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Intramuscular Injection Evaluation Tool

This document is a performance evaluation tool for intramuscular injections. It evaluates learners on their preparation, procedure, and after care skills. The evaluation contains 19 competencies rated on a scale of 0-3. A rating of 3 indicates the skill was performed completely as expected, while 0 indicates the skill was missed or done incorrectly. The tool is used to assess skills like preparing the medication, identifying the patient, administering the injection with proper technique, and disposing of supplies after care. The total score is calculated by dividing the sum of competency ratings by 75 and multiplying by 100 to get a percentage score.

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ABCEDE, ANDREA
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441 views2 pages

Intramuscular Injection Evaluation Tool

This document is a performance evaluation tool for intramuscular injections. It evaluates learners on their preparation, procedure, and after care skills. The evaluation contains 19 competencies rated on a scale of 0-3. A rating of 3 indicates the skill was performed completely as expected, while 0 indicates the skill was missed or done incorrectly. The tool is used to assess skills like preparing the medication, identifying the patient, administering the injection with proper technique, and disposing of supplies after care. The total score is calculated by dividing the sum of competency ratings by 75 and multiplying by 100 to get a percentage score.

Uploaded by

ABCEDE, ANDREA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
  • Procedure
  • Preparation
  • After Care

PERFORMANCE EVALUATION TOOL FOR

INTRAMUSCULAR INJECTION

NAME: __________________________________________________________ SCORE: _________________________


SECTION / GROUP NO: __________________ DATE: ________________ FACULTY: ____________________________

Direction: Rate the learners based on the competencies listed below.

NUMERICAL RATING DESCRIPTION


3 – ACCEPTABLE Demonstrates expected procedure/behavior completely.
2 – MODERATELY
Demonstrates expected procedure/behavior with minimal error.
ACCEPTABLE
1 – SLIGHTLY Demonstrates expected procedure/behavior with many errors.
ACCEPTABLE
0 - UNACCEPTABLE Missed procedure or procedure done but entirely incorrect.

A. PREPARATION RATING REMARKS


1. Checks physician’s order and compare with MAR. 0 1 2 3
2. Assess 0 1 2 3
 Clients for any allergies.
 Assess patient’s knowledge of the medication and procedure and
may provide an appropriate time for education.
 Studies drug action and expected response.
 Assess the site where injection to be given (should have no
lesions, injuries or hairless)
 Client’s willingness to participate for the procedure.

3. Correctly identify the client with the 2 identifiers (client stating name or 0 1 2 3
ID tag and date of birth).
4. Assemble articles and supplies 0 1 2 3
5. Determines patient’s age, weight, size of muscle to determine site and 0 1 2 3
needle size to be used.
6. Performs hand hygiene and apply clean gloves. 0 1 2 3

B. PROCEDURE
1. Check accuracy and completeness of the MAR. 0 1 2 3
2. Prepare medications for one patient at a time using aseptic
Technique
0 1 2 3
 Confirms correct dosage according to physician’s order, available drug
and computation.
 Dilutes content of vial with diluent and shakes gently
3. Help patient to comfortable position. Position patient depending on 0 1 2 3
chosen site.
4. Aspirates desired amount of medicine from the vial/ampule using aseptic
0 1 2 3
technique
5. Changes aspirating needle to gauge 23 needle and expels air from the 0 1 2 3
syringe
6. Puts the syringe, medicine and cotton ball with alcohol to the medicine 0 1 2 3
tray and bring to bedside
7. Selects a site free of skin lesions, tenderness, swelling, hardness or
0 1 2 3
localized inflammation and one that has not been used frequently
8. Provide privacy 0 1 2 3
9. Cleanse the site with an antiseptic swab. Using a circular motion, starts
0 1 2 3
at the center and moves outward about 5cm.
10. Holds the swab between the third and fourth fingers of your non – 0 1 2 3
dominant hand in readiness for needle withdrawal or position the swab on the
client’s skin above the intended site. Allows the skin to dry prior to
injecting medication.
11. Remove needle cap by pulling it straight off. 0 1 2 3
12. Holds the syringe between the thumb and forefinger and pierces the 0 1 2 3
skin quickly and smoothly at a 90-degree angle to insert the needle into the
muscle.
13. Administer injection. 0 1 2 3

 Position ulnar side of nondominant hand just below site and pull skin
laterally. approximately 2.5 to 3.5cm (1 to 11/2 inches). Hold position
until medication is injected. With dominant hand, inject needle quickly
at 90-degree angle into muscle.

 Pull back on plunger 5 to 10 seconds. If no blood appears, inject


medication slowly.
[Link] the medication steadily and slowly while holding the syringe. 0 1 2 3
15. Withdraws the needle smoothly at the same angle of insertion. Do not 0 1 2 3
massage site.
16. Discard uncapped needle or needle enclosed in safety shield and 0 1 2 3
attached syringe into a puncture-proof and leak-proof receptacle.
17. Put patient in a comfortable position. 0 1 2 3

C. AFTER CARE
18. Dispose sharp needles in the sharp container. 0 1 2 3
19. Removes gloves after used and disposed on proper waste disposal. 0 1 2 3

Total Score ÷ 75 X 100 = _________________

______________________________________ _________________________________________
Signature of Student Signature of Faculty

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