4
Able
to p
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ndep
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tly
The
com
ple
ted c
om
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kli
st m
ust
be
giv
en t
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Nurs
e M
anag
er b
y t
he
com
ple
tion o
f ori
enta
tion.
*M
ust
be
com
ple
ted
wit
hin
90 d
ays
aft
er s
tart
date
on
un
it
Ple
ase
not
that
MA
’s w
ork
in a
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m r
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ip w
ith a
n R
N a
nd c
ontr
ibute
to t
he
nurs
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ing s
core
req
uir
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n M
edic
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Safe
ty e
xam
pri
or
to a
dm
inis
teri
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s in
FH
C.
Med
icati
on
Exam
Sco
re:
_______________________
D
ate
of
exam
: ____________________________
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mo
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Ro
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2
3
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3
4
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cop
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ref
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0
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2
3
4
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0 1
2
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4
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Req
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Da
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2
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4
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0
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3
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7
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CO
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0
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4
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0 1
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b)
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0 1
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c)
MD
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0 1
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d)
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0
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f)
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0
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4
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4
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Tel
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0
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Mic
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Occ
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Rep
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0
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Cu
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VIS
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Tra
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9
Dem
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xce
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rankli
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quar
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Cen
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beh
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andar
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ES
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Bas
ic e
mplo
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ent
stan
dar
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�
Att
endan
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nd p
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onsi
sten
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ith h
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poli
cy
YE
S
N
O
�
Appea
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ant
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ress
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poli
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Y
ES
NO
�
Good s
afet
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ract
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ow
ed
Y
ES
NO
�
Com
munic
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oin
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eeds
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S
N
O
�
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ned
and a
ccep
ted j
ob d
escr
ipti
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incl
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ehav
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l st
andar
ds
______
YE
S
______N
O
Ori
enta
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erio
d h
as b
een s
atis
fact
ori
ly c
om
ple
ted
Y
ES
NO
(P
leas
e ex
pla
in a
nd i
ndic
ate
acti
on t
o b
e ta
ken
)
Com
men
ts:
Em
plo
yee
Sig
nat
ure
Dat
e
Pre
cepto
r S
ignat
ure
Dat
e
M
anag
er S
ignat
ure
D
ate
1/1
0
Up
dat
ed D
Bie
wer
MedicalAssistantClinicalSkillsAssessmentCourse
January2010 Page1
Course Description: (Please provide 2-3 sentences of a broad overview of the course) Is this course a X Formative and/or X Evaluative? Does this course address any of the following: Introduction of New Skills Expansion of Practice X Maintenance of Skills Team Training Needs Assessment: (What brought about the needs for this course?) Medical Assistants (MA) have a brief orientation that occurs at the bedside. Generally the skills are being overseen by other MA’s with varied levels of experience and preceptor training. Also, MA’s are being assessed by physicians who may have very little experience doing the skills themselves. An evaluation of competency in MAs of multiple settings shows a need for consistency, education about evidence-based practice, and a better process of competency assessment/evaluation. Service Line: Ambulatory Principal Faculty
Name Title E-mail Address Phone / Pager Debbie Biewer, RN, BSN (Melly Goodell, MD)
Ambulatory Quality Educator (Physician Sponsor)
443-777-8460/410-932-0325
Course Outline
Learning Objectives: (Need to be measurable, observable, and achievable. At the end of this course, learners will be able to………. 1. Perform clinical skills using evidence-based practice guidelines
2. Comply with organizational policies and procedures, as well as regulatory compliance standards, while providing patient care
3. Improve quality of care and patient safety through improved comfort level with clinical and communicative skills
Critical Actions of this Course: (These are the actions that are necessary for the participant to complete in order to meet the above objectives.)
Vital Signs: 1. Proper selection and application of BP cuff (not over clothing; right size; correct placement over artery)
2. For patients under age 2: measure pulse using stethoscope over apical site
3. Correct pulse ox placement
4. Proper use of thermometers (red tip vs. blue tip); safe insertion of rectal thermometer (1-1.5” adult; 1/2-1” peds)
5. Obtain accurate results when measuring pulse, respirations, blood pressure, and temperature
Patient Measurements
1. Accurate head circumference measurement around largest bony prominence in back of head
2. Chooses age appropriate weight scale
3. Accurate height measurement; infant: make sure results are not skewed by movement
4. Maintains safety when placing patient on/off scale; verbalizes what to do for patient w/limited mobility
Respiratory Assessment
1. Observe full respiratory cycle (inspiration and expiration) for 30 sec.; chest wall must be in sight
2. Correct peak flow measurement/able to demonstrate proper technique
Medication Administration
1. Allergy assessment prior to administering (verbal w/pt or by verifying in medical record)
2. Checks for written medication order/verbalizes that verbal orders are urgent/emergent only
3. Verifies pt identification using 2 identifiers by asking patient, NOT by “telling” patient
4. Follows “6 rights” of medication administration when preparing/administering medication
5. Check labels—not expired
6. Neb treatment: age appropriate method of administration
7. Verbalizes what do to if a medication error/near miss occurs (notify provider/supervisor, complete an occurrence report)
MedicalAssistantClinicalSkillsAssessmentCourse
January2010 Page2
Critical Actions of this Course: (These are the actions that are necessary for the participant to complete in order to meet the above objectives.)
Vital Signs: 1. Proper selection and application of BP cuff (not over clothing; right size; correct placement over artery)
2. For patients under age 2: measure pulse using stethoscope over apical site
3. Correct pulse ox placement
4. Proper use of thermometers (red tip vs. blue tip); safe insertion of rectal thermometer (1-1.5” adult; 1/2-1” peds)
5. Obtain accurate results when measuring pulse, respirations, blood pressure, and temperature
Patient Measurements 1. Accurate head circumference measurement around largest bony prominence in back of head
2. Chooses age appropriate weight scale
3. Accurate height measurement; infant: make sure results are not skewed by movement
4. Maintains safety when placing patient on/off scale; verbalizes what to do for patient w/limited mobility
Respiratory Assessment
1. Observe full respiratory cycle (inspiration and expiration) for 30 sec.; chest wall must be in sight
2. Correct peak flow measurement/able to demonstrate proper technique
Medication Administration
1. Allergy assessment prior to administering (verbal w/pt or by verifying in medical record)
2. Checks for written medication order/verbalizes that verbal orders are urgent/emergent only
3. Verifies pt identification using 2 identifiers by asking patient, NOT by “telling” patient
4. Follows “6 rights” of medication administration when preparing/administering medication
5. Check labels—not expired
6. Neb treatment: age appropriate method of administration
7. Verbalizes what do to if a medication error/near miss occurs (notify provider/supervisor, complete an occurrence report)
8. Oral medications: selects oral syringe or medicine cup for administration
9. Injections:
a. Use landmarks/correct site placement
b. Proper technique for each type of injection (SubQ, IM, ID)
c. Correct selection of needle length as appropriate for pt, medication, and route
d. Activates safety device and disposes of in sharps container
Sterile Procedures 1. Proper set up of sterile field: no contamination
2. Correct sterile gloving
Patient Safety
1. Hand washing before/after all clinical procedures/direct patient care
2. Proper use of gloves, including when giving injection or obtaining a specimen
3. I.D. patient prior to procedures/documentation by asking patient to verify/speak their name and 2nd identifier
Specimen Collection 1. I.D. patient prior to obtaining specimen
2. Check order prior to obtaining specimen
3. Label specimen in the presence of the patient
4. Proper technique for obtaining specimen
5. Urine collection—reagent strips not expired
6. Proper timing of reading specimen results—uses timer, does not read too early/late
Supporting resources required for course: Power Point Article/text Video X Evaluation Checklist X Evaluation Questions