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O2 Therapy Checklist

This document outlines the procedure checklist for administering oxygen therapy to a patient. It contains 20 steps that must be completed including: preparing equipment, assessing the patient's condition, setting the oxygen flow rate, applying the delivery device, monitoring the patient's response and vital signs, documenting care provided, and performing hand hygiene. Completing all steps correctly results in a score of 1 for each item and a total possible score of 20.

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BALIWANG, MARCOS JR. G.
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1K views2 pages

O2 Therapy Checklist

This document outlines the procedure checklist for administering oxygen therapy to a patient. It contains 20 steps that must be completed including: preparing equipment, assessing the patient's condition, setting the oxygen flow rate, applying the delivery device, monitoring the patient's response and vital signs, documenting care provided, and performing hand hygiene. Completing all steps correctly results in a score of 1 for each item and a total possible score of 20.

Uploaded by

BALIWANG, MARCOS JR. G.
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
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COLLEGE OF HEALTH SCIENCES

Related Learning Experience

Procedure Checklist
ADMINISTRATION OF OXYGEN THERAPY
Name: _______________________________ Date: ____________________
Group: _______________ Score: __________________
Grading criteria
SCORE DESCRIPTION
1 The student performed the skill completely and correctly
0 The student performed the skill incompletely and incorrectly or did not perform the
item at all.

Performance Skill Score Remarks


1. Perform proper hand hygiene
2. Gather equipment (oxygen delivery devices,
if using O2 tank, check if full)
3. Ensure pulse oximetry is available.
4. Check patient’s ID using 2 identifiers
5. Assess the patient’s condition and level of
oxygen therapy required (ex. facemask,
humidified oxygenation, nasal cannulas).
6. Position patient in an upright position, if
tolerable.
7. Check and document baseline observations
including saturations, respiratory rate, blood
pressure and pulse.
8. Check prescription for oxygen with a stated
target saturation range
9. Explain procedure to the patient and gain
consent where possible
10. Check equipment for safety and efficacy
11. Ensure delivery device is connected via
tubing to oxygen supply
12. Set oxygen flowmeter to desired oxygen
setting (L/min) and ensure proper flow (use
fingertips)
13. Apply an oxygen mask or a nasal cannula as
appropriate and reassure the patient

14. Monitor response to oxygen therapy


15. Titrate oxygen according to oxygen
saturations to maintain saturations within
prescribed target range.
16. Check patient’s comfort
17. Provide continued reassurance to patient and
opportunity to ask questions

18. Document – time, flow rate, delivery device,


O2 saturation
19. Continuously monitor patient as appropriate
(ex. SPO2 using pulse oximeter, PR, BP)
20. Perform hand hygiene
Total Score: (20)
Source:
Dougherty, L. & Lister, S. (2015), The Royal Marsden Clinical Nursing Procedures, The Royal Marsden
NHS Foundation Trust, Wiley & Blackwell

Evaluated by: Conforme:


_______________________________ _______________________________
Signature over Printed Name of Instructor Signature over Printed Name of Student

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