name: Assist with insertion or placement of selected device, as appropriate


name: Apply external transcutaneous pacemaker electrodes to clean, dry skin on the left anterior chest and to the posterior chest, as appropriate


name: Set rate according to patient need as directed by physician (general guidelines: 90 to 110 beats per minute surgical patients, 70 to 90 beats per minute medical patients, 80 beats per minute cardiac arrest patients)


name: Set the milliamperage according to patient (general adult guidelines: nonurgent 10 mA; emergent 15 to 20 mA); increase mA until capture is present


name: Monitor patient response to mA setting at regular intervals in anticipation of fluctuations resulting from endothelial sheath formation around electrode tips


name: Set the sensitivity (general adult guidelines: 2 to 5 millivolt, if failure to sense occurs, turn millivolt DOWN; if sensing beats not actually present, turn millivolt UP)


name: Initiate pacing by slowly increasing mA level delivered until consistent capture (capture threshold) occurs (general guidelines of mA output at 1.5 to 3 times higher than threshold, and minimally 15 to 20 mA in emergent conditions)


name: Obtain chest x-ray examination after insertion of invasive temporary pacemaker


name: Observe for changes in cardiac or hemodynamic status that indicate a need for modifications in pacemaker status


name: Monitor for failure to pace and determine cause (e.g., battery failure, lead dislodgement, wire fracture, disconnected wire or cable), as appropriate


name: Monitor for failure to capture and determine cause (e.g., lead dislodgement or malposition, battery failure, pacing at voltage lower than capture threshold, faulty connections, lead fracture, ventricular perforation), as appropriate


name: Monitor for conditions that potentially influence capture and sensing (e.g., fluid status changes, pericardial effusion, electrolyte or metabolic abnormalities, certain medications, tissue inflammation, tissue fibrosis, tissue necrosis)


name: Perform capture and sensitivity threshold testing every 24 to 48 hours with newly inserted pacers to determine best generator settings (contraindicated in patients paced 90% or more of the time)


name: Perform threshold testing separately for atrial and ventricular chambers


name: Provide appropriate incisional care for pacemakers with insertion sites (e.g., dressing change, antimicrobial and sterile occlusive dressing per facility protocol)


name: Ensure that all equipment is grounded, in good working order, and carefully located (e.g., in a location from which it will not be dropped on the floor)


name: Ensure that wires are of a length to deter inadvertent dislodging of electrodes


name: Insulate electrode wires when not in use (e.g., cover unused thoracic wires with the fingertip of a disposable glove)


name: Teach patient and family member(s) precautions and restrictions required when temporary pacemaker is in place (e.g., limitation of movement, avoid handling the pacemaker)


name: Identify pain intensity during movements such as required recovery activities (e.g., coughing and deep breathing, ambulation, transfers to chair)


name: Explore patient's knowledge and beliefs about pain, including cultural influences


name: Monitor pain using a valid and reliable rating tool appropriate for age and ability to communicate


name: Question patient regarding the level of pain that allows a state of comfort and appropriate function and attempt to keep pain at or lower than identified level


name: Ensure that the patient receives prompt analgesic care before the pain become severe or before pain-inducing activities


name: Administer analgesics around-the-clock the first 24 to 48 hours after surgery, trauma, or injury except if sedation or respiratory status indicates otherwise


name: Monitor sedation and respiratory status before administering opioids and at regular intervals when opioids are administered


name: Follow agency protocols in selecting analgesic and dosage


name: Use combination analgesics (e.g., opioids plus nonopioids), if pain level is severe


name: Avoid use of analgesics that may have adverse effects in older adults


name: Administer analgesics using the least invasive route available, avoiding the intramuscular route


name: Provide PCA and intraspinal routes of administration, when appropriate


name: Modify pain control measures on the basis of the patient's response to treatment


name: Prevent or manage medication side effects


name: Notify physician if pain control measures are unsuccessful


name: Provide accurate information to the family about the patient's pain experience


name: Use a valid and reliable chronic pain assessment tool (e.g., Brief Pain Inventory-Short Form, McGill Pain Questionnaire-Short Form, Fibromyalgia Impact Questionnaire)


name: Evaluate with patient the effectiveness of past pain control measures


name: Control environmental factors that may influence the patient's pain experience


name: Question the patient regarding pain at frequent intervals, often at the same time as checking vital signs or at every office visit


name: Instruct patient and family about principles of pain management


name: Encourage patient to monitor own pain and to use self-management approaches


name: Collaborate with patient, family, and other health professionals to select and implement pain control measures


name: Evaluate the effectiveness of pain control measures through ongoing monitoring of the pain experience


name: Watch for signs of depression (e.g., sleeplessness, not eating, flat affect statements of depression, or suicidal ideation)


name: Watch for signs of anxiety or fear (e.g., irritability, tension, worry, fear of movement)


name: Incorporate the family in the pain relief modality, when possible


name: Consider referrals for patient and family to support groups and other resources, as appropriate


name: Evaluate patient satisfaction with pain management at specified intervals


name: Understand the relationship between the parent's behavior and child's age-appropriate goals


name: Identify personal factors that effect on the success of the educational program (e.g., cultural values, presence of any negative experiences with social service providers, language barriers, time commitment, scheduling issues, travel, and general lack of interest)


name: Identify the presence of family stressors (e.g., parental depression, drug addiction, alcoholism, low literacy, limited education, domestic violence, marital conflict, blending of families after divorce, and excessive punishment of children)


name: Instruct parent on normal physiological, emotional, and cognitive characteristics of adolescents


name: Provide online resources, books, and literature designed to teach parents about teen parenting


name: Instruct parents about essential communication skills that will increase their ability to empathize with their adolescent and assist their adolescent to problem solve


name: Instruct parents about methods of communicating their love to adolescents


name: Instruct parents to use reality and consequences to manage adolescent behavior


name: Ask parent to describe the behaviors of the child


name: Design an education program that builds on the family's strengths


name: Involve parents in the design and content of the education program


name: Identify personal factors that effect on the success of the education program (e.g., cultural values, presence of any negative experiences with social service providers, language barriers, time commitment, scheduling issues, travel, and general lack of interest)


name: Instruct parent on normal physiological, emotional, and behavioral characteristics of child


name: Provide online resources, books, and literature designed to teach parents about parenting


name: Instruct parents on the importance of a balanced diet, three meals a day, and nutritious snacks


name: Discuss approaches parents can use to assist children to express feelings positively


name: Make home visits as indicated by level of risk


name: Refer to male home visitors to work with fathers, as appropriate


name: Provide information on Medicare coverage for leave or "bedhold" fee, as appropriate


name: Discuss pass with responsible person describing nursing care and self-care, as needed


name: Obtain medications to be taken on pass and instruct responsible person


name: Provide assistive devices and equipment, as appropriate


name: Instruct appropriate person on the information that is needed about medication, food, alcohol intake, and activities when on pass


name: Document on sign-out form the date and time of departure; name, strength, dose, and quantity of medications provided; directions given; and other pertinent actions


name: Verify that medications were taken as instructed on return


name: Recommend discontinuation of opioid administration by other routes


name: Avoid use of meperidine hydrochloride (Demerol)


name: Instruct patient and family to monitor pain intensity, quality, and duration


name: Instruct patient and family to monitor respiratory rate and blood pressure


name: Validate that the patient can use a PCA device (i.e., is able to communicate, comprehend explanations, and follow directions)


name: Instruct patient and family members how to use the PCA device


name: Instruct patient and family members about the action and side effects of pain-relieving agents


name: Monitor closely for respiratory depression in at-risk patients (e.g., older than 70 years; history of sleep apnea; concurrent use of PCA with a central nervous system depressant; obesity; upper abdominal or thoracic surgery and PCA bolus of greater than 1 mg; history of renal, hepatic, pulmonary, or cardiac impairment)


name: Explain to the patient the importance of proper identification throughout the health encounter


name: Ask the patient his/her first name, last name, and date of birth


name: Select the most appropriate location(s) for placing the identification device(s)


name: Ensure that identification devices are put in appropriate locations


name: Have on hand a number of replacement bands and an easy process for a new bracelet to be stamped and applied should a wristband be removed


name: Standardize the format of the wristbands across the health care institution


name: Compare the information provided by the patient with the information in the identification device before every administration of care (e.g., administering medications, performing invasive procedures, conducting diagnostic tests, transferring patient)


name: Use at least two patient identifiers when laboratory samples are obtained or when medications or blood products are administered


name: Conduct verification of patient at multiple points in time when procedure is complex and involves several stages


name: Use identification by family member or good friend when patient cannot provide information


name: Institute a "stop-the-line" policy if a misidentification error is suspected (i.e., do not carry out the intended action until positive identification is made)


name: Educate the patient about the risks related to an incorrect identification


name: Compare the information provided by a family member with the information in the identification device to confirm a patient's death


name: Ensure a best practice for patient identification by instituting a clearly written, easy to understand, agency policy


name: Observe peer during performance of service as required for evaluation


name: Focus evaluation on quality, safety, and patient satisfaction outcomes


name: Consider the nurse's developmental stage (novice to expert) when conducting the evaluation


name: Provide cushion for chair, as appropriate


name: Inspect condition of incision or tear(s) (e.g., episiotomy, laceration, circumcision)


name: Provide and assist with sitz baths, as necessary


name: Apply protective barrier (e.g., zinc oxide, petrolatum), as appropriate


name: Apply prescribed medication (e.g., antibacterial, antifungal), as appropriate


name: Document characteristics of drainage, as appropriate


name: Instruct patient or significant other, as appropriate, regarding inspection of perineum for pathology (e.g., infection, skin breakdown, rash, abnormal discharge)


name: Monitor sharp or dull and hot or cold discrimination


name: Monitor for paresthesia (e.g., numbness, tingling, hyperesthesia, hypoesthesia, and level of pain), as appropriate


name: Encourage patient to use the unaffected body part to determine temperature of food, liquids, bathwater, etc.


name: Instruct patient or family to monitor position of body parts when bathing, sitting, lying, or changing position


name: Monitor fit of bracing devices, prosthesis, shoes, and clothing


name: Administer analgesics, corticosteroids, anticonvulsants, tricyclic antidepressants, or local anesthesias, as necessary


name: Monitor for thrombophlebitis and venous thromboembolism


name: Flush with prepared heparin and saline, as appropriate and per agency protocol


name: Monitor for immediate complications such as bleeding, nerve or tendon damage, cardiac decompression, respiratory distress, or catheter embolism


name: Remove catheter according to manufacturer's instructions and per agency protocol


name: Draw laboratory samples and review blood chemistries (e.g., blood urea nitrogen, serum creatinine, and serum Na, K, and PO4 levels)


name: Monitor for signs of infection (e.g., peritonitis and exit site inflammation/drainage)


name: Perform speculum examination to visualize status of vaginal mucosa


name: Insert pessary according to manufacturer's instructions


name: Perform second examination in upright position to verify fit


name: Arrange for immediate transport of specimen to laboratory


name: Position targeted extremity lower than level of heart


name: Avoid tourniquet application time of greater than 1 minute to minimize hemolysis of sample


name: Order serum bilirubin levels, as appropriate per protocol or primary practitioner request


name: Report laboratory values to primary practitioner


name: Monitor serum bilirubin levels, per protocol or practitioner request


name: Obtain a physician's order or confer with a physician within 1 hour after the restraint is initiated


name: Renew orders for physical restraint according to state rules and regulations and professional standards of care


name: Ensure face to face evaluation is conducted by an appropriately credentialed provider within 1 hour of initiating use of physical restraints


name: Do not tie restraints to side rails of bed


name: Provide appropriate level of supervision to monitor patient and to allow for therapeutic actions, as needed


name: Provide for movement of extremities in patient with multiple restraints by rotating the removal and reapplication of one restraint at a time as safety permits


name: Involve patient in making decisions to move to a more or less restrictive form of intervention, when appropriate


name: Inform family about the risks and benefits of restraints and restraint reduction


name: Follow-up important electronic messages (e.g., texts, e-mails) with verbal contact


name: Use health history to determine the suitability of herbal or flower essence therapy


name: Instruct the patient about therapeutic use of herbs or flower essences (e.g., background, philosophy, modes of action, contraindications)


name: Select variety of plant indicated in relation to the individual's state of health


name: Obtain medicinal substances from reputable source


name: Consider using prepared stock flower essences such as the Bach collection of 38 flower essences


name: Prepare medicinal herbs or flowers (e.g., gather, wash, cut, cook), as indicated


name: Determine the form in which the medicinal plant or plant part is prepared (e.g., infusion, decoction, maceration)


name: Store preparations out of direct sunlight in a moderate environment


name: Determine dose and guidelines for the administration of herbal products


name: Assist the patient on the correct use of herbal products (e.g., preparation, time of administration, method of administration)


name: Explain the effects of interaction with other prescribed medicines, if necessary


name: Monitor for the expected response or potential adverse effects


name: Record in the clinical history the action and response to phytotherapy


name: Confirm the need for pneumatic tourniquet use in the physician's or anesthesia professional's plan of care


name: Verify that the entire tourniquet system is complete, clean, and functioning according to the manufacturer's instructions for use


name: Select a tourniquet cuff of appropriate width and length for extremity (e.g., as wide as possible without inhibiting surgical site exposure; use contoured cuffs for patient extremities that taper between the upper and lower edge of the cuff; cuff length should provide bladder overlap on limb and full engagement of hook-and-loop fasteners)


name: Evaluate patient for considerations related to tourniquet use (e.g., planned location of the tourniquet, condition of skin under and distal to the planned cuff site, size and shape of the extremity, peripheral pulses and sensation distal to the planned cuff site, ability to move digits in the involved extremity)


name: Screen for potential contraindications for tourniquet use (e.g., risk factors for deep vein thrombosis, ischemic extremities)


name: Assure that tourniquet tubing and connectors are incompatible with other tubing (e.g., IV tubing, vacuum system) or labeled to clearly identify that they are part of the tourniquet system


name: Label tourniquet tubing clearly to indicate that tubing belongs to which cuff and which is associated with which components of the tourniquet system(s) during procedures involving tourniquet control on two extremities


name: Position cuff tubing on or near the lateral aspect of the extremity


name: Verify the correct surgical site before application of tourniquet cuff


name: Wrap a low-lint, soft padding (e.g., limb protection sleeve, two layers of stockinet, cotton roll) around extremity under site of tourniquet cuff, ensuring that padding is wrinkle-free and does not pinch skin


name: Apply and secure tourniquet cuff snugly around the extremity, avoiding neurovascular sites and ensuring that skin is not pinched


name: Protect patient skin under the tourniquet cuff to prevent fluid accumulation (e.g., skin prep solutions, irrigation)


name: Protect reusable tourniquet cuffs from contamination by fluid, blood, and other potentially infectious material during surgery


name: Apply tourniquet protectors (e.g., U-shaped drapes, adhesive drapes, tourniquet covers) to minimize soiling, as indicated


name: Set the tourniquet pressure to maintain the minimum effective pressure as instructed by physician, anesthesia professional, or per agency policy and based on patient's systolic blood pressure and limb circumference


name: Alert anesthesia professional before wrapping the extremity


name: Inflate the cuff under the direction of physician or anesthesia professional


name: Monitor patient continuously during use and on deflation of tourniquet for physiological responses to tourniquet cuff inflation


name: Assure that activation indicators and pressure displays are visible and audible alarms sufficiently loud to be heard over other sounds in the operating room


name: Assure pneumatic tourniquet inflation time kept to a minimum


name: Inform physician of tourniquet inflation time at regular, established intervals


name: Verify the tourniquet inflation pressure during the time-out process


name: Avoid overheating patient when the tourniquet cuff is inflated, particularly in pediatric patients


name: Deflate the tourniquet cuff under the direction of the physician and anesthesia professional


name: Confirm sequence and timing of deflation of each tourniquet when tourniquets are used on two extremities


name: Document tourniquet equipment identification number, cuff site, pressure, inflation and deflation times, condition of skin under cuff, and peripheral circulatory and neurological evaluation, as per agency policy


name: Provide a report on pressure settings, duration of the pneumatic tourniquet inflation, and patient outcomes when transferring the care of the patient to other caregivers


name: Monitor patient for systemic responses and blood loss after cuff has been deflated


name: Report complications to the physician and anesthesia professional and to other caregivers when the patient care is transferred


name: Inspect and clean pneumatic tourniquet after use and according to manufacturer's written instructions


name: Clean reusable cuffs and bladders using a U.S. Environmental Protection Agency registered hospital disinfectant, per agency policy


name: Participate in proficiency testing programs as required by institution


name: Use appropriate specimen for the test being performed


name: Perform testing on collected specimens in a timely manner


name: Store reagents according to manufacturer's requirements or as stated in institution's procedure manual


name: Follow manufacturer guidelines and institutional procedures for instrument calibration


name: Document quality control checks as required


name: Perform test according to manufacturer directions or as stated in institutional procedures


name: Verify the results of the point of care test with use of a central laboratory when a critical clinical decision is to be made


name: Perform cleaning and maintenance of instruments according to manufacturer guidelines or as stated in institutional procedure


name: Document cleaning and maintenance as required


name: Establish a multidisciplinary team including representation from relevant laboratory groups to oversee appropriate resources (e.g., equipment, space available, documentation needs) and training of personnel, as needed in particular setting


name: Establish operational teams to oversee day to day operations, including training, proficiency testing, quality assurance, stock management, computer needs and Internet connectivity, and safety, as needed in particular setting


name: Incorporate preferred sleeping position into plan of care if not contraindicated


name: Avoid placing amputation stump in flexion position


name: Determine length and type of procedure, anesthesia requirements, patient's age, body weight, and current medication regime


name: Identify high risk surgical situations (e.g., procedure greater than 2 hours, morbidly obese patients, vascular surgeries, excessive sustained pressure to certain body areas, cool environment with exposure of large body surfaces)


name: Determine patient's range of motion, stability of joints, or presence of prostheses or implants


name: Document specific risk factors that may predispose patient to position-related injuries


name: Check operating room table before patient transfer to ensure it is functioning, locked, and properly prepared with correct padded attachments


name: Assure all needed equipment is clean and in good working order


name: Assure a minimum of four persons to assist with transferring patient to the operating room table


name: Lock wheels of stretcher and operating room bed during transfer of patient


name: Document mode of operating room table transfer and number of persons assisting


name: Check with anesthesia before moving an anesthetized patient


name: Maintain body mechanics and employ ergonomic theory to prevent injury to self


name: Provide warmth, privacy, and reassurance, as needed


name: Protect all tubes, drains, lines, breathing circuits, and other devices


name: Use assistive devices for immobilization, securing patient to operating room bed without compromising circulation underneath any restraining straps


name: Employ restraining straps to prevent slippage of extremities


name: Support all body parts and maintain body alignment when moving an anesthetized patient


name: Avoid pulling or dragging patients during transfers


name: Maintain patient's proper body alignment at all times


name: Place on an appropriate therapeutic mattress or pad, as indicated


name: Position patient for comfort whether asleep or awake


name: Assure operative field adequately exposed


name: Assure no awkward position, undue pressure on a body part, or use of stirrups or traction will obstruct the vascular supply to any body part


name: Assure that respirations are not impeded by pressure of arms on the chest or by patient gown constricting neck or chest


name: Employ padded shoulder braces to prevent irreparable nerve injury when Trendelenburg position employed


name: Apply padding or position patient to avoid pressure to superficial nerves


name: Monitor physiological effects of positioning and traction devices, as appropriate


name: Intervene in situations in which position compromises patient outcomes


name: Ensure access to airway, intravenous catheters, and monitoring devices


name: Ensure that equipment or personnel do not create or impose pressure on patient during the procedure


name: Monitor position, straps, and padding to assure placement is maintained throughout procedure


name: Document all intraoperative assessments related to positioning and safety measures


name: Reposition patient slowly at procedure end to allow for adequate hemodynamic accommodation


name: Use appropriate body mechanics when positioning patient


name: Provide the patient with an adapted call system (e.g., low pressure, voice control, sip-and-puff straw like switch, chin movement switch) depending on level of motor function


name: Use heel boots to maintain ankles in neutral position


name: Position the head of bed as low as possible (measured by pulmonary function) to increase the surface area of the body and decrease pressure on bony prominences


name: Turn using the log roll technique every 2 hours or more frequently, as indicated


name: Stabilize the spine during position changes by keeping the spine in anatomical alignment (e.g., zero rotation)


name: Monitor brain tissue oxygen and intracranial pressure in critically ill patients during positioning changes, as appropriate


name: Monitor skin integrity under bracing device or orthosis collar


name: Brace traction weights when moving patient


name: Monitor for skin breakdown over bony prominences (e.g., sacrum, ischial tuberosities, heels)


name: Provide passive range of motion to affected limbs as determined by rehabilitation staff


name: Instruct family members on how to assist patient to turn in bed and how to provide range of motion, as appropriate


name: Encourage patient to participate in position changes (i.e., remind staff when it is time to be turned) as feasible


name: Instruct on ways (e.g., tilt, recline) to provide pressure relief to decrease potential for skin breakdown when using a wheelchair


name: Monitor for orthostatic hypotension when transferring to a sitting position in wheelchair


name: Use a slide board to assist transfer to a chair or wheel chair for those patients with fair balance


name: Select the appropriate wheelchair for the patient (e.g., standard adult, semi reclining, fully reclining, amputee, extra wide, narrow)


name: Select a wheelchair with seat low to floor for patient who will get around using foot propelling


name: Ensure that there is at least 2 to 3 inches of clearance on each side of the chair


name: Monitor for effects of prolonged sitting (e.g., pressure ulcers, skin tears, bruises, contractures, discomfort, incontinence, social isolation, falls)


name: Provide padding and other enhancements (e.g., contoured padded backs, padded leg rest panels, arm troughs, padded trays) for patients with special needs


name: Determine appropriate time frame for patient to remain in wheelchair based on health status


name: Provide trapeze or slide board to assist with transfer, as appropriate


name: Determine airway and circulatory adequacy


name: Obtain handoff report from the operating room nurse and anesthetist or anesthesiologist


name: Clarify any postoperative orders to be initiated in the post anesthesia care unit


name: Administer warming measures (e.g., warm blankets, convection blanket), as needed


name: Administer narcotic antagonists per agency protocol, as appropriate


name: Administer IV medication to control shivering, as per agency protocol


name: Remove external objects from body (e.g., clothing, tubes, monitors), as needed


name: Place incontinent pad under buttocks and between legs


name: Respect the family's religious beliefs and rituals


name: Monitor lochia for color, amount, odor, and presence of clots


name: Have patient empty bladder before postpartum check and frequently


name: Monitor fundal location, height, and tone, being sure to support the lower uterine segment during palpation


name: Monitor perineum or surgical incision and surrounding tissue (i.e., monitor for redness, edema, ecchymosis, discharge, and approximation of wound edges)


name: Encourage early and frequent ambulation, assisting patient, when needed


name: Encourage the postoperative patient to perform respiratory exercises, assisting patient, when needed


name: Comfort the patient experiencing shaking chills (i.e., provide warm blankets and offer beverages)


name: Instruct patient on perineal care to prevent infection and reduce discomfort


name: Perform or assist with perineal care (i.e., apply ice pack, encourage patient to take sitz baths, and apply dry heat)


name: Monitor breasts for temperature and color and nipple condition


name: Monitor bladder, including intake and output (e.g., emptying of bladder, palpable, color, odor, input, and output)


name: Facilitate return to normal urinary functioning (i.e., assist with sitz baths, promote hydration, pour warm water on perineum, and encourage ambulation)


name: Monitor bowels (e.g., date and time of last bowel movement, bowel sounds, presence of flatus)


name: Facilitate return to normal bowel functioning (i.e., administer stool softener or laxative, instruct patient to increase consumption of fluids and fiber, encourage ambulation)


name: Provide measures to reduce likelihood of deep vein thrombosis development (e.g., leg exercises and compression boot application)


name: Monitor legs for Homans' sign and arrange for further testing, if needed


name: Offer reassurance to patient on her ability to care for self and infant


name: Provide information about mood changes (e.g., postpartum "blues," depression, and psychosis), including symptoms warranting further evaluation and treatment


name: Monitor for symptoms of postpartum depression or psychosis


name: Provide anticipatory guidance on physiological and psychological changes and their management


name: Discuss sexuality and contraceptive choices


name: Monitor parent-infant attachment behaviors


name: Facilitate optimal parent-infant attachment


name: Instruct patient on nutritional needs, including the importance of a balanced diet and supplements, if indicated


name: Instruct patient on infant's nutritional needs


name: Provide adequate education and support on chosen feeding method


name: Refer patient to lactation consultant, if indicated


name: Instruct patient on danger signs that warrant immediate reporting (e.g., fever, depression)


name: Administer Rh immune globulin and Rubella vaccine, if indicated


name: Assist parent in scheduling newborn examination and postpartal examination


name: Refer to appropriate resources for community support or follow-up care


name: Describe clinical focus of the unit and agency


name: Communicate goals of the unit and agency


name: Display an accepting attitude to individual assigned to the unit and agency


name: Discuss clinical ladder and types of care providers and their specific responsibilities


name: Review emergency code procedures, as appropriate


name: Shape expectations for workload and scheduling


name: Be aware of own personality and how that affects teaching style


name: Be alert as to how generational differences may influence work attitudes and relationships


name: Share clinical stories and lessons learned to help shape clinical judgment


name: Provide emotional support, especially during highly stressful times


name: Determine student's knowledge and skill level before delegating a task


name: Provide as many opportunities as possible to practice complex skills (e.g., IV insertion, catheter insertion, leading team meetings, presentations to staff)


name: Ensure that students know and understand fire and disaster policies and emergency procedures


name: Discuss care plan for assigned patients, as appropriate


name: Facilitate student's communication with physicians and giving of patient reports


name: Establish and use electronic technologies (e.g., e-mail, text messages, social networks) to keep in touch with faculty member and students, as appropriate


name: Encourage student to work same days and same hours as preceptor


name: Discourage use of multiple preceptors per student


name: Refer for prenatal diagnostic tests as needed for genetic, medical, or obstetrical risk factors


name: Support decision making about advisability of pregnancy based on identified risk factors


name: Encourage dental examination during preconception to minimize exposure to x-ray examinations and anesthetics


name: Administer medication to terminate pregnancy, per protocol


name: Encourage significant other to support patient before, during, or after abortion, if desired or with consent from the patient


name: Provide information for referral to support groups (e.g., Resolve through Sharing, Compassionate Friends, SHARE Pregnancy and Infant Loss Support)


name: Refer for psychological support or counseling, as needed


name: Consider cultural and religious beliefs and values


name: Identify individual needs, concerns, and preferences, foster involvement in decision making, and identify and address barriers to care


name: Discuss importance of participating in prenatal care throughout entire pregnancy and encourage involvement of patient's partner or other family member


name: Monitor for hypertensive disorder (e.g., blood pressure, edematous ankles, hands, and face, and proteinuria)


name: Instruct patient on quickening and importance of monitoring fetal activity


name: Review with patient changes noted on fetal growth and status


name: Discuss nutritional needs and concerns (e.g., balanced diet, folic acid, food safety, and supplements)


name: Instruct patient on effects of exposure to or ingestion of harmful substances (e.g., alcohol, illicit drugs, teratogens, medications, herbs, and tobacco)


name: Discuss activity level with patient (e.g., appropriate exercise, activities to avoid, and importance of rest)


name: Provide genetic counseling and testing if indicated


name: Instruct patient on routine laboratory testing to occur throughout pregnancy (e.g., urinalysis, hemoglobin level, ultrasound, gestational diabetes, and HIV)


name: Monitor psychosocial status of patient and patient's partner


name: Monitor for risk factors affecting patient or fetal health status (e.g., mental health disorder and intimate partner violence)


name: Offer support and counsel to the patient presenting with an unplanned or unwanted pregnancy


name: Offer anticipatory guidance about physiological and psychological changes and discomforts (e.g., nausea, vomiting, musculoskeletal changes, fears, and breast tenderness)


name: Assist patient in identifying strategies to cope with changes and relieve discomforts associated with pregnancy


name: Review safety precautions to be taken during pregnancy (e.g., seat belt use, avoidance of hot tubs and saunas, and travel restrictions)


name: Provide accurate information pertaining to risks, benefits, contraindications, and side effects of immunizations, if needed


name: Assist patient in preparing for labor and delivery (i.e., discuss pain management options, review labor signs and symptoms, discuss special circumstances requiring medical intervention, and encourage planned involvement of patient's partner or family)


name: Offer anticipatory guidance on infant care and considerations (e.g., circumcision, feeding, and selection of pediatric health care provider)


name: Discuss postpartal concerns and considerations (e.g., family planning and contraception, returning to work or school, and physiological and psychological changes)


name: Provide referral to appropriate service (e.g., supplemental food program, drug dependency treatment, and mental health counseling), if needed


name: Explain procedures in a way that the patient can understand


name: Communicate any concerns (e.g., abnormal laboratory or diagnostic test results, issues related to the patient's understanding of the planned procedure) to the surgeon


name: Involve patient in decisions related to surgery


name: Assure that patient has significant other for postoperative needs, such as transportation home as indicated


name: Link sensations to their cause when it may not be self-evident


name: Consider the status of the existing chronic health condition


name: Review past medical history, medications, allergies, and past diagnostic testing pertinent to the presenting condition


name: Evaluate the diagnostic utility of the test in addressing the specific clinical question (i.e., understand sensitivity and specificity of the diagnostic test for the presenting condition)


name: Consult with accepted evidence-based practice guidelines, specialists, and other health care professionals, as appropriate


name: Provide the patient or family members with the rationale for the proposed testing, including how the information would benefit clinical decision making or continued monitoring


name: Allow for discussion and questions of the testing


name: Provide alternatives to diagnostic testing, as appropriate


name: Consider the availability and cost of the diagnostic testing and include the patient and family in the discussion


name: Instruct the patient and family on what to expect of the diagnostic test


name: Have a system in place to ensure test results are received when expected


name: Identify a method that ensures accurate communication of test date, time, and location to the patient or caregiver


name: Instruct the patient and family on the test date, time, location, and how to expect test results to be reported


name: Employ a system that provides for the timely return of diagnostic test results and assurance that missing or delayed reports are noted and pursued


name: Monitor for adverse effects of the diagnostic test


name: Maintain knowledge of diagnostic testing used in practice (e.g., sensitivity or specificity, rationale, alternatives, standards of care, evidence based practice, side effects, monitoring and state regulations or policy issues)


name: Determine signs and symptoms of current health problem


name: Review past and current therapeutic treatments tried for the health problem, including the reasons for stopping treatment


name: Document the effects of other treatments on the health problem


name: Identify nonpharmacological treatments (e.g., exercise, diet, physical therapy, occupational therapy, heat and cold treatment) that are indicated for current health problems


name: Consider the availability and cost of the recommended treatment and include the patient and family in the discussion


name: Provide the patient and family members with the rationale for the proposed treatment, expected outcome, and duration of the treatment


name: Allow for questions and discussion related to the diagnosis and treatment and provide alternatives to the treatment


name: Monitor for adverse effects of the treatment


name: Ensure for follow up to assess response to treatment


name: Maintain knowledge of treatments commonly used in practice, including rationale, alternatives, standards of care, evidence-based practice, side effects, monitoring, and state regulations or policy issues


name: Ensure the presence of a person dedicated to provide support to the infant


name: Evaluate the need for painful procedures


name: Separate the number and grouping of laboratory and diagnostic procedures according to infant's tolerance


name: Avoid painful procedures at the same time as nonemergency routine care


name: Use minimal amounts of tape or adhesives


name: Use noninvasive monitoring devices whenever possible


name: Instruct parents about signs and symptoms of pain and the comfort that they can provide


name: Reduce light and noise whenever possible during painful procedures


name: Use facilitated tucking (i.e., hand swaddle to hold extremities flexed and contained close to the trunk)


name: Use blanket swaddling after a painful procedure


name: Use nonnutritive sucking with a pacifier


name: Use sucrose solution with pacifier before and throughout painful procedures


name: Facilitate breastfeeding or feed breast milk during painful procedures


name: Facilitate kangaroo care (i.e., skin-to-skin contact) with parent during painful procedures, when possible


name: Facilitate holding by parent, when possible


name: Assemble a multidisciplinary product selection and evaluation team if change will affect other providers


name: Gather information on use of the existing product that is being replaced


name: Establish criteria for product selection


name: Decide on a disposable versus a reusable product


name: Strive for standardization of inventory when within and across facilities, when possible


name: Select a product that has an uncomplicated user interface


name: Solicit input from other health care providers (e.g., biomedical engineers, pharmacists, physicians, other agencies), as needed


name: Determine whether a higher cost product achieves better patient outcomes


name: Report significant medical device adverse events to the FDA (Food and Drug Administration) as well as to the manufacturer


name: Explain the purpose and process of the technique to the patient


name: Instruct patient to wear comfortable, unrestricted clothing


name: Screen for neck or back orthopedic injuries to which hyperextension of the upper spine would add discomfort and complications


name: Screen for increased intracranial pressure, capillary fragility, bleeding tendencies, severe acute cardiac difficulties with hypertension, or other conditions in which tensing muscles might produce greater physiological injury and modify the technique, as appropriate


name: Ask patient to loosen any tight clothing


name: Instruct the patient to sit in a reclining chair or lie down on a comfortable surface


name: Instruct the patient to assume a passive attitude by focusing on achieving relaxation in specific body muscles and refrain from focusing on any other thoughts


name: Instruct the patient to take a deep breath through the abdomen and hold for a few seconds and then exhale slowly


name: Have the patient repeat the deep breathing several times, asking the patient to imagine the tension being released from the body with each exhale


name: Have the patient tense systematically, for 5 to 10 seconds, each of 8 to 16 major muscle groups progressively from head to toe


name: Begin by asking the patient to take a deep breath and tighten the muscles in the forehead by raising the eyebrows as high as possible for 5 to 10 seconds and then release the tension, focusing on the feeling of the muscles relaxing as he/she exhales


name: Pause for 10 seconds before moving on to the next muscle group


name: Establish interval of initial prompted voiding schedule based upon voiding pattern


name: Establish beginning and ending time for prompted voiding schedule if not for 24 hours


name: Prompt for maximum of three times, to use toilet or substitute regardless of continence status


name: Offer assistance with toileting regardless of continence status


name: Administer opiate antagonists, as indicated


name: Participate in selection and development of quality indicators appropriate to clinical setting and patient population


name: Include structure, process, and outcome quality indicators


name: Promote and use electronic health records for collection, exchange, and analysis of data


name: Negotiate solutions cognizant of local work loads


name: Participate on evidence-based practice and quality improvement committees, as appropriate


name: Participate on intradisciplinary and interdisciplinary problem-solving teams


name: Monitor pretreatment workups for patients at risk for earlier onset, longer duration, and more distressing side effects


name: Provide information to patient and family regarding radiation effect on malignant cells


name: Utilize recommended radiation precautions in the management of patients with cardiac pacemakers


name: Provide special skin care to tissue folds that are prone to infection (e.g., buttocks, perineum, and groin)


name: Avoid application of deodorants and aftershave lotions to treated areas


name: Discuss the need for skin care, such as maintenance of dye markings, avoidance of soap, and other ointments, and protection during sunbathing or heat application


name: Initiate oral health restoration activities, such as use of artificial saliva, saliva stimulants, non-alcohol-based mouth sprays, sugarless mints, and fluoride treatments, as appropriate


name: Teach patient need for frequent dental follow-up care as dental caries can form rapidly


name: Promote therapeutic diet to prevent complications


name: Encourage rest immediately after treatments


name: Assist patient in achieving adequate comfort levels through the use of pain management techniques that are effective and acceptable to the patient


name: Teach patient and family about the effects of therapy on bone marrow functioning, as appropriate


name: Instruct patient and family on ways to prevent infection, such as avoiding crowds, using good hygiene, and handwashing techniques, as appropriate


name: Institute neutropenic and bleeding precautions, as indicated


name: Initiate and maintain protection according to agency protocol for patient receiving internal radiation treatment (e.g., gold seed placement or radiopharmaceutical agents)


name: Explain protection protocols to patient, family, and visitors


name: Limit visitor time in room, as appropriate


name: Limit staff time in the room if patient is isolated for radiation precautions


name: Distance oneself from the radiation sources while giving care (e.g., stand at the head of the bed of patient with uterine implants), as appropriate


name: Use a consistent approach (e.g., kind firmness, active friendliness, passive friendliness, matter-of-fact, and no demands) that reflects the particular needs and capabilities of the patient


name: Speak in a distinct manner with an appropriate pace, volume, and tone


name: Avoid frustrating the patient by demands that exceed capacity (e.g., repeated orientation questions that cannot be answered, abstract thinking when patient can think only in concrete terms, activities that cannot be performed, decision making beyond preference or capacity)


name: Present reality in manner that preserves the patient's dignity (e.g., provides an alternate explanation, avoids arguing, and avoids attempts to convince the patient)


name: Repeat patient's last expressed thought, as appropriate


name: Interrupt confabulation by changing the subject or responding to the feeling or theme rather than the content of the verbalization


name: Engage patient in concrete "here and now" activities (e.g., ADLs) that focus on something outside self that is concrete and reality oriented


name: Provide physical prompting and posturing (e.g., moving patient's hand through necessary motions to brush teeth), as necessary for task completion


name: Recommend patient wear personal clothing and assist, as needed


name: Provide objects that symbolize gender identity (e.g., purse or cap), as appropriate


name: Provide for adequate rest and sleep, including short-term, daytime naps, as needed


name: Encourage family to participate in care based on abilities, needs, and preferences


name: Modulate human and environmental sensory stimuli (e.g., visiting sessions, sights, sounds, lighting, smells, and tactile stimulation) based on patient's needs


name: Remove stimuli (e.g., pictures on the wall and television) that create misperception in a particular patient, when possible.


name: Provide psychoeducation to family and significant others regarding promotion of reality orientation


name: Monitor for changes in orientation, cognitive and behavioral functioning, and quality of life


name: Identify any deficits that may limit participation in recreational activities (e.g., mobility, cognitive, economic)


name: Assist patient to identify meaningful recreational activities (e.g., sports, drama, games, arts and crafts)


name: Monitor patient's physical and mental capacities while participating in recreational activities


name: Provide new recreational activities that are age and ability appropriate


name: Monitor emotional, physical, and social response to recreational activity


name: Place a warm water or saline soaked cloth over the protruding bowel to protect it from drying


name: Determine whether appropriate supportive care is available in the home or community


name: Evaluate accessibility of environmental needs for the patient in the home or community


name: Inform patient of appropriate Internet sites for use after discharge


name: Contact appropriate agency or health care provider


name: Minimize time between discharge and appointment with next provider


name: Send written referral and patient's plan of care electronically, as appropriate


name: Provide patient or family member with a copy of the referral information, as appropriate


name: Create a calm and comfortable environment


name: Use aroma or gentle music to create a healing atmosphere


name: Ask about the chief complaints, such as the presence of pain in certain areas or the presence of a particular illness


name: Have the Reiki receiver sit comfortably or lay down on a massage table, fully clothed, in a supine position


name: Relax your mind and take a few deep breaths to focus yourself


name: Remember: the Reiki does the work, not the practitioner


name: Begin by sending Reiki from about 3 feet away as a gentle way of beginning the session, if possible


name: Follow a specific series of hand placements: over eyes, over ears, one hand on forehead and one hand on top of head, hands under head, over the neck, upper chest, upper abdomen, lower abdomen, thighs (one at a time), knees (one at a time), lower legs, ankles, feet, bottoms of feet, have client roll over on to stomach, shoulders, waist area, lower back, backs of legs, and front of legs


name: Draw or visualize Reiki symbols (e.g., power, mental or emotional, distance) as guided by your intuition


name: Allow your intuition to guide your movements by placing hands on (or a few inches over) the part of the body that most requires healing


name: Stay in each area for 5 to 15 minutes or until you feel the energy flow more slowly or your intuition informs you it is time to move hand position


name: Ask for specific permission during the session to work on sexual organs or parts of the body that would be considered inappropriate, if so guided


name: Move one hand at a time so that you maintain contact as much as possible


name: Note whether the patient has experienced a relaxation response and any related changes


name: Describe the rationale for relaxation and the benefits, limits, and types of relaxation available (e.g., music, meditation, rhythmic breathing, jaw relaxation, and progressive muscle relaxation)


name: Screen for current decreased energy level, inability to concentrate, or other concurrent symptoms that may interfere with cognitive ability to focus on relaxation technique


name: Use soft tone of voice with a slow, rhythmical pace of words


name: Provide undisturbed time because patient may fall asleep


name: Regularly evaluate individual's report of relaxation achieved, and periodically monitor muscle tension, heart rate, blood pressure, and skin temperature, as appropriate


name: Use relaxation as an adjuvant strategy with pain medication or in conjunction with other measures, as appropriate


name: Identify, with the patient, a theme for each session (e.g., work life)


name: Determine which method of reminiscence (e.g., taped autobiography, journal, structured life review, scrapbook, open discussion, and storytelling) is most effective


name: Introduce props (e.g., music for auditory, photo albums for visual, perfume for olfactory), addressing all five senses to stimulate recall


name: Encourage verbal expression of both positive and negative feelings of past events


name: Maintain focus of sessions, more on the process than on an end product


name: Assist the patient in creating or adding to a family tree, or to write his/her oral history


name: Use direct questions to refocus back to life events, as necessary


name: Instruct patient about ovulation prediction and detection techniques (e.g., basal temperature and urine testing)


name: Schedule tests based on the menstrual cycle, as needed


name: Collaborate with in vitro fertilization team in screening and selecting gamete donors


name: Draw specimens for endocrine determination


name: Perform ultrasound examinations to ascertain follicular growth


name: Inform about ectopic pregnancy precautions


name: Schedule follow-up medication, tests, and ultrasound examinations


name: Refer for genetic counseling related to maternal age at conception, as needed


name: Monitor breathing patterns (e.g., bradypnea, tachypnea, hyperventilation, Kussmaul respirations, Cheyne-Stokes respirations, apneustic, Biot's respiration, ataxic patterns)


name: Monitor oxygen saturation levels continuously in sedated patients (e.g., SaO2, SvO2, SpO2), per agency policy and as indicated


name: Provide for noninvasive continuous oxygen sensors (e.g., finger, nose, or forehead devices) with appropriate alarm systems in patients with risk factors (e.g., morbidly obese, confirmed obstructive sleep apnea, history of respiratory problems requiring oxygen therapy, extremes of age), per agency policy and as indicated


name: Monitor for diaphragmatic muscle fatigue, as indicated by paradoxical motion


name: Note changes in SaO2, SvO2, end tidal CO2, and ABG values, as appropriate


name: Provide frequent intermittent monitoring of respiratory status in at-risk patients (e.g., opioid therapy, newborn, mechanical ventilation, facial or chest burns, neuromuscular disorders)


name: Establish a therapeutic relationship with patient and family


name: Inform patient and family of available state funding for respite care


name: Coordinate community support services (i.e., meals, day care, summer camp)


name: Monitor skill level of respite care provider


name: Provide a program of suitable activities, as appropriate


name: Evaluate unresponsiveness to determine appropriate action


name: Obtain the automated external defibrillator (AED)


name: Attach the AED and implement specified actions


name: Initiate 30 chest compressions at specified rate and depth, allowing for complete chest recoil between compressions, minimizing interruptions in compressions, and avoiding excessive ventilation


name: Provide two rescue breaths after initial 30 chest compressions completed


name: Tailor rescue actions to the most likely cause of arrest (e.g., cardiac or respiratory arrest)


name: Monitor patient response to resuscitation efforts


name: Clear oral, nasal, and tracheal secretions when possible and without interfering with chest compressions, as appropriate


name: Administer manual ventilation when possible and without interfering with chest compressions, as appropriate


name: Connect the person to an ECG monitor if needed when defibrillation is completed


name: Interpret ECG and deliver cardioversion or defibrillation, as needed


name: Assist with insertion of endotracheal tube (ET), as indicated


name: Assess lung sounds after intubation for proper ET position


name: Assure organized post cardiac arrest care (e.g., safe transport to appropriate nursing care unit)


name: Offer family members opportunities to be present during resuscitation when in the best interests of the patient


name: Support family members who are present during resuscitation (e.g., ensure safe environment, provide explanations and commentary, allow appropriate communication with patient, continually assess needs, provide opportunities to reflect on resuscitation efforts after event)


name: Monitor fetal vital signs using auscultation and palpation or electronic fetal monitor, as appropriate


name: Discontinue syntocinon to decrease uterine activity


name: Reposition mother to left lateral or hands-and-knees position


name: Give a bolus of 1 L crystalloid IV fluid


name: Administer IV vasopressor if blood pressure is low


name: Perform a vaginal examination with fetal scalp stimulation


name: Use fetal scalp electrode if fetal heart rate tracing is suboptimal


name: Open the airway by slightly extending the neck, placing in the "sniffing" position


name: Monitor oxygen saturations by placing an oximeter probe on the right wrist


name: Initiate positive-pressure ventilation for apnea, gasping, or heart rate lower than 100 beats per minute


name: Set oxygen blender at 21% at 5 to 8 L to fill resuscitation bag and titrate based on oxygen saturations, as necessary


name: Give chest compression for heart rate of less than 60 beats per minute or if greater than 80 beats per minute with no increase


name: Continue compressions until heart rate is greater than or equal to 60 beats per minute


name: Prepare medications (e.g., narcotic antagonists, epinephrine, volume expanders, and sodium bicarbonate), as needed


name: Review past health history and documents for evidence of existing or previous medical and nursing diagnoses and treatments


name: Review data derived from routine risk assessment measures


name: Determine availability and quality of resources (e.g., psychological, financial, education level, family and other social, and community)


name: Identify biological, environmental, and behavioral risks and their interrelationships


name: Instruct on risk factors and plan for risk reduction


name: Consider criteria useful in prioritizing areas for risk reduction (e.g., awareness and motivation level, effectiveness, cost, feasibility, preferences, equity, stigmatization, and severity of outcomes if risks remain unaddressed)


name: Discuss and plan for risk reduction activities in collaboration with individual or group


name: Plan for long-term monitoring of health risks


name: Plan for long-term follow-up of risk reduction strategies and activities


name: Determine residential status of mother (e.g., place of residence, homelessness, living with someone, immigration status)


name: Determine outcomes of all prior pregnancies


name: Determine prior history of abuse and violence


name: Determine prior history of depression or other mental illness


name: Review, update, and complete information as pregnancy develops and at intrapartum, postpartum, and neonatal admissions, as needed


name: Review maternal history of chemical dependency, noting duration, type of drugs used (including alcohol), and time and strength of last dose before delivery


name: Document psychosocial adaptation to pregnancy by the patient, the father, other children and adults in the household, family members, and others in close relationship to the pregnant woman


name: Note presence of multiple gestation and consider challenges of raising multiples


name: Note any medications (e.g., sedative, anesthetic, or analgesic) administered to mother during intrapartal period


name: Note maternal morbidities that could delay attachment (e.g., prolonged labor, infection, sedating medications)


name: Note fetal and neonatal morbidities (e.g., fetal distress, hypoxia, oligohydramnios or polyhydramnios, hyperglycemia or hypoglycemia) that could delay its ability to interact with caretakers


name: Note attachment behaviors to multiples (e.g., twins, triplets)


name: Promote family attachment through patient education


name: Implement activities that promote attachment


name: Evaluate behavioral assessment of neonates during early pediatric visits for possible indications of parenting adjustment problems


name: Promote a postpartum maternal follow-up at 2 to 6 weeks to a qualified health care professional


name: Promote newborn follow-up at 2 and 6 weeks by a qualified health care professional


name: Prioritize areas for risk reduction in collaboration with the individual or family


name: Promote newborn safety by requiring newborn discharge into an approved car seat


name: Refer to the appropriate community agency for follow-up if risk of parenting problems or a lag in attachment has been identified


name: Discuss issues in testing other family members as relevant


name: Refer to genetic health care specialists for genetic counseling, as needed


name: Assist patient to identify various roles in life cycle


name: Assist patient to identify role transition periods throughout the lifespan


name: Assist patient to identify behaviors needed for role development


name: Remove all items from seclusion area that patient might use to harm self or others


name: Inform patient of video surveillance, as appropriate


name: Explain reasons for the video monitoring


name: Give careful consideration to who is responsible for watching the video monitor for changes in patient status


name: Reassure patient of safety within the seclusion area during monitoring


name: Distinguish direct visual inspection from checks performed through video monitoring and document appropriately


name: Reduce sensory stimuli around the seclusion area


name: Involve patient in making decisions to move to a more or less restrictive intervention, when appropriate


name: Document rationale for restrictive intervention, patient's response to intervention, patient's physical condition, nursing care provided throughout intervention, and rationale for terminating the intervention


name: Provide written discharge instructions, as per agency protocol


name: Record seizure characteristics (e.g., body parts involved, motor activity, and seizure progression)


name: Assist patient to identify the effect of illness on self-concept


name: Consider the culture of the patient when promoting self-care activities


name: Provide social interaction, as appropriate


name: Use unbreakable and weighted dishes and glasses as necessary


name: Determine needs for safety-related changes in home (e.g., wider door frames to allow for wheelchair access to bathroom, removal of scatter-rugs)


name: Obtain transportation enhancements to offset disabilities (e.g., hand controls on cars, wide rear-view mirror), as appropriate


name: Verify adequacy of lighting throughout house, especially in working areas (e.g., kitchen, bathroom) and at night (e.g., appropriately placed nightlights)


name: Determine current ability of patient to transfer self (e.g., mobility level, limitations of movement, endurance, ability to stand and bear weight, medical or orthopedic instability, level of consciousness, ability to cooperate, ability to comprehend instructions)


name: Select transfer technique that is appropriate for patient


name: Instruct patient in all appropriate techniques with the goal of reaching the highest level of independence


name: Instruct individual on techniques for transfer from one area to another (e.g., bed to chair, wheelchair to vehicle)


name: Instruct individual in use of ambulatory aids (e.g., crutches, wheelchairs, walkers, trapeze bars, cane)


name: Make sure equipment works before using it


name: Provide privacy, avoid drafts, and preserve the patient's modesty


name: Use proper body mechanics during movements


name: Keep patient body in proper alignment during movements


name: Raise and move patient with a hydraulic lift as necessary


name: Move patient using a transfer board as necessary


name: Evaluate patient at end of transfer for proper body alignment, nonocclusion of tubes, wrinkled linens, unnecessarily exposed skin, adequate patient level of comfort, raised side rails, and call bell within reach


name: Provide encouragement to patient as he/she learns to transfer independently


name: Explore individual's perception of his/her capability to perform the desired behavior


name: Explore individual's perception of benefits of executing the desired behavior


name: Identify individual's perception of risks of not executing the desired behavior


name: Provide information about the desired behavior


name: Assist individual to commit to a plan of action for changing behavior


name: Reinforce confidence in making behavior changes and taking action


name: Provide an environment supportive to learning knowledge and skills needed to carry out the behavior


name: Use teaching strategies that are culturally and age appropriate (e.g., games, computer-assisted instruction, or conversation maps)


name: Engage in role play to rehearse behavior


name: Provide positive reinforcement and emotional support during the learning process and while implementing the behavior


name: Provide opportunities for mastery experiences (e.g., successful implementation of the behavior)


name: Use positive persuasive statements regarding the individual's ability to carry out the behavior


name: Encourage interaction with other individuals who are successfully changing their behavior (e.g., support group or group education participation)


name: Prepare individual for the physiological and emotional states that may be experienced during initial attempts to carry out a new behavior


name: Encourage patient to engage in self-talk and to verbalize positive affirmations daily to self


name: Assist the patient to cope with bullying or teasing


name: Explore previous achievements of success


name: Assist patient to identify significance of culture, religion, race, gender, and age on self-esteem


name: Instruct parents to recognize children's accomplishments


name: Determine whether the patient is an appropriate candidate for self-hypnosis


name: Utilize self-hypnosis as an adjunct to other treatment modalities (e.g., individual hypnotherapy by a therapist, individual psychotherapy, group therapy, family therapy, etc.)


name: Obtain history of the problem to be treated by self-hypnosis


name: Determine goals for self-hypnosis with patient


name: Determine patient's receptivity about using self-hypnosis


name: Correct myths and misconceptions of self-hypnosis


name: Assist the patient to identify appropriate induction techniques (e.g., Chevreul's pendulum illusion, relaxation, imagining walking down a staircase, eye closure, arm levitation, simple muscle relaxation, visualization exercises, attention to breathing, repetition of key words/phrases, and others)


name: Assist the patient to evaluate progress made toward therapy goals


name: Encourage the patient to examine personal values and beliefs and his or her satisfaction with them


name: Assist the patient in identifying the target behaviors' effects on social and environmental surroundings


name: Assist the patient in identifying the stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination


name: Encourage the patient to identify appropriate, meaningful reinforcers and rewards


name: Encourage the patient to choose a reinforcer or reward that is significant enough to sustain the behavior


name: Foster moving toward primary reliance on self-reinforcement instead of family or nurse for rewards


name: Encourage the patient to adjust the shaping plan to enhance behavior change (e.g., size of steps or reward), if needed


name: Explore with the patient the option of using a technological device in organizing coding sheets, change data, cue analysis, and visual measures of change (e.g., computer, smart phone)


name: Explore with the patient the potential use of imagery, meditation, or progressive relaxation in attempting behavior change


name: Facilitate the patient and family to make choices concerning their care, as appropriate


name: Ensure patients and family members have the appropriate resources to assume more responsibility


name: Provide opportunities for self-evaluation and self-reflection


name: Assist parents in identifying age-appropriate tasks for which a child could be responsible, as appropriate


name: Encourage patient to verbalize fears and to ask questions about sexual functioning


name: Collect the client's sexual history paying close attention to normal patterns of functioning and the terms used by the patient to describe sexual function


name: Determine the duration of sexual dysfunction and potential causes


name: Monitor for stress, anxiety, and depression as possible causes of sexual dysfunction


name: Determine the knowledge level of the patient and understanding about sexuality in general


name: Discuss the effect of the health and illness on sexuality


name: Discuss the effect of medications and supplements on sexuality, as appropriate


name: Discuss the effect of changes in sexuality on significant other


name: Help patient to express grief and anger about alterations in body functioning or appearance, as appropriate


name: Instruct the patient on use of medication(s) and devices to enhance ability to perform sexually, as appropriate


name: Include the significant other in the counseling as much as possible, as appropriate


name: Use humor and encourage patient to use humor to relieve anxiety or embarrassment, being careful to use humor that is appropriate to the situation, tactful, and respectful of patient beliefs and cultural background


name: Draw arterial blood gases and monitor tissue oxygenation


name: Monitor trends in hemodynamic parameters (e.g., CVP, MAP, pulmonary capillary/artery wedge pressure)


name: Monitor determinants of tissue oxygen delivery (e.g., PaO2, SaO2, hemoglobin levels, CO), if available


name: Monitor sublingual carbon dioxide levels and/or gastric tonometry, as appropriate


name: Monitor laboratory values (e.g., CBC with differential, coagulation profile, ABG, lactate level, cultures, and chemistry profile)


name: Administer IV fluid challenge while monitoring hemodynamic pressures and urinary output, as appropriate


name: Administer crystalloid or colloid intravenous fluids, as appropriate


name: Administer packed red blood cells, fresh frozen plasma, and/or platelets, as appropriate


name: Monitor for hyperdynamic state of septic shock post fluid resuscitation (e.g., increased CO, decreased SVR, flushed skin, or increased temperature)


name: Monitor fluid status, including daily weights, hourly urine output, I&O


name: Monitor renal function (e.g., BUN, Cr levels, creatinine clearance)


name: Administer continuous renal replacement therapy or hemodialysis, as appropriate


name: Insert nasogastric tube to suction and monitor secretions, as appropriate


name: Administer recombinant activated protein C, as appropriate


name: Administer low dose vasopressin, as appropriate


name: Administer corticosteroids, as appropriate


name: Administer DVT and stress ulcer prophylaxis, as appropriate


name: Offer emotional support to the patient and family, encouraging realistic expectations


name: Monitor for signs and symptoms of decreased cardiac output


name: Monitor for inadequate coronary artery perfusion (ST changes on EKG, elevated cardiac enzymes, angina), as appropriate


name: Monitor and evaluate indicators of tissue hypoxia (mixed venous oxygen saturation, central venous oxygen saturation, serum lactate levels, sublingual capnometry)


name: Administer supplemental oxygen, as appropriate


name: Maintain optimal preload by administering IV fluids or diuretics, as appropriate


name: Prepare patient for cardiac revascularization (percutaneous coronary intervention or coronary artery bypass graft)


name: Administer positive inotropic/contractility medications, as appropriate


name: Promote optimal preload while minimizing afterload (e.g., administer nitrates while maintaining pulmonary artery occlusion pressure within prescribed range), as appropriate


name: Promote adequate organ system perfusion (with fluid resuscitation and/or vasopressors to maintain mean arterial pressure greater than or equal to 60 mm Hg, as appropriate


name: Monitor for physiological changes related to loss of vascular tone (e.g., note decreased BP, bradycardia, tachypnea, reduced pulse pressure, anxiety, oliguria)


name: Consider Trendelenburg position if head injury has been ruled out


name: Administer high flow oxygen, as appropriate


name: Administer epinephrine via SQ, IV, or ET routes for anaphylaxis, if appropriate


name: Assist in early endotracheal intubation, as appropriate


name: Administer atropine for bradycardia, as appropriate


name: Utilize transcutaneous pacing, as appropriate


name: Monitor pneumatic antishock garment, as appropriate


name: Maintain two large-bore intravascular access sites


name: Administer isotonic crystalloids as bolus doses, keeping systolic pressure at 90 mm Hg or more, as appropriate


name: Administer antihistamine and/or corticosteroid, as appropriate


name: Treat overdoses with appropriate reversal agent


name: Insert NG tube and administer charcoal lavage, as appropriate


name: Monitor trends in hemodynamic parameters (e.g., CVP, MAP, PAWP, or PCWP wedge pressure)


name: Avoid stimuli that will precipitate neurogenic reaction (e.g., skin stimulation, distended bladder, or constipation)


name: Monitor for sudden loss of blood, severe dehydration, or persistent bleeding


name: Check all secretions for frank or occult blood


name: Monitor for fall in systolic blood pressure to less than 90 mm Hg or a fall of 30 mm Hg in hypertensive patients


name: Monitor sublingual carbon dioxide levels


name: Monitor for signs/symptoms of hypovolemic shock (e.g., increased thirst, increased HR, increased SVR, decreased urine output, decreased bowel sounds, decreased peripheral perfusion, altered mental status, or altered respirations)


name: Administer IV fluids such as isotonic crystalloids or colloids, as appropriate


name: Administer warmed IV fluids and blood products, as indicated


name: Administer blood products (e.g., packed red blood cells, platelets, or fresh frozen plasma), as appropriate


name: Monitor laboratory studies (e.g., serum lactate, acid-base balance, metabolic profiles, and electrolytes)


name: Monitor for early compensatory shock responses (e.g., normal blood pressure, narrowed pulse pressure, mild orthostatic hypotension [15 to 25 mm Hg], slight delayed capillary refill, pale/cool skin or flushed skin, slight tachypnea, nausea and vomiting, increased thirst, or weakness)


name: Monitor for early signs of systemic inflammatory response syndrome (e.g., increased temperature, tachycardia, tachypnea, hypocarbia, leukocytosis, or leucopenia)


name: Monitor for early signs of cardiac compromise (e.g., declining CO and urinary output, increasing SVR and PCWP, crackles in the lungs, S3 and S4 heart sounds, and tachycardia)


name: Monitor possible sources of fluid loss (e.g., chest tube, wound, and nasogastric drainage; diarrhea; vomiting; and increasing abdominal and extremity girth, hematemesis, or hematochezia)


name: Monitor for signs of inadequate tissue oxygenation (e.g., apprehension, increased anxiety, changes in mental status, agitation, oliguria, and cool, mottled periphery)


name: Monitor daily weights, intake, and output


name: Monitor laboratory values, especially Hgb and Hct levels, clotting profile, ABG, lactate level, electrolyte levels, cultures, and chemistry profile


name: Monitor invasive hemodynamic parameters (e.g., CVP, MAP, and central/mixed venous oxygen saturation), as appropriate


name: Monitor sublingual CO2 or gastric tonometry, as appropriate


name: Test urine for blood, and protein, as appropriate


name: Monitor for signs/symptoms of ascites and abdominal or back pain


name: Place patient in supine, legs elevated position (volume, vasogenic) or supine, head and shoulders elevated (cardiogenic), as appropriate


name: Insert and maintain large-bore IV access, as appropriate


name: Administer antiarrhythmics, diuretics, and/or vasopressors, as appropriate


name: Monitor blood glucose and administer insulin therapy, as appropriate


name: Administer IV, intraosseous, or endotracheal epinephrine, as appropriate


name: Advise patients at risk to wear or carry medical alert information


name: Inspect dressing daily, as per agency protocol


name: Inspect skin and mucous membranes for redness, extreme warmth, edema, or drainage


name: Use an assessment tool to identify patients at risk for skin breakdown (e.g., Braden Scale)


name: Monitor skin and mucous membranes for areas of discoloration, bruising, and breakdown


name: Document skin or mucous membrane changes


name: Institute measures to prevent further deterioration (e.g., overlay mattress, repositioning schedule)


name: Maintain focus on the target audience through all activities


name: Cultivate partnerships with the target audience and appropriate professionals


name: Identify the overall goal to be achieved in collaboration with the target audience


name: Identify the key formal, social, and governmental groups involved


name: Conduct a needs assessment of the environment, identifying target audience desires


name: Conduct organization or group assessment


name: Identify appropriate quantitative and qualitative research to provide information, support, and indicators of success


name: Design a plan of action based on mutually agreed-upon goals


name: Nurture the voluntary basis of the planned social change


name: Identify the product (behavior change), the price (consumer's actions), and the place (how the product reaches the consumer)


name: Consider the financial resources necessary and available


name: Identify specific activities for each goal, including naming of appropriate participants


name: Implement the plan in collaboration with the target population


name: Control the plan through monitoring of assigned tasks


name: Provide appropriate reports on a timely basis


name: Evaluate the plan for achievement of goals with consideration of sustainability and affordability


name: Promote relationships with persons who have common interests and goals


name: Promote sharing of common problems with others


name: Promote involvement in totally new interests


name: Facilitate the use of sensory deficit aids, such as eyeglasses and hearing aids


name: Encourage participation in group and/or individual reminiscence activities


name: Facilitate patient participation in storytelling groups


name: Apply special specimen collection devices for infants, toddlers, or impaired adults, as needed


name: Label specimen with appropriate data before leaving the patient


name: Refer to support groups, mutual self-help, or other spiritually based programs, as appropriate


name: Use therapeutic communications to establish trust and empathic caring


name: Monitor circulation (e.g., pulse, capillary refill, and sensation) in injured body part


name: Cover open wound with dressing and control bleeding before applying splint


name: Minimize movement of patient, especially injured body part


name: Identify most appropriate splint material (e.g., rigid, soft, anatomical, or traction)


name: Immobilize joint above and joint below injury site


name: Place injured hand or wrist in position of function


name: Apply splint in position injured body part is found, using hands to support injury site, minimizing movement, and using the assistance of another health care team member when possible


name: Instruct patient or family how to care for the splint


name: Ensure that staff members provide care within their approved scopes of practice


name: Ensure that staff members have current licensure, as appropriate


name: Incorporate understanding of generational differences when assigning and evaluating work


name: Initiate disciplinary action, as appropriate, adhering to policies and procedures


name: Ensure the product to be infused has been prepared, labeled, and classified according to institution protocol


name: Explain the procedure and the aim of the infusion of hematopoietic stem cells to patients and caregivers


name: Inform the patient and the family about the possible negative effects (e.g., transfusion reaction, volume overload, pulmonary embolism, changes in vital signs, and nausea/vomiting) that may appear during infusion


name: Use peppermint oil or hard candy to counteract the offensive smell and taste of preservative


name: Prepare infusion equipment without filter and other necessary materials (e.g., physiological serum 0.9%, venous pressure measurement systems, sphygmomanometer, phonendoscope, thermometer, and pulsometer)


name: Verify that the infusion equipment has no filter and no infusion pumps to avoid cellular damage


name: Use saline solution to flush the equipment


name: Prepare emergency material and drugs to treat serious negative reactions, including anaphylaxis kit, oxygen administration equipment, and suction equipment


name: Use gloves during the manipulation of the infusion product


name: Ensure aseptic manipulation of equipment, connections, and product


name: Administer prehydration solution according to the protocol


name: Coordinate immediate administration of the defrosted infusion product


name: Administer premedication prescribed according to the protocol of the institution


name: Avoid irradiation and any type of mechanical or physical damage to the infusion product


name: Make sure that the infusion product is received in optimal isolation and refrigeration conditions (1° to 24° C)


name: Verify the labeling and the identification of both the bags and the patient (using patient name and hospital number) immediately before infusion


name: Administer the infusion through a central venous catheter through the largest lumen available for ease of flow


name: Infuse each bag at the rate, sequence, and time established in the protocol guidelines of the institution and according to the tolerance of the patient


name: Monitor for possible adverse reactions (e.g., nausea, vomiting, abdominal cramps, diarrhea, facial flare, arrhythmia, dyspnea) and stop the infusion and call the physician, if necessary


name: Irrigate the infusion catheter with saline solution after the infusion of each bag


name: Irrigate the intravenous line with saline solution if syringes were used to infuse the product in order to reduce the loss of stem cells that could remain in the lumen of the catheter or infusion system


name: Dispose of spare material and hazardous waste according to agency protocol


name: Monitor vital signs according to institutional protocol during and after the procedure


name: Record volume of stem cells and normal saline administered


name: Monitor the elimination of urine, paying attention to volume, color, and osmolality


name: Observe for signs and symptoms of circulatory overload


name: Record the patient's response (e.g., tolerance and negative effects) according to the protocol of the institution


name: Document adverse events according to agency protocol


name: Bed rest with bedside commode, as appropriate


name: Restrict television, radio, and other stimulants


name: Provide information to patient and family regarding need for environmental modifications and visiting limitations


name: Notify physician of neurological deterioration


name: Monitor CSF output and characteristics, if indicated


name: Instruct patient not to strain or perform Valsalva maneuver


name: Foster a trusting relationship while setting clear limits (i.e., provide gentle but firm evidence of dysfunction, stay focused on substance abuse or dependency, and inspire hope)


name: Consider presence of comorbidity, or cooccurring psychiatric or medical disorder, making changes in treatment accordingly


name: Assist patient in understanding disorder as a disease related to several factors (e.g., genetic, psychological, and situational circumstances)


name: Inform patient that the volume and frequency of substance use leading to dysfunction varies greatly between people


name: Instruct patient on effects of substance used (e.g., physical, psychological, and social)


name: Discuss treatment needs for associated medical, psychological, social, vocational, housing, and legal difficulties


name: Encourage or praise patient efforts to accept responsibility for substance use-related dysfunction and treatment


name: Administer medications (e.g., disulfiram, acamprosate, methadone, naltrexone, nicotine patches or gum, or buprenorphine), as indicated


name: Instruct patient or family about medications used for treatment


name: Provide therapy (e.g., cognitive therapy, motivational therapy, counseling, family support, family therapy, or adolescent community reinforcement approach), as indicated


name: Establish multidisciplinary programs (e.g., short-term inpatient residential therapy, detoxification program, or residential therapeutic community treatment), if appropriate


name: Encourage patient to participate in self-help support program during and after treatment (e.g., 12-step programs, Women for Sobriety, or Rational Recovery)


name: Discuss importance of abstaining from substance use, identifying most appropriate treatment goal (e.g., complete abstinence, day-by-day sobriety, or use of substance in moderation)


name: Coordinate and facilitate group confrontation strategy to address use of and role defenses play in substance use (e.g., denial)


name: Instruct patient on stress management techniques (e.g., exercise, meditation, and relaxation therapy)


name: Assist patient in developing healthy, effective coping mechanisms


name: Identify and address dysfunctional relationship patterns in patient's familial or other social ties (e.g., codependency and enabling)


name: Assist in identifying and facilitating connections with supportive persons


name: Assist in resocialization, rebuilding relationships, and decreasing self-centeredness


name: Monitor for substance use during treatment (e.g., urine screens and breath analysis)


name: Monitor for infectious disease (e.g., HIV/AIDS, hepatitis B and C, and tuberculosis), treating and providing assistance to modify behaviors, if necessary


name: Assist patient in developing self-worth, encouraging positive efforts and motivation


name: Participate in efforts to remain abreast of available programs, resources, and legislation aimed at education, prevention, and treatment of substance use disorders


name: Instruct patient on symptoms or behaviors that increase chances of relapse (e.g., exhaustion, depression, dishonesty, and complacency)


name: Develop plan for relapse prevention (e.g., contracting, identify resources for various needs in stressful situation, and identify health promoting activities to take place of substance use)


name: Instruct family on substance use disorder and related dysfunction and include in treatment planning and activities


name: Encourage family to participate in recovery efforts


name: Monitor respiratory and cardiac systems (e.g., hypertension, tachycardia, and bradypnea)


name: Monitor for changes in level of consciousness


name: Implement precautions for patient at risk for suicide


name: Monitor withdrawal symptoms (e.g., fatigue, sensory disturbances, irritability, violence, depression, panic attacks, cravings, insomnia, agitation, muscle pain, appetite changes, yawning, weakness, headache, runny nose, dilated pupils, chills, anxiety, sweating, nausea, vomiting, tremors, psychosis, and ataxia)


name: Implement precautions for patient at risk for seizures


name: Provide adequate nutrition (e.g., small amounts of fluids frequently and high-calorie foods)


name: Implement precautions for patient at risk for falling


name: Maintain low-stimulation environment (e.g., talk in a low, calm voice; provide reassurance about safety; and ensure a comfortable, darkened, quiet, and nonthreatening environment)


name: Encourage patient to participate in follow-up support (e.g., peer group therapy, individual or family counseling, and drug recovery educational programs)


name: Offer supportive assistance (e.g., provision of food and shelter, structured psychotherapy)


name: Facilitate support by family and significant others


name: Instruct patient and family on process of drug use and dependency


name: Monitor respiratory, cardiac, gastrointestinal, renal, and neurological status


name: Place patient in most appropriate position (e.g., semi-Fowler's position if patient is awake; left lateral recumbent position if patient is unresponsive)


name: Provide safe environment (i.e., pad side rails, keep bed in lowest position, remove dangerous objects, and position safety officer near patient's room)


name: Establish rapport with patient or family (i.e., use nonjudgmental approach; do not reprimand)


name: Perform necessary toxicology screening and system function tests (e.g., urine and serum drug screening, arterial blood gases, electrolyte levels, liver enzymes, blood urea nitrogen, and creatinine)


name: Contact poison control center for assistance in determining definitive treatment


name: Establish intravenous access, administering infusions, as prescribed


name: Monitor for symptoms specific to drug consumed (e.g., constricted pupils, hypotension, and bradycardia for opiate overdose; nausea, vomiting, diaphoresis, and right upper quadrant pain 48 to 72 hours after acetaminophen overdose; and dilated pupils, tachycardia, seizures, and chest pain for cocaine overdose)


name: Administer agents specific to substance consumed and patient symptoms (e.g., antiemetics, naloxone, thiamine, glucose, flumazenil, calcium, vasopressors, antiarrhythmics, and inotropics)


name: Administer agents or perform procedures to impair drug absorption and increase drug excretion (e.g., ipecac, activated charcoal, gastric lavage, hemodialysis, cathartics, exchange transfusion, altering urine and serum pH, and whole-bowel irrigation)


name: Communicate with patient, providing reassurance, addressing hallucinations or delusions, and conveying understanding of fears or other feelings


name: Treat hyperthermia (i.e., apply ice packs for fever caused by amphetamine or cocaine intoxication)


name: Provide instruction on proper use of drug


name: Assist patient in identifying ways to minimize potential for accidental overdose (e.g., store medications in original container, address issues with confusion or memory, and store medications out of children's reach)


name: Instruct family or caregiver on patient's need for follow-up care


name: Instruct family or caregiver on aspiration and seizure precautions


name: Provide referral (e.g., home health agency, social worker, psychiatry, or drug use treatment program)


name: Advocate for quality of life and pain control issues


name: Provide small amounts of prescriptive medications that may be lethal to those at risk, to decrease opportunity for suicide, as appropriate


name: Avoid repeated discussion of past suicide history by keeping discussions focused on present and future


name: Discuss plans for dealing with suicidal ideation in future (e.g., precipitating factors, who to contact, where to go for help, ways to alleviate feelings of self-harm)


name: Work with physicians and others to standardize the specifications for products and reduce total number of supplies


name: Assist in the automation and upkeep of the inventory list to avoid overstocking and overspending


name: Coordinate purchases with other departments to reduce costs, as appropriate


name: Work with suppliers and vendors to ensure best product at lowest cost, as needed


name: Have supplies shipped directly to patient's home, as appropriate


name: Review supply budget and inventory costs, as appropriate


name: Participate in the value analysis process to determine whether it is the "right product" at the "right price"


name: Participate in the governing agency's integrated supply chain management process, as appropriate


name: Understand how the use of GS1 Global Traceability Standard to identify items and locations can improve patient safety and reduce costs of supplies


name: Determine the most appropriate venue for the group's meeting (e.g., face to face or online)


name: Identify faith-based groups as available options for clients, as appropriate


name: Use a written contract, if deemed appropriate


name: Form a group of optimal size (e.g., 5 to 12 members)


name: Schedule a limited number of sessions (e.g., 6 to 12) in which the work of the group will be accomplished


name: Assist the group to progress through the stages of group development, from orientation through cohesiveness to termination


name: Refer the patient to other specialist, as appropriate


name: Identify psychological response to situation and availability of support system


name: Identify degree of family support, financial support, and other resources


name: Determine barriers to unused and underused support systems


name: Monitor current family situation and the support network


name: Refer to a self-help group or Internet-based resource, as appropriate


name: Identify community resource strengths and weaknesses and advocate for change, when appropriate


name: Refer to a community-based prevention or treatment program, as appropriate


name: Involve family/significant other(s) and friends in the care and planning


name: Identify available resources for caregiver support


name: Perform surgical hand antisepsis in accordance with the hospital protocol or rules


name: Don a sterile gown and gloves using aseptic technique


name: Assist the surgical team while they don gown and gloves


name: Adopt a position that allows you to keep the surgical field in sight throughout the surgery


name: Ensure that appropriate instruments, supplies, and equipment are sterile and in good working order


name: Transfer the scalpel or dermatographic pencil to the surgeon, as appropriate


name: Provide the instruments in an appropriate safe manner


name: Maintain the sterility of the surgical field throughout the procedure, disposing of contaminated elements, and taking measures to preserve surgical integrity and asepsis


name: Remove soiled sponges and deposit them in an appropriate place, replacing them with clean ones


name: Clean the incision site and drains of blood, secretions, and residual skin antiseptic


name: Assist in the closing of the surgical wound


name: Dry the skin at the incision site and drains


name: Apply reinforcement bands, dressings, or bandages to the surgical wound


name: Connect the drains to their collection systems, attach them, and keep them in the appropriate position


name: Assist in transferring patient to the cart or bed and transport to appropriate postanesthesia or postoperative area


name: Document information, as per agency policy


name: Consult surgical schedules, check operating room assignments, and obtain information on the surgical procedure and anesthetic technique


name: Change into the scrubs, footwear, cap, and mask specific to the surgical area before entering the operating room


name: Place tables containing instruments and equipment in the appropriate areas


name: Keep sharp and pointed objects (e.g., scalpel blades and needles) separate from other objects in order to avoid injuries during preparation


name: Verify the safety and proper operation of the equipment and instruments required for patient care (e.g., surgical table, perfusion pumps, temperature regulating equipment, electric scalpels)


name: Obtain the sterile supplies and materials appropriate to the surgery, observing aseptic technique


name: Confirm the integrity of the packages or wrappings, expiration dates, and sterility controls, and follow the traceability of the materials in keeping with hospital regulations


name: Prepare the consumable clothing and supplies appropriate to the type of surgery


name: Drape the instrument tables, Mayo tables, and auxiliary tables with sterile cloth or impermeable fields, as appropriate


name: Establish a safety perimeter around the tables and materials with regard to other professional and nonsterile areas


name: Provide towels/pads for the surgical team to dry their hands on


name: Secure devices in the surgical field (e.g., cables, circuit cameras, aspirators)


name: Remove instruments and supplies from the surgical table once the surgery is finished


name: Remove field forceps, aspirator tube, electric scalpel, and other elements from the surgical field after the conclusion of the operation


name: Roll up the fields, sheets, and surgical drapes used in the surgery, avoiding the spread and contamination of the air, and dispose of them in an appropriate container


name: Remove scalpel blades from their handles, needles, sharp and pointed objects and deposit them in appropriate containers


name: Separate the clean materials and instruments from the dirty or highly contaminated ones to facilitate cleaning, disinfection, and later sterilization


name: Coordinate and assist in the cleaning and preparation of the operating room for the next patient (i.e., collect and put away machines, supports, and other supplies)


name: Arrange the oxygenation and artificial ventilation equipment and material (e.g., laryngoscopes, tubes, aspirator, masks, Magill forceps, stiffening wires, phonendoscope)


name: Monitor the accessories specific to the required surgical position (e.g., supports, stirrups, fasteners)


name: Participate in a preoperative briefing with others, as per agency policy


name: Welcome the patient, establishing a relationship of trust and offering counsel


name: Ask patient or appropriate other to state patient's name and birth date


name: Participate in the preoperative "time out" to verify correct patient, procedure, and site, as per agency policy


name: Assist in the transfer of the patient to the surgical table while monitoring devices


name: Preserve the patient's privacy, avoiding unnecessary exposure or chills


name: Count sponges, sharps, and instruments before, during, and after surgery, as per agency policy


name: Record results of counts, as per agency policy


name: Provide a sterile container for depositing sharp objects


name: Verify that prep solutions are nonflammable or that flammable prep agents have evaporated before draping