procedure check lists

1. STI College
College of Nursing
Intramascular / Intradermal
Procedure Remarks
Done Not
Done
1. Check the doctor’s order. Explain the procedures to the patient.
2. Get the medicine ticket. Check with the doctor’s order and solve for
the dosage PRN.
3. Secure the ordered drug. Wash hands.
4. Pick the cotton balls with alcohol using the forceps and place them
on the sterile tray.
5. Pick the syringe, injecting needle and withdrawing needle and place
them on the sterile tray.
6. Prepare the drug for.
AMPULES
1. Pick the syringe with your hand and attach the injecting needle and
place it on the sterile tray.
2. Disinfect the file and neck of an ampule with a cotton ball with
alcohol.
3. Protect your fingers with OS and file the neck of an ampule.
4. Wipe off the dust with cotton ball and break the top potion.
5. Withdraw the solution into the syringe. Recap the needle and place
it on the sterile tray.
6. Place the prepared drug for injection on top of the medication ticket.
VIAL LIQUID FORM
1. Alcoholize the file and break the seal with the file. Wipe the top part
of the vial with cotton ball soaked with alcohol.
2. Pick the withdrawal needle and attach the needle to the syringe.
3. Withdraw the desired amount. Change the withdrawing needle with
the injecting needle.
4. Place the prepared syringe on top of the medication ticket.
VIAL POWDERED FORM
1. Place the syringe in the sterile tray.
2. Alcoholize the file and break the seal with the file. Wipe the rubber
top with cotton ball soaked with alcohol.
3. Pick the withdrawal needle and attach the needle to the syringe.
4. Withdraw the desired amount of distilled water.
5. Disinfect the vial with powder using the cotton balls with alcohol.
6. Inject the distilled water into the powder vial. Remove the needle
and the syringe. Rub with your palms the powder vial until the
powder will be dissolved.
7. Disinfect the vial again.
INTRADERMAL PREPARATION
1. Pick the tuberculin syringe and attach the withdrawal needle.
2. Withdraw first 0.9 ml distilled water then 0.1 ml of the medication.
3. Change the withdrawing needle with the injecting needle.
4. Place the syringe on the tray.
5. Place enough cotton balls with alcohol on the tray.
6. Bring the tray to the bedside.
7. Check the medication card with the patient’s name .call the name of

2. Score/Grade:
Name and Signature of Student
Name and Signature of Clinical Instructor
the patient.
8. Expose the site and disinfect using a cotton ball with alcohol. Get
the syringe from the tray. Expel the air from the syringe.
9. Taut the inner aspect of the forearm.
10. The needle is inserted with the bevel upward at 10-15 degree angle.
Do not aspirate.
11. Inject the drug by pressing the plunger slowly until a wheal or bleb
is formed.
12. Withdraw the needle; do not press the site with a cotton ball soaked
with alcohol.
13. Encircle the formed wheal or bleb using a blue or black pen.
14. Test results are read 30 minutes after the ID injection.
INTRAMASCULAR PREPARATION
1. Expose the site and disinfect using a cotton ball with alcohol. Get
the syringe from the tray. Expel the air from the syringe.
2. Grasp the patient’s flesh firmly between the thumb and the 1st two
fingers of the left hand and inject the needle quickly. For obese
patient, press the flesh firmly.
3. Hold the hub with the thumb and the forefinger of the left hand then
pull the plunger to check if the needle did not hit a blood vessel.
4. Inject the drug by pressing the plunger with the thumb of the right
hand.
5. Withdraw the needle quickly, and then press the site with cotton
ball soaked with alcohol. Massage the site unless contraindicated.
6. Place the used syringe on top of the tray. Turn the medication card
downward.
7. Readjust the patient’s clothing.
8. Check the site before leaving the patient.
9. Sign the medication sheet: time, drug, amount and the site of
injection.