Procedural Competency Evaluation for Training - Incentive Spirometry

Instructions:

Please evaluate the procedures in the video and select from the list Satisfactory or Unsatisfactory/Not Observed.

Satisfactory: no errors of omission or commission
Unsatisfactory: errors of omission or commission occured, or step was not viewed on video.

Full Name:
Email:
Employed By:
1. Verifies physician order and scans chart for pertinent data.
2. Washes and disinfects hands.
3. Attains, assembles, troubleshoots equipment as indicated.
4. Introduces self to patient.
5. Checks patient identification.
6. Explains purpose of procedure to patient.
7. Assesses patient as indicated (B.S., pulse,and respiratory rate)
8. Positions patient as indicated.
9. Sets and explains volume goals.
10. Instructs patient on how to perform inhalations and breath hold.
11. Instructs patient to cough
12. Instructs patient on splinting technique
13. Instructs patient on how and when to repeat therapy.
14. Washes or disinfects hands.
15. Charts therapy and notifies appropriate personnel of modifications as indicated.